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Background: Adequate alveolar ridges are fundamental to successful rehabilitation with implants. There are diverse techniques for reconstructing atrophied ridges, of which bone substitute grafts is one possibility., Purpose: The aim of this study was to carry out radiological and histomorphometric evaluations of bone response to collagenized porcine bone xenografts over a 4-month period following their insertion in rabbits' tibiae., Material and Methods: Twenty New Zealand rabbits were used. Twenty collagenized porcine bone xenografts (Osteobiol® mp3, Tecnoss Dental s.r.l., Torino, Italy), in granulated form of 600 to 1,000 µm, were inserted in the proximal metaphyseal area of the animals' tibiae and 20 control areas were created. Following implantation, the animals were sacrificed in four groups of five, after 1, 2, 3, and 4 months, respectively. Radiological and histomorphometric studies were made., Results: After 4 months, radiological images revealed bone defects with a decrease in graft volume and the complete repair of the osseous defect. No healed or residual bone alterations attributable to the presence of the implants were observed. Histomorphometric analysis at 4 months found mean values for newly formed bone, residual graft material, and non-mineralized connective tissue of 25.4 ± 1.8%, 36.37 ± 3.0%, and 38.22 ± 2.5%, respectively. There were no statistical differences in the length of cortical formation with collagenized porcine xenograft (98.9 ± 1.1%) compared with the control samples (99.1 ± 0.7%) at the end of the study period., Conclusions: The biomaterial used proved to be biocompatible, bioabsorbable, and osteoconductive and as such, a possible bone substitute that did not interfere with the bone's normal reparative processes., (© 2011 Wiley Periodicals, Inc.)

Background: One of the most important antidepressants side effects is dry mouth. The aim of this study was to evaluate the clinical efficacy of a topical sialogogue spray containing 1% malic acid on patients affected by dry mouth caused by antidepressants drug., Materials and Methods: This research took the form of a double-blind, randomized clinical trial at Faculty of Dentistry of University of Granada (Spain). Seventy participants with antidepressant-induced dry mouth were divided into two groups: for the first "intervention group" (35 subjects) a topical sialogogue spray (1% malic acid) was applied, while for the second "control group" (35 subjects), a placebo spray was applied; for both groups, the sprays were applied on demand during 2 weeks. The dry mouth questionnaire (DMQ) was used to evaluate dry mouth symptoms before and after product/placebo application. Unstimulated and stimulated salivary flows rates, before and after application, were measured., Results: Dry mouth symptoms improved after 1% malic acid topical spray application (p < .05). After 2 weeks of 1% malic acid application, unstimulated and stimulated salivary flows rates increased significantly (p < .05)., Conclusions: A sialogogue spray containing 1% malic acid improved dry mouth feeling of the patients suffering antidepressant-induced dry mouth and increased unstimulated and stimulated salivary flows rates., (© 2012 Wiley Periodicals, Inc.)

Objectives. The aim was to evaluate survival and success rates, soft tissue health, and radiographic marginal bone loss (MBL) of zirconia implants placed in the esthetic and posterior areas of the jaws and in association with multiple or single implant restorations after at least 6 months of definitive restoration. Material and Methods. 35 one-piece zirconium implants were utilized for single or partially edentulous ridges rehabilitation. All implants received immediate temporary restorations and six months after surgery were definitively restored. Every 6 months after implant placement, a clinical-radiographic evaluation was performed. For each radiograph, the measurements of MBL were calculated. Results. The results showed that the mean MBL at 48-month followup was 1.631 mm. The mean MBL during the first year of loading was not more significant for implants placed in the first molar regions than for those positioned in other areas. Moreover, no differences in marginal bone level changes were revealed for multiple and single implants, whereas MBL in the first year was observed to be slightly greater for implants placed in the maxilla than for those placed in the mandible. Conclusion. Zirconia showed a good marginal bone preservation that could be correlated with one-piece morphology and characteristics of zirconia implants.

