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Introduction: Alveolar ridge augmentation is often required before dental implant placement. In this context, autologous bone grafts are considered the biological gold standard. Still, bone block harvesting is accompanied by some serious potential disadvantages and possible complications, such as pain, bleeding, and nerve irritation. Several studies aimed to compare autologous to allogeneic bone grafts concerning bone quality and implant survival rates; this is the first prospective study analyzing and comparing morbidity-related parameters after alveolar ridge augmentation using autogenous and allogeneic bone blocks from patients' perspective., Methods: Using a questionnaire, 36 patients were asked to evaluate the surgery as well as the post-operative period concerning pain, stress, sensibility deficits, satisfaction with, and consequences from the surgery as well as the preferred procedure for future alveolar ridge augmentations., Results: No significant differences were shown regarding stress and pain during and after surgery, whereas the rate of nerve irritations was twice as high in the autologous group. The swelling was significantly higher in patients with autologous bone blocks (p = 0.001). Nevertheless, the overall satisfaction of patients of both groups was very high, with over 8/10 points., Conclusions: The swelling was the main reason for patients' discomfort in both groups and was significantly higher after autologous bone augmentation. Since this side effect seems to be a highly relevant factor for patients' comfort and satisfaction, it needs to be discussed during preoperative consultation to allow shared decision-making considering the anticipated morbidity., (© 2023 The Authors. Clinical Implant Dentistry and Related Research published by Wiley Periodicals LLC.)

Purpose: The aim of this article was to analyze the horizontal, vertical, and histological effects of alveolar ridge preservation (ARP) versus the ones of unassisted socket healing, in the format of an up-to-date review and meta-analysis., Materials and Methods: An extensive electronic search in the electronic databases of the National Library of Medicine was conducted for articles published up to June 2014 to identify literature presenting data on the topic of ARP. Only randomized controlled trials, controlled clinical trials, and prospective trials were included for meta-analysis., Results: After screening 903 abstracts from the electronic database, we included 64 studies in qualitative and 18 in quantitative synthesis. Quality assessment characterized a medium risk of bias for the included literature. The meta-analysis showed a mean difference between test and control groups of approximately 1.31 to 1.54 mm in bucco-oral bone width and 0.91 to 1.12 mm in bone height. Additionally, the intergroup difference in percentage of vital bone was assessed to be inconclusive across the included studies. Implants could be inserted into the determined position without further augmentation in 90.1% of the experimental sites, while this was the case in only 79.2% of the control sockets., Conclusions: Resorption of the alveolar ridge cannot be totally stopped by ARP, while it still can be prevented compared with unassisted healing. No reliable predictions on the histological effects could be made due to limited data. Further on, no recommendation for a specific technique of ARP could be made. In conclusion, there is still need for ongoing research on the topic, even though the lower percentage of implant sites that needed additional augmentation in test sockets seemed to bring a patient benefit., (© 2015 Wiley Periodicals, Inc.)

Background and Purpose: Tapered implant designs aim to improve primary stability and implant survival in soft bone. However, respective clinical long-term data are scarce. Therefore, a clinical and radiological evaluation of the long-term success of a transgingival-supracrestal inserted tapered implant system with special emphasis on the influence of augmentation procedures was conducted., Material and Methods: In a retrospective study design, all in the Department of Oral and Maxillofacial Surgery of the University Medical Centre, Mainz, Germany, between May 2002 and March 2012, placed tapered implants (Straumann TE®, Basel, Switzerland) were analyzed. In this time period, a total of one hundred ninety-seven tapered implants were inserted in 90 patients. For patients available for clinical recall, success criteria according to Albrektsson and Buser were evaluated., Results: The in situ rate was 96.3% after an average time in situ of 62 ± 31 months. In one hundred twenty-seven sites, bone augmentation procedures were performed. Hereof, 96 sites were sinus augmentation procedures and 31 sites were alveolar ridge augmentations. For patients with sinus augmentation procedures, implant survival was 97.9% and for patients with alveolar ridge augmentations, implant survival was 93.5% after 5 years, indicating a higher implant survival for sinus augmentation, however not statistically different (p = .194). Implant diameter and timing of implant placement had no significant impact on implant survival (p > .05). Mean marginal bone loss was -0.50 ± 1.54 mm for patients receiving maxillary sinus augmentation and -1.16 ± 1.13 mm for patients with alveolar ridge augmentations, indicating a lower marginal bone loss in patients receiving maxillary sinus augmentation (p = .046). Implant success rates ranged between 88% and 92% after a mean follow-up of 6 years., Conclusions: Within the limits of the retrospective character of this study, the tapered soft tissue level implant showed especially in maxillary sinus augmentation promising long-term survival and success rates and a low peri-implant bone resorption compared with the literature., (© 2015 Wiley Periodicals, Inc.)

