Search

BACKGROUND During the third Summer Camp of European Association of Osseointegration (EAO), 40 junior representatives from various European societies and associations were brought together to discuss and explore the following topics in Implant Dentistry in the next 10 years: (I) certification, (II) societies and associations, (III) continuing education, and (IV) innovations. AIMS The aims of all working groups were to identify and outline the present situation in the area of the selected topic and to propose improvements and innovations to be implemented in the following 10 years. MATERIALS AND METHODS Four different groups were assigned randomly to one of the four working units. The method to discuss the selected topics was World Cafe. The summaries of four topics were then given to all participants for peer review. RESULTS AND CONCLUSIONS All four groups presented the conclusions and guidelines accordingly: (I) The recognition for Implant Dentistry and accreditation of training programs would lead to an improvement of the quality of care to the benefit of the patients; (II) Dental associations and societies have to continuously improve communication to meet needs of dental students, professionals, and patients (III) European Dental Board should be installed and become responsible for continue dental education; (IV) dental engineering, peri-implant diseases, and digital workflow in dentistry currently have limited tools that do not guarantee predictable results.

This 3-year prospective randomized controlled trial compared the clinical, microbiological and biochemical outcome of minimally (Turned, Tur) and moderately rough (TiUnite®, TiU) implant surfaces in a split-mouth design.The study population included 14 subjects: nine fully edentulous and five partially edentulous subjects with a history of periodontitis. Implants (n = 78, 39 Tur and 39 TiU) were installed randomly in each patient. Peri-implant clinical parameters and intra-oral radiographs were recorded after 3 years of loading. Subgingival plaque and peri-implant crevicular fluid samples were collected and analysed using culture and quantitative polymerase chain reaction for the biofilm, and enzyme-linked immunosorbent assay for the concentration of osteoprotegerin and receptor activator of nuclear factor kappa-B ligand, respectivelyNo statistically significant differences in clinical, microbiological and biochemical parameters could be observed when comparing the Tur and TiU implant surfaces.After 3 years of loading, in periodontitis susceptible patients, the moderately rough, TiU implants demonstrated a similar clinical outcome compared with the smoother, turned implants. Longer follow-up and studies using different implant types are needed to confirm the statement that minimally and moderately rough implant surfaces perform similar, both from a clinical and from a microbiological point of view.

Quirynen M, Van Assche N. Microbial changes after full-mouth tooth extraction, followed by 2-stage implant placement. J Clin Peridontol 2011; doi: 10.1111/j.1600-051X.2011.01728.x. Abstract: Background: Recent studies showed that qPCR could detect bacteria related to periodontitis and peri-implantitis in a low concentration after full-mouth tooth extraction. This study monitored the microbiota from tooth extraction, over 9 months of full edentulism, up to 1 year after abutment connection. Material and methods: Ten patients with severe periodontitis were recruited. Six months after tooth extraction, implants were inserted. Three to 6 months later, they were connected to abutments. Plaque samples were collected from the tongue dorsum, saliva, and subgingival area (teeth/implants) before extraction up to 1 year after abutment connection, and analysed via culture, qPCR, and checkerboard technology. Results: A reduction in the total amount of aerobic and anaerobic CFU/ml was observed. The concentration of Porphyromonas gingivalis and Tannerella forsythia (qPCR and checkerboard) in the saliva and, to a lower extent, on the tongue dorsum reduced. For Prevotella intermedia, changes were negligible and no changes could be detected for Aggregatibacter actinomycetemcomitans. The pristine subgingival niches were quickly colonized by key pathogens. Their final concentration remained low, while the detection frequencies remained very high over time. Conclusion: Complete edentulation results in a significant reduction of bacteria related to periodontitis and peri-implantitis, with the exception of A. actinomycetemcomitans, which might indicate that key pathogens can survive without pockets.

Variations in jaw bone neurovascularisation must be identified to decrease the potential risk for haemorrhages and neural disturbances during surgical procedures such as implant placement and orthognatic surgeries. The aim of this study is to characterise additional mental foramina (AMF) through cone beam computed tomography (CBCT) images, by describing their frequency, size, location and direction of their associated bony canals, as well as to assess their corresponding ipsilateral and contralateral mental foramina (MF). CBCT images from 285 patients were analysed. Prevalence of AMF was 9·4%. From 0 to 2 AMF were observed, with two bilateral cases. Two cases of unilateral absence of MF were registered. Patients presenting AMF did not differ significantly from those without AMF regarding gender, age or ethnicity. Diameters of AMF and their corresponding ipsilateral and contralateral MF were 1·9 mm (±0·7 mm), 3·8 mm (±0·6 mm) and 4·1 mm (±0·6 mm), respectively. Ratios between diameters of AMF and corresponding ipsilateral MF ranged between 0·24 and 0·99. Location of AMF was variable, with most cases located posteriorly, posterior-inferiorly, posterior-superiorly or anterior-superiorly to their respective MF. Significant anatomical variability regarding neurovascularisation was observed among patients and CBCT examinations presented as a valuable tool for individually assessing these anatomical features.