Objectives: The pineal gland hormone, melatonin, is an immunomodulator and neuroendocrine hormone; it also stimulates monocyte, cytokine and fibroblast proliferations, which influence angiogenesis. The aim of this study was to investigate the effects of melatonin on angiogenesis during bone defect repair by means of radiological and histomorphometric evaluations of bone response to melatonin implants., Materials and Methods: Twenty New Zealand rabbits weighing 3,900-4,500 g were used. Twenty melatonin implants were inserted in the proximal metaphyseal area of the animals' right tibia and 20 control areas were located in the left proximal metaphyseal area. Following implantation, the animals were sacrificed in groups of five, after 1, 2, 3 and 4 weeks, respectively. Anteroposterior and lateral radiographs were taken, and radiographic thermal imaging analysis was performed for all groups at different time stages following implant insertion. Samples were sectioned at 5 μm and stained using Hematoxylin-Eosin and Masson's trichrome, supplementing radiographic findings with histomorphometric analysis., Results: After 4 weeks, radiological images showed complete repair of the bone defects. No healed or residual bone alterations attributable to the presence of the melatonin implant were observed. Histomorphometric analysis at 4 weeks showed the presence of a higher density newly formed bone. There were statistically significant differences in the length of cortical formation between the melatonin group and the control group during the first weeks of the study; there were also statistically significant differences in the number of vessels observed in the melatonin groups at the first two study stages., Conclusion and Clinical Relevance: Melatonin may have potential beneficial effects on bone defect repair.

This study reports the characterization process and in vivo application of a new block bone graft of α-TCP with silicate in three different percentages in the aim of determining the influence of the silicate. Three groups of cylindrical implants (6 ± 0.01 mm diameter, 8 ± 0.01 mm length) with varying Si composition were studied: A: 3 wt % C(2) S; B: 1.5 wt % C(2) S; C: 100 wt % TCP-0 wt % C(2) S. These were implanted randomly in critical size defects in New Zealand rabbits. X-ray diffraction analysis was performed to determine the crystalline phases of the different compositions. Histomorphometric analysis produced one measurement of bone-to-implant contact. Comparing the α-TCPss ceramics, the trial found improved mechanical properties due to the silicon content in solid solution as well as densification. Previous studies have shown that the mechanical strengths of sintered ceramics correlate to densification as well as grain size and mechanical properties. Because of its mechanical and biological behavior, the study has shown α-TCP with C(2) S to be an alternative to other bone graft substitutes for use in bone reconstructive surgery in the fields of veterinary, medicine, and oral and maxillofacial surgery., (Copyright © 2012 Wiley Periodicals, Inc.)

Aim: The aim of this 1-year prospective cohort study was to evaluate the outcomes and complications of immediately loaded mini dental implants used for stabilizing mandibular overdentures in edentulous patients wearing conventional complete dentures., Materials and Methods: Thirty patients received mandibular conventional complete dentures that were subsequently retained by 4 immediately loaded mini dental implants placed in the interforaminal region. Overdenture success, implant success and biological and prosthetic complications were evaluated after the first year of service. Quality of life using the Oral Heath Impact Profile (OHIP)- EDENT test, satisfaction with dental prosthesis and chewing efficiency using questionnaires and a Visual Analogue Scale (VAS) were evaluated twice: after they had received mandibular complete dentures, and again after they had received mandibular overdentures., Results: After 1 year, no overdenture failed and 2 implants did not osseointegrate, resulting in a 98.3% success rate for loaded implants and 95.9% for total implants used (3 out of 123 were not loaded due to fracture). A flap surgical approach was performed in 7 patients, 3 implants fractured during insertion, 3 overdentures fractured, occlusion balancing was necessary for 11 dentures and relining for 8. Implant rehabilitation provided significant improvement in quality of life, stability, comfort, chewing and speaking ability while no significant differences were found in quality of maintenance of hygiene and for aesthetics., Conclusions: Mini dental implant retained overdentures can be a successful therapeutic procedure for treating mandibular edentulism that improves quality of life, patient satisfaction and chewing ability in patients wearing maxillary dentures. Longer follow-ups are needed to validate this therapy in the medium and long-term.

Purpose: To show the presence and direction of the collagen fiber orientation around platform-switched (PS) and non-platform switched (NPS) implants at the crestal bone level., Materials and Methods: Twelve implants (six PS and six NPS implants) were placed with single-stage surgery in three dogs. The implant abutments were disconnected and reconnected after 8, 10, 12, and 14 weeks. The animals were sacrificed in the 18 week. The specimens were stained with hematoxylin and eosin and examined using polarized light microscopy., Results: The PS implant specimens showed circular fiber orientation at the implant platform level and the NPS implants showed similar fiber orientation at the bone level of the first implant thread. All specimens demonstrated a circular fiber orientation of the collagen fibers at the crestal bone level., Conclusions: The discrepancy in implantabutment diameter involving a change from a wider implant platform to a smaller abutment diameter, described as platform switching, seems to provoke a circular fiber orientation at the implant platform level. Similar circular fiber orientation was found at the first implant thread bone level for regular implants without platform switching. The histologic results support the hypothesis that platform switching can reduce crestal bone loss and can serve as a "mechanical retention factor" for periodontal fiber orientation. More clinical and histologic studies are needed to corroborate this preliminary finding.