Background: Biofunctionalized implant surfaces may accelerate bony integration and increase long-term stability., Purpose: The aim of the study was to evaluate the osseous reaction toward biomimetic titanium implants surfaces coated with quasicovalent immobilized fibronectin in an in vivo animal model., Materials and Methods: A total of 84 implants (uncoated [control 1, n = 36], streptavidin-biotin coated [test 1, n = 24], streptavidin-biotin-fibronectin coated [test 2, n = 24]) were inserted 1 mm supracortically in the proximal tibia of 12 rabbits. The samples were examined after 3 and 6 weeks. Total bone-implant contact (tBIC; %), bone-implant contact in the cortical (cBIC; %) and in the spongious bone (sBIC; %) as well as the percentage of linear bone fill (PLF; %) were evaluated., Results: After 3 weeks, streptavidin-biotin-fibronectin implants had a significant higher sBIC (p = .043) and PLF (p = .007) compared with the uncoated samples. After 6 weeks, this difference was significant for tBIC (p = .016) and cBIC (p < .001). Additionally, uncoated screws showed a significant higher sBIC when compared with the fibronectin coating (p < .001). Streptavidin-biotin-coated implants showed less bone growth at both time points of all examined parameters when compared with their counterparts (all p < .001)., Conclusions: Quasicovalent immobilization of biotinylated fibronectin with the streptavidin-biotin-fibronectin system on smooth surface titanium shows a beneficial faster osseous healing in vivo. Besides, an antifouling effect of the streptavidin-biotin coating was proven., (© 2015 Wiley Periodicals, Inc.)

Introduction: Osteoconductive characteristics of different implant surface coatings are in the focus of current interest. The aim of the present study was to compare the vertical osteoconductivity at the implant shoulder of supracrestal inserted calcium-phosphate coated implants (SLA-CaP) with conventional sand-blasted/acid-etched (SLA) implants in a rabbit model., Materials and Methods: SLA-CaP and SLA implants were inserted bilaterally in the mandible of four rabbits in a split-mouth design. The implants were placed 2 mm supracrestal. After 3 weeks, at the left and right implant shoulder, the percentage of linear bone fill (PLF) as well as bone-implant contact (BIC-D) were determined., Results: After 3 weeks, newly formed woven bone could be found at the shoulder of the most of both surface-treated implants (75%). PLF was significantly higher in SLA-CaP implants (11.2% vs. 46.5%; n = 8, p = .008). BIC-D was significantly increased in the SLA-CaP implants (13.0% vs. 71.4%; n = 8, p < .001) as well., Conclusion: The results of this study show for the first time that calcium-phosphate coated surfaces on supracrestal inserted implants have vertical osteoconductive characteristics and increase the bone-implant contact at the implant shoulder significantly in a rabbit model. In clinical long-term settings, these implants may contribute to a better vertical bone height., (© 2012 Wiley Periodicals, Inc.)

Background and Purpose: Titanium (Ti) surface roughness and surface hydrophilicity are key factors to regulate osteogenic cell responses during dental implant healing. In detail, specific integrin-mediated interactions with the extracellular environment trigger relevant osteogenic cell responses like differentiation and matrix synthesis via transcriptions factors. Aim of this study was to monitor surface-dependent osteogenic cell adhesion dynamics, proliferation, and specific osteogenic cell differentiation over a period of 7 days., Materials and Methods: Ti disks were manufactured to present smooth pretreatment (PT) surfaces and rough sandblasted/acid-etched (SLA) surfaces. Further processing to isolate the uncontaminated TiO(2) surface from contact with atmosphere provided a highly hydrophilic surface without alteration of the surface topography (modSLA). Tissue culture polystyrene (TCPS) served as control. Human osteogenic cells were cultivated on the respective substrates. After 24 hours, 48 hours, 72 hours, and 7 days, cell morphology on the Ti substrates was visualized by scanning transmission electron microscopy. As a marker of cellular proliferation, cell count was assessed. For the analysis of cell adhesion and differentiation, specific gene expression levels of the integrin subunits β1 and αv, runx-2, collagen type Iα (COL), alkaline phosphatase (AP), and osteocalcin (OC) were obtained by real-time RT-PCR for the respective time points. Data were normalized to internal controls., Results: TCPS and PT surfaces preserved a rather immature, dividing osteogenic phenotype (high proliferation rates, low integrin levels, and low specific osteogenic cell differentiation). SLA and especially modSLA surfaces promoted both cell adhesion as well as the maturation of osteogenic precursors into post-mitotic osteoblasts. In detail, during the first 48 hours, modSLA resulted in lowest cell proliferation rates but exhibited highest levels of the investigated integrins, runx-2, COL, AP, and OC., Conclusion: Our results revealed a strong synergistic effect between submicron-scale roughness and surface hydrophilicity on early osteogenic cell adhesion and maturation., (© 2011 Wiley Periodicals, Inc.)