Aims: To explore the relationship between primary implant stability and different parameters related to implant or bone properties. Materials and methods: Twenty-four patients received a total of 136 Straumann SLActive implants. Resonance frequency analysis (RFA) was performed at implant placement, and RFA and Periotest (PTV) were scored at loading. Bone density [Hounsfield (HU) scores] and coronal cortical thickness at osteotomy sites were measured from pre-operative computerized tomography scans. Results: Implant length, diameter or the presence of bony dehiscence did not have a significant effect on the mean RFA scores at implant insertion. Significant linear relations were found between RFA or PTV scores and HU values (P

Background: From an ecological viewpoint, the oral cavity, in fact the oro-pharynx, is an 'open growth system'. It undergoes an uninterrupted introduction and removal of both microorganisms and nutrients. In order to survive within the oro-pharyngeal area, bacteria need to adhere either to the soft or hard tissues in order to resist shear forces. The fast turn-over of the oral lining epithelia (shedding 3 x/day) is an efficient defence mechanism as it prevents the accumulation of large masses of microorganisms. Teeth, dentures, or endosseous implants, however, providing non-shedding surfaces, allow the formation of thick biofilms. In general, the established biofilm maintains an equilibrium with the host. An uncontrolled accumulation and/or metabolism of bacteria on the hard surfaces forms, however, the primary cause of dental caries, gingivitis, periodontitis, peri-implantitis, and stomatitis. Objectives: This systematic review aimed to evaluate critically the impact of surface characteristics (free energy, roughness, chemistry) on the de novo biofilm formation, especially in the supragingival and to a lesser extent in the subgingival areas. Methods: An electronic Medline search (from 1966 until July 2005) was conducted applying the following search items: 'biofilm formation and dental/oral implants/surface characteristics', 'surface characteristics and implants', 'biofilm formation and oral', 'plaque/biofilm and roughness', 'plaque/biofilm and surface free energy', and 'plaque formation and implants'. Only clinical studies within the oro-pharyngeal area were included. Results: From a series of split-mouth studies, it could be concluded that both an increase in surface roughness above the R(a) threshold of 0.2 mum and/or of the surface-free energy facilitates biofilm formation on restorative materials. When both surface characteristics interact with each other, surface roughness was found to be predominant. The biofilm formation is also influenced by the type (chemical composition) of biomaterial or the type of coating. Direct comparisons in biofilm formation on different transmucosal implant surfaces are scars. Conclusions: Extrapolation of data from studies on different restorative materials seems to indicate that transmucosal implant surfaces with a higher surface roughness/surface free energy facilitate biofilm formation. To cite this article: Teughels W, Van Assche N, Sliepen I, Quirynen M. Effect of material characteristics and/or surface topography on biofilm development. Clin. Oral Imp. Res. 17 (Suppl. 2), 2006; 68-81. ispartof: Clinical oral implants research vol:17 issue:S2 pages:68-81 ispartof: location:SWITZERLAND, Pfaffikon status: published

To compare the subgingival microbiota around two differently designed implant systems that were in function for more than 12 years in a randomised split-mouth study design, and to compare the outcome with natural dentition.A total of 18 partially edentulous patients received at least two TiOblast™ (Astra Tech) and two Brånemark (Nobel Biocare) implants following a split-mouth design. At the last follow-up visit, periodontal parameters (probing depth, bleeding on probing and plaque) were recorded and intraoral radiographs were taken to calculate bone loss. Subgingival plaque samples were collected for culture, qPCR and checkerboard DNA-DNA hybridisation analysis. These data were related to implant design and bone loss. This study setup allowed a comparison of 34 Astra Tech (Impl A) with 32 Brånemark (Impl B) implants.During the 12-year follow up, five patients dropped out. One Brånemark implant was lost before abutment connection in a dropout patient. Mean bone loss between loading and year 12 was 0.7 mm (range: -0.8-5.8) (Impl A), and 0.4 mm (range: -1.1-4.1) (Impl B). No significant microbiological differences (qualitative and quantitative) could be observed between both implant types. Compared to teeth, subgingival plaque samples from implants did not reach the concentration of pathogens, even after 12 years of function.These data show that both implant systems (with differences in macro-design and surface characteristics), in patients with good oral hygiene and a stable periodontal condition, can maintain a successful treatment outcome without significant subgingival microbiological differences after 12 years of loading. The presence of periodontopathogens did not necessarily result in bone loss.