Objective: To carry out a histomorphometric analysis of a new highly porous (95%) biphasic calcium phosphate (hydroxyapatite 60%/B-tricalcium phosphate 40%), used to fill critical size defects in rabbit tibiae, supplementing histomorphometric findings with radiographic thermal imaging, EDX analysis and Ca/P ratio mapping at different time stages., Materials and Methods: Two critical size defects of 6 mm diameter were created in both tibiae of 21 New Zealand rabbits, test group (Ossceram) and control group. Histomorphometric, radiographic thermal imaging, EDX and element mapping analysis were performed at 15, 30 and 60 days after graft insertion., Results: Histomorphometric analysis at 30 days showed more new bone formation in defects filled with Ossceram 4.41 ± 0.23 mm than the test group 1.94 ± 0. 28 mm (P<0.05). Element analysis revealed higher percentages of Ca (42.33 ± 2.8%) and P (1.3 ± 0.8%) in the test group than in the control group (P<0.05). Element mapping showed that Ca and P were concentrated in medullar and cortical zones in the test group but were concentrated only in cortical zones in the control group. Test group histomorphometry at 60 days showed complete closure of the cortical defect 5.37 ± 0.32 mm more than the control group 2.3 ± 0.54 mm. There was no cortical defect closure or medullar bone formation in the control group (P<0.05). Element analysis revealed higher percentages of Ca (32.26 ± 21.7%) and P (1.5 ± 0.3%) in the test group than in the control group (P<0.05)., Conclusion: Defects of a critical size in a rabbit tibia model can be sealed using a highly porous biphasic calcium phosphate; this supports new bone formation, creates a bridge between borders and facilitates bone ingrowth. Furthermore, this study observed partial dissolution of the mineral phase of the graft material and its incorporation into the surrounding bone. Radiographic thermal imaging may be used to supplement histological and chemical analyses., (© 2011 John Wiley & Sons A/S.)

Background: Insufficient alveolar bone height often prevents the placement of standard dental implants in the posterior part of edentulous maxilla. In order to increase adequately the vertical dimension of the reabsorbed alveolar process, a sinus lift procedure is often necessary. The aim of this study was to evaluate histologic results of a prehydrated corticocancellous porcine bone used in maxillary sinus augmentation., Methods: Patients (age 18-70 years) with a residual bone height requiring a maxillary sinus augmentation procedure to place dental implants were eligible for this study. All patients were treated with the same surgical technique consisting of sinus floor augmentation via a lateral approach. The space obtained by elevation of the mucosa wall was grafted with prehydrated and collagenated corticocancellous porcine bone. Biopsies were harvested 6 months after the augmentation procedures., Results: Twenty-four patients were enrolled. The mean percentage of new formed bone was 43.9 ± 18.6% (range 7.5-100%), whereas the mean percentage of residual graft material was 14.2 ± 13.6% (range 0-41.9%). The new bone/residual graft material ratio in the maxillary sinuses was 3.1. The mean soft tissues percentage was 41.8 ± 22.7% (range 0-92.5%)., Conclusion: The present study suggested that porcine bone showed excellent osteoconductive properties and could be used successfully for sinus augmentation. Moreover, the porcine bone showed a high percentage of reabsorption after 6 months; this might be because of the presence of collagen and the porosity of the graft material., (© 2010 Wiley Periodicals, Inc.)