Background: Ceramic biomaterial blocks like hydroxyl apatite are too brittle for simple simultaneous vertical augmentation and dental implant placement. Biological scaffolds of xenogenic or allogenic origin are known to be advantageous., Purpose: The aim of this study was the proof of principle for combined vertical bone augmentation and dental implantation with marginal cuffs made of biological scaffolds with interconnecting porous system and titanium dental implants., Materials and Methods: Cylindrical porcine biomaterial rings (processed, mineralized bone matrix) were placed in combination with titanium dental implants in the tibia model using six chinchilla bastard rabbits (n = 12 samples). Histological examination included undecalcified histological examination with toluidine blue staining and fluorescence microscopy. Animals were sacrificed after 30 days., Results: The results showed bony healing in the scaffolds with immature bone tissue ingrowth following the trabecular structure, showing lamellar cancellous bone healing. Fluorescence microscope showed analogous results., Conclusion: The biological scaffold proved a biocompatibility in a xenogenic setting. The vertical bone augmentation with simultaneous implantation was successful and proved the feasibility of the concept., (© 2011 Wiley Periodicals, Inc.)

Purpose: Long-term results in the clinical outcome of different implant systems, including high patient numbers and a long follow-up time, are rare. This retrospective study evaluated the cumulative survival rate of a self-tapping, cylindrical implant system with a conical implant-abutment connection after 10 years of prosthetic loading., Materials and Methods: A total of 516 TiOblast implants (Astra Tech AB, Mölndal, Sweden) were placed in 108 patients. The patients were treated in the Department of Oral and Maxillofacial Surgery, Johannes Gutenberg University, Mainz, Germany, between September 1994 and May 2005. The main indications for implantation were the treatment of edentulous mandibles (74%) and partial edentulism (15%). Twenty-three implants were placed postradiation, and a further 64 implants were irradiated after insertion. In 153 implants, a bony augmentation was conducted prior to implantation., Results: The in situ rate was 89.7% after an average implantation time of 108 months. Eighty-three patients with 403 implants were available for investigation. Seventeen patients with 76 implants have died since 1994. Absence of osseointegration (n = 22), peri-implantitis (n = 18), fracture of the implants (n = 9), failing of primary stability (n = 2), and implants next to tumors (n = 2) were the reasons of explantation in 26 patients. Under analysis with different implant success-assessment criteria, the success rate showed results from 76 to 89%., Conclusion: With respect to the critical patient selection including a high number of patients with minor and major augmentations, the 10-year clinical use of the studied implant system showed acceptable results., (© 2010 Wiley Periodicals, Inc.)

Background: There is a lack of clinical studies on the self-aligning attachment system (Locator(R); Zest Anchors, Inc. homepage, Escondido, CA, USA) for two-implant-retained overdentures in the edentulous mandible. Therefore, a comparison of the Locator with two traditional designs (a rotational gold matrix and a rubber O-ring type) in clinical 1-year use was conducted., Materials and Methods: From 2003 to 2007, 60 patients received two Osseotite(R) TG Standard implants (BIOMET 3i Implant Innovations, Palm Beach Gardens, FL, USA) in the intraforaminal area of the edentulous mandible. The implants were left unloaded for 3.5 months, randomized to three different attachment systems, and loaded through a mandibular overdenture. Twenty-three patients received a self-aligning attachment system (Locator) and 33 patients a ball attachment (Dal-Ro(R)[BIOMET 3i Implant Innovations]n = 25; TG-O-Ring(R)[Cendres & Metaux SA, Biel-Bienne, Switzerland]n = 8). After 12 months of delivery of the overdentures, the oral situation was evaluated: prosthodontic maintenance and biologic complications, subjective patients' experience, and oral health-related life quality (Oral Health Impact Profile [OHIP-G 49])., Results: After 1-year of clinical service, 8 of 120 implants were lost (9.6%). The Locator system brought up 34 prosthetic complications, especially the need for change of the male parts or activation because of loss of retention. The TG-O-Ring patients showed 14 complications, most of them the change of the O-Rings. The patients with the Dal-Ro abutment had seven minor complications in 12 months of clinical use. Biologic complications and patients' oral health-related life quality showed no significant difference among the three experimental groups., Conclusions: Prosthodontic maintenance was restricted to loss of retention for all systems. Within the observation period of this study, the self-aligning attachment system showed a higher rate of maintenance than the ball attachments. The patients' oral health-related life qualities as well as the biologic parameters do not differ when using the three abutment systems.