Search

Implant surface micro and macro topography plays a key role in early osseointegration. The physicochemical features of the implant surface (ie, chemical composition, hydrophobicity/hydrophilicity and roughness) influence the deposition of extracellular matrix proteins, the precipitation of bone mineral, and the stimulation of cells. Modification of the implant topography provides better primary stability and faster osseointegration, allowing for immediate placement or immediate loading. Randomized clinical trials are warranted to compare the response of osseointegration with various implant micro and macro surface topographies in people with various local or systemic risk factors.

Cement-retention is a viable option in restoring dental implants. A wide range of dental cements with different properties are commercially available for use in the cementation of implant prostheses. The selection of a dental cement for proper clinical application can be challenging. This article overviews the commercially available dental cements used in cement-retained implant-supported prostheses. Guidelines for cement selection are presented according to abutment and prosthetic material. Cementation techniques to reduce excess cement in peri-implant tissues are also mentioned.

This systematic literature review investigated the effect of microthreaded-neck dental implants on crestal bone loss. Using the participants, interventions, comparison groups, outcomes, and study design (PICO) system, we addressed the following focused question: Do microthreaded-neck dental implants positively affect the crestal bone level around dental implants? We searched 3 electronic databases to find articles published between January 1995 and June 2016 that contained any combination of the following keywords: dental implant, microthread, microthreaded, crestal bone level, crestal bone loss, and alveolar bone level. We excluded case reports, review articles, letters to the editor, commentaries, and articles published in a language other than English. We found a total of 70 articles. After eliminating duplicates and applying PICO eligibility criteria, we selected only articles that reported the results of randomized controlled trials, prospective or retrospective cohort studies, case control studies, cross-sectional studies, or other types of clinical trials that compared the microthreaded implant design with other implant designs. We were left with 23 articles for review. The 23 articles reported crestal bone loss ranging from .05 mm to .9 mm, with a range of 12 to 96 months of follow-up. Less crestal bone was lost with dental implants that had a microthreaded neck design than with machined-surface or conventional rough-surface dental implants. Thus, microthreaded dental implants are a better choice than are implants with other designs. Future studies should use standardized imaging techniques to evaluate the placement of these implants in bone-augmented sites.

Loss of soft and hard tissue is common after tooth extraction. Substantial resorption of alveolar bone compromises esthetics and may result in prosthetic and surgical limitations. Immediate implant placement at the time of tooth extraction is used to maintain alveolar ridge dimensions. Clinical studies support the successful outcome of immediate placement of dental implants in fresh extraction sockets; comparative clinical studies have found that implant survival rates after immediate placement are similar to those after delayed placement. This article addresses surgical techniques for immediate implant placement and the prevention and the management of complications associated with this procedure.

Although osseointegrated dental implants have become a predictable and effective modality for the treatment of single or multiple missing teeth, their use is associated with clinical complications. Such complications can be biologic, technical, mechanical, or esthetic and may compromise implant outcomes to various degrees. This article presents prosthetic complications accompanied with implant-supported single and partial fixed dental prostheses.

Background:The aim of this investigation is to evaluate clinical and histologic outcome of using medical‐grade calcium sulfate hemihydrate (MGCSH) mixed with platelet‐rich plasma (PRP) for extraction socket preservation graft before implant placement. Methods:This study is a single‐site, randomized and controlled investigation. Sixteen patients with a non‐restorable tooth requiring extraction followed by implant placement were enrolled in this study. After extraction of a tooth, eight selected patients randomly received MGCSH mixed with PRP in the extraction sockets (test group), and eight selected patients randomly received collagen resorbable plug dressing material (control group). At the time of extraction and 3 months later (at implant placement surgery), vertical and horizontal socket dimensions were measured. Bone core samples were retrieved from the center of the healed socket before implant placement for histomorphometric analysis. Results:There was a statistically significant difference between the two groups based on histomorphometric analysis (P<0.05). New vital bone percentage regenerated after 3 months of healing was 66.5% ± 10.4% in sockets grafted with MGCSH mixed with PRP compared to 38.3% ± 9.3% collagen resorbable plug. There was no statistically significant difference in the amount of vertical and horizontal bone resorption (P>0.05) between groups. In all cases but two in the control group, implants were placed with primary stability. Conclusion:MGCSH mixed with PRP showed greater vital bone volume at 3 months with rapid enhancement of bone healing compared to PRP‐free collagen resorbable graft.

Background:This 2‐year randomized clinical trial compared bone regeneration and esthetic outcome between immediate and conventional loading of dental implants placed immediately after extraction in patients with a history of periodontal disease. Methods:Patients were randomly assigned to receive immediate implants with either immediate loading or conventional loading after 3 months. Both groups received a periodontal flap, tooth extraction, implant placement, allograft bone, and membrane placement. The immediate loading group received a temporary crown. In the conventional loading group primary closure was achieved. All patients were followed up at 3, 6, 12, and 24 months. Evaluation included radiographic bone changes, papillary esthetic outcome, and implant survival rate. Results:Seventy‐two patients were recruited into the study. However, 60 patients received immediate implant placement after extraction: 30 with conventional loading and 30 with immediate loading. In the immediate loading group the implant survival rate at 2 years was 96.7%, and the mean bone gain was 1.19 mm. The corresponding figures in the conventional loading group were 93.3% and 1 mm. The gain in bone level occurred mainly from baseline to 1 year postoperatively in both groups (P<0.001). The papilla index decreased from baseline to 1 year in both groups (P<0.001) and changed only slightly thereafter. There were no significant differences between the two groups in the amount of bone gain or papilla index change during 2 years. Conclusions:Immediate loading of a single implant placed in a fresh extraction site in periodontally compromised patients resulted in similar bone gain and soft tissue esthetic outcomes compared to delayed loading. Primary closure and delayed loading to ensure bone regeneration around implants were not critical in this study.