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Dental implants are an increasingly popular solution to missing teeth. Implants are prone to colonisation by pathogenic oral bacteria which can lead to inflammation, destruction of bone and ultimately implant failure. The aim of this study was to investigate the use of chlorhexidine (CHX) hexametaphosphate (HMP) nanoparticles (NPs) with a total CHX concentration equivalent to 5 mM as a coating for dental implants. The CHX HMP NPs had mean diameter 49 nm and composition was confirmed showing presence of both chlorine and phosphorus. The NPs formed micrometer-sized aggregated surface deposits on commercially pure grade II titanium substrates following immersion-coating for 30 s. When CHX HMP NP-coated titanium specimens were immersed in deionised water, sustained release of soluble CHX was observed, both in the absence and presence of a salivary pellicle, for the duration of the study (99 days) without reaching a plateau. Control specimens exposed to a solution of aqueous 25 µM CHX (equivalent to the residual aqueous CHX present with the NPs) did not exhibit CHX release. CHX HMP NP-coated surfaces exhibited antimicrobial efficacy against oral primary colonising bacterium Streptococcus gordonii within 8 h. The antimicrobial efficacy was greater in the presence of an acquired pellicle which is postulated to be due to retention of soluble CHX by the pellicle.

This clinical report describes an unusual consequence of peri-implantitis and subsequent implant failure in a 72-year-old man. Following uneventful implant removal, osteomyelitis developed at the implant site, which subsequently weakened the mandible sufficiently for a pathological fracture to occur. The patient was treated successfully by use of an intensive oral hygiene regime, antibiotics, and conservative management. The consequences and management of implant failure are discussed, as well as issues relating to the management of osteomyelitis and pathological bone fracture.

Objectives: The study presented was designed to analyse the mechanical performance and the primary and secondary stability characteristics of endosseous titanium implants with 1 degree (EXP1) and 2 degrees (EXP2) of taper when compared with the standard Brånemark design (Nobel Biocare AB, Gothenburg, Sweden)., Materials and Methods: One pair of 10 mm EXP1 and control implants were placed in the femoral condyles of six rabbits. Paired 6 mm EXP1 and control implants and 6 mm EXP2 and control implants were placed in the tibial metaphysis. The control implants used were 4 mm diameter standard Brånemark implants, the same length as the test implants. At placement, insertion torque (IT) and resonance frequency analysis (RFA) measurements were performed. Six weeks postoperatively when the animals were killed, RFA and removal torque (RT) measurements were made., Results: At placement, significantly higher IT was needed to insert the EXP implants compared with the controls. RFA values were significantly higher for EXP1 implants placed in the tibia but not in the femur. In pooling data from the femur and tibia there was a significant difference. The EXP2 implants failed to insert fully and demonstrated a lower RFA value than may have been expected due to the exposed threads, although this difference was not statistically significant., Conclusions: The results from the present study showed that 1 degrees of taper results in a better primary stability compared with the standard Brånemark design. There was no evidence that the tapered design caused negative bone tissue reactions. All the implants gained in stability during the healing period.

Background: Surgical technique and implant design have an effect on the primary stability of oral implants, which in turn increases resistance to implant micromotion during healing., Purpose: This study was designed to compare the parameters associated with implant insertion using two different methods of enhancing implant primary stability and to identify any relationship between these parameters and changes in the stability of implants during the initial 6-month healing period following implant insertion. A comparison was made between two methods of enhancing primary implant stability: method 1, standard Brånemark System implants (Nobel Biocare AB, Gothenburg, Sweden) inserted with a technique designed to enhance primary stability, and method 2: Brånemark Mk IV implants (Nobel Biocare AB) inserted according to the manufacturer's instructions., Materials and Methods: Thirteen patients were selected for inclusion in the study. A total of 42 implants were placed. Insertion torque data were recorded, and bone quality at the implant site was assessed at implant insertion. Resonance frequency analysis measurements were taken at implant insertion as well as at second-stage surgery 6 months later., Results: A statistically significant difference was recorded between the mean maximum insertion torque for type 4 bone and bone types 2 and 3. No significant difference was recorded between bone types 2 and 3. A significantly lower resonance frequency value was seen for standard implants placed into type 4 bone (p < .05). Across all implant types a significant difference in the energy required when inserting implants into type 4 bone and bone types 2 and 3 was seen. A significantly lower mean energy requirement was seen between the Mk IV implants placed into type 4 bone and the other combinations of implant types and bone., Conclusions: Within the limitations of this study, the results agree with the manufacturer's claim that when compared with standard implants, the design of the Mk IV implant increases implant primary stability with a reduction in the energy imparted into the bone at the implant site.

The article discusses the study on the complications and risks of dental implant treatment following an implant consent process.

Bacterial colonisation of exposed implant and abutment surfaces can lead to peri-implantitis, a common cause of oral implant failure. When an abutment becomes exposed in the oral environment the typical recommendation is to debride it, to obtain a smoother surface which might be expected to reduce bacterial colonisation. The aim of this study was to evaluate, in vitro, a conventional polishing protocol (PP1) and a simplified polishing protocol (PP2), suggested to have advantages over PP1. The surface morphology and roughness of titanium abutments were characterised at each stage of polishing, and adhesion of oral bacteria was evaluated, using atomic force microscopy, environmental scanning electron microscopy and optical profilometry. PP1 and PP2 methodologies resulted in indistinguishable surface finishes, with fewer scratches than the unmodified surface, and equal roughness values. PP2 resulted in less disruption and less removal of surface material. Early biofilm formation by Streptococcus mutans was reduced on surfaces polished using PP2, but not PP1. Biofilms of Actinomyces naeslundii were more extensive on polished abutment surfaces. Simplified protocol PP2 may be preferable to conventional protocol PP1, since less material is removed, and there is less chance of rough areas remaining. Polishing, however, does not necessarily reduce oral bacterial colonisation. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Zirconia ceramic material has been widely used in implant dentistry. In this in vitro study the physiochemical properties of titanium and zirconia materials were investigated and the affinity of different bacteria to different materials was compared. Methods: Disc samples with different surface states were used: polished partially stabilized zirconia (PZ), titanium blasted with zirconia (TBZ), titanium blasted with zirconia then acid etched (TBZA), and polished titanium (PT) as a control. Surface topography was examined using scanning electron microscopy and profilometry. Contact angle, surface free energy (SFE), surface microhardness and chemical composition were determined. Disc samples were separately incubated with Streptococcus mitis and Prevotella nigrescens, either with or without pre-coating with human saliva, for 6h and the surface area covered by bacteria was calculated from fluorescence microscope images. Results: PZ and TBZ exhibited lower surface free energy and lesser surface wettability than PT. Also, PZ and TBZ surfaces showed lower percentage of bacterial adhesion compared with control PT surface. Conclusions: The zirconia material and titanium blasted with zirconia surface (TBZ surface) showed superior effect to titanium material in reducing the adhesion of the experimented bacteria especially after coating with saliva pellicle. Modifying titanium with zirconia lead to have the same surface properties of pure zirconia material in reducing bacterial adhesion. SFE appears to be the most important factors that determine initial bacterial adhesion to smooth surface. [Copyright &y& Elsevier]