Purpose: Two different stereolithographic surgical guide systems, NobelGuide (Nobel Biocare) and SimPlant (Materialise), were compared clinically, and the survival rates of the planned immediately loaded dental implants with prefabricated provisional restorations were evaluated., Materials and Methods: Patients were treated with implants using either the Materialise SimPlant system or the Nobel Biocare system. All implants were planned on cone beam computed tomography (CBCT) or CT-derived images. Mucosa-, bone-, or tooth-supported stereolithographic guides were produced using the two commercial systems. A provisional was placed immediately after implant insertion in all cases., Results: Fourteen patients were enrolled. Seventy-five implants were placed (34 with Materialise, 41 with Nobel Biocare) using stereolithographic surgical guides. All but one implant were loaded immediately with prefabricated provisionals. In all cases, implants were in place for a minimum of 12 months. No complications related to associated anatomy occurred. One implant failed, leading to a combined cumulative survival rate of 98.7%. There were no other intraoperative or postoperative complications. Implants placed by bone-supported guides had increased patient symptoms of postoperative swelling and discomfort. All provisionals were successful., Conclusions: Both types of stereolithographic surgical templates were sufficiently accurate in transferring the planned implant positions to the surgical field, allowing the placement of prefabricated provisionals. These technologies are most beneficial in patients in whom the simultaneous placement of multiple implants in combination with complex restorations is planned.

The aim of this study was to evaluate the force decay of two brands of orthodontic elastics, both offering latex and non-latex products. Samples were subjected to continuous stretching, measuring force at 5 seconds, 8 hours, and 24 hours in both dry and wet conditions. Five hundred samples were used, GAC® and Lancer® 0.25 inch and 4 oz, divided into testing sample sizes of n = 25 per group. For the dry test, elastics were kept stretched to three times their internal diameter for 5 seconds (initial force), 8 hours, and 24 hours; for the wet test, they were stretched for 8 and 24 hours. Both brands showed initial forces significantly greater than those specified by the manufacturers (P < 0.05). Comparing wet/dry conditions, there was a greater force loss in the wet medium than the dry. As for elastic composition (latex or non-latex), the only significant difference found was between Lancer elastics with and without latex in dry conditions, force loss being greater for latex-free elastics. Comparing brands, there was greater force loss with GAC than with Lancer. Comparing elastic force at the eight-hour mark and the twenty-four hour mark to the initial force (only in wet conditions), GAC latex and non-latex and Lancer latex elastics showed significantly less force at eight and twenty four hours than initially. On the other hand, Lancer non-latex was the only type of elastics that did not show a significant decrease in its initial elastic characteristics at eight hours in wet conditions. Nevertheless, Lancer non-latex did show significantly less force in wet conditions at twenty four-hours than the forces observed initially and at eight-hours.

Purpose: The aim of this study was to evaluate the effect of a new porcine biomaterial and collagen paste in 20 New Zealand rabbits., Materials and Methods: Forty implants using a porcine xenograft made up of 80% corticocancellous collagenated bone particles of ≤300 μm in size were placed in the proximal metaphyseal area of both tibiae. Four periods of time were formed: 1h, 5, 8, and 15 months. After implantation, an anteroposterior and lateral radiological study was carried out. Samples were sectioned at 5 μm and stained using hematoxylin-eosin, Masson's trichromic, and Gordon-Switt reticulin stains., Results: These results confirmed the biocompatibility of this porcine biomaterial-collagen paste; only a few, occasional macrophages and scattered lymphocytes were observed. No fibrosis was observed between the implants and the bone. Moreover, the material was osteoconductive acting as a "scaffold" for bone cells, and there was a progressive increase in bone growth in and around the implants., Conclusion: This new porcine biomaterial-collagen paste seemed to be biocompatible, bioresorbable, and osteoconductive.

Purpose: The aim of the present study was to evaluate bone remodeling and bone-to-implant contact (BIC) after immediate placement at different levels in relation to the crestal bone of Beagle dogs., Materials and Methods: The mandibular bilateral second, third and fourth premolars of six Beagle dogs were extracted and six implants were immediately placed in the hemi-arches of each dog. Randomly, three cylindrical and three tapered implants were inserted crestally (control group) and 2 mm subcrestally (experimental group). Both groups were treated with a minimal mucoperiosteal flap elevation approach. A gap from the buccal cortical wall to the implant was always left. Three dogs were allowed a 4-week submerged healing period and the other three an 8-week submerged healing period. The animals were sacrificed and biopsies were obtained. Biopsies were processed for ground sectioning. Histomorphometric analysis was carried out in order to compare buccal and lingual bone height loss, and BIC between the two groups., Results: All implants osseointegrated clinically and histologically. Healing patterns examined microscopically at 4 and 8 weeks for both groups (crestal and subcrestal) yielded similar qualitative bone findings. The distance from the top of the implant collar to the first BIC in the lingual crest (A-Lc) showed a significant difference (P=0.0313): 1.91 ± 0.2 mm in the control group and 1.08 ± 0.2 mm in the experimental group. There was less bone resorption in subcrestal implants than crestal implants. The mean percentage of newly formed BIC was greater with the cylindrical implant design (46.06 ± 4.09%) than with the tapered design (32.64 ± 3.72%)., Conclusion: These findings suggest that apical positioning of the top of the implant does not jeopardize bone crest and peri-implant tissue remodeling. However, less resorption of the Lc may be expected when implants are placed 2 mm subcrestally., (© 2011 John Wiley & Sons A/S.)