Recent studies showed that qPCR could detect bacteria related to periodontitis and peri-implantitis in a low concentration after full-mouth tooth extraction. This study monitored the microbiota from tooth extraction, over 9 months of full edentulism, up to 1 year after abutment connection.Ten patients with severe periodontitis were recruited. Six months after tooth extraction, implants were inserted. Three to 6 months later, they were connected to abutments. Plaque samples were collected from the tongue dorsum, saliva, and subgingival area (teeth/implants) before extraction up to 1 year after abutment connection, and analysed via culture, qPCR, and checkerboard technology.A reduction in the total amount of aerobic and anaerobic CFU/ml was observed. The concentration of Porphyromonas gingivalis and Tannerella forsythia (qPCR and checkerboard) in the saliva and, to a lower extent, on the tongue dorsum reduced. For Prevotella intermedia, changes were negligible and no changes could be detected for Aggregatibacter actinomycetemcomitans. The pristine subgingival niches were quickly colonized by key pathogens. Their final concentration remained low, while the detection frequencies remained very high over time.Complete edentulation results in a significant reduction of bacteria related to periodontitis and peri-implantitis, with the exception of A. actinomycetemcomitans, which might indicate that key pathogens can survive without pockets.

To explore the relationship between primary implant stability and different parameters related to implant or bone properties.Twenty-four patients received a total of 136 Straumann SLActive implants. Resonance frequency analysis (RFA) was performed at implant placement, and RFA and Periotest (PTV) were scored at loading. Bone density [Hounsfield (HU) scores] and coronal cortical thickness at osteotomy sites were measured from pre-operative computerized tomography scans.Implant length, diameter or the presence of bony dehiscence did not have a significant effect on the mean RFA scores at implant insertion. Significant linear relations were found between RFA or PTV scores and HU values (P0.05), or cortical bone thickness (P0.05), both at insertion as well as at loading.RFA and PTV scores can be predicted based on implant and especially bone related factors.

Aim: To monitor the intra-oral microbiological changes after full-mouth extraction using quantitative polymerase chain reaction (qPCR). Material and Methods: Nine patients with severe, aggressive periodontitis, for whom a full-mouth tooth extraction was the only remaining treatment option were recruited. Before and 6 months after extraction, microbial samples were obtained (tongue, saliva and subgingival plaque) and analysed by qPCR. Results: The elimination of subgingival niches, by extraction of all natural teeth, resulted in a 3-log reduction of Porphyromonas gingivalis and Tannerella forsythia, and more modest reductions of Aggregatibacter actinomycetemcomitans and Prevotella intermedia. However, the detection frequencies of these periodontopathogens in saliva and on the tongue remained unchanged after full-mouth tooth extraction. Conclusion: In contrast to what has been believed so far, full-mouth tooth extraction does not result in eradication of all periodontopathogens but only in a significant reduction. The clinical consequences of this observation remain speculative.

This retrospective study aimed to determine the consequence of early cover screw exposure on peri-implant marginal bone level.Sixty Astra Tech MicroThread implants installed in partially edentulous jaws were compared: 20 implants were placed following a two-stage procedure and were unintentionally exposed to the oral cavity (two-stage exposed), 20 implants were placed following a two-stage procedure and were surgically exposed after a subgingival healing time of 3-6 months (two-stage submerged), and 20 implants were placed following a one-stage surgical protocol (one-stage). Digital radiographs were taken at implant placement for all implants, and after abutment surgery for the two-stage exposed and two-stage submerged groups or after 3 months for the one-stage group. Bone loss mesially and distally was measured with an on-screen cursor after calibration.Mean bone re-modelling was 1.96 mm (range: 0.2-3.2 mm) around the two-stage exposed implants, 0.01 mm (range: 0.0-0.3 mm) around the two-stage submerged implants and 0.14 mm (range: 0.0-1.2 mm) around the one-stage implants.The unintentional perforation of two-stage implants resulted in significant bone destruction, probably because the biological width was not considered.