Objective: The aim of this prospective clinical study was to evaluate the survival rates at 5 years of expanded platform implants placed in the anterior zone of the maxilla and immediately restored with single crowns., Materials and Methods: Implants incorporating the platform-switching concept were placed in fresh extraction sockets in the maxillary arch, with each patient receiving a provisional restoration immediately after implant placement. After 15 days, final screwed restorations were inserted. Mesial and distal bone heights were evaluated using digital radiography on the day following implant placement and at 1, 3, 6, 9, 12, 24, 36 months and 5 years. Primary stability was measured with resonance frequency analysis (RFA) using the Osstell Mentor device. Sixty-four implants were placed in 32 men and 32 women ranging in age between 29 and 60 (mean: 39.64 ± 5.16 years)., Results: Mean mesial bone loss was 0.08 mm (SD 0.42). Mean distal bone loss was 0.14 mm (SD 0.56). Over the course of the 5 years, the mean RFA value was 72.5 ± 3.1 SD., Conclusion: The platform-switched implants remained stable over the course of 5 years and had an overall survival rate of 97.1%., (© 2011 John Wiley & Sons A/S.)

Although the metal devices used in orthodontic treatments are manufactured highly resistance to corrosion, they may still suffer some localized corrosion resulting from the oral cavity conditions. The corrosion causes the release of metals from the alloys used for their manufacture. In this report, we evaluated the in vivo metal ions release of three alloys (stainless steel, titanium and nickel-free) usually used in the orthodontics treatments and its genotoxicity. We applied to 15 patients, between 12 and 16 years, 4 tubes and 20 brackets. Samples from oral mucosa were taken before the treatment and 30 days later. The concentration of the titanium, chromium, manganese, cobalt, nickel, molybdenum and iron were detected using inductively coupled plasma mass spectrometry (ICP-MS). The genotoxicity was measured with a comet assay (Olive moment). The oral mucosa cells in contact with the stainless steel alloy displayed the greatest titanium and manganese concentrations and those in contact with the nickel-free alloy presented the greatest concentration of chromium and iron. Both alloys, stainless steel and nickel-free, induced a higher DNA damage in the oral mucosa cells than the titanium alloy, in which the Olive moment was similar to controls. Based on the results of our study, we can conclude that titanium brackets and tubes are the most biocompatible of the three alloys.

Introduction: After a tooth extraction, the height of the buccal wall tends to decrease. The literature indicates that regenerative techniques (guided bone regenerative [GBR] techniques) have succeeded in improving the bone levels. Therefore, this experiment set out to compare the physiological bone remodelling in Beagle dog models after implant placement in a fresh extraction socket, with and without the application of regenerative procedure., Materials and Methods: Five dogs were used in this study. Test and control sites were randomly selected. The experimental teeth (fourth pre-molar and first molar) were hemi-sected removing the distal roots and placing implants. Porcine bone was placed to fill the gap around the implant on the test sites and a reabsorbable membrane was used to cover the area. The dogs were put down at different times (2 weeks, 1 month and 3 months). The measurements were taken immediately and at 2, 4, 12 weeks after implant placement. Student's test for paired data was used to compare the means of the clinical measurements., Results: At 2 weeks: On the control sites, few signs of resorption were detected at the first molar only, while at the test sites bone levels were placed at the implant shoulder or above. At 4 weeks: On the control site, slight bone remodelling was observed, while on the test site minor signs of resorption or an increase of bone levels were detected. At 12 weeks: The alveolar crest on the control sites showed various degrees of remodelling. On the test sites stable bone levels or an increase of bone crest was observed., Conclusion: With the limits of this study, the findings showed that GBR techniques were able to limit resorption of the alveolar crest after tooth extraction. A pattern of bone remodelling after tooth extraction and implant placement was observed in the control sites (no GBR) as well as in test sites (GBR), and although the exact cause of this is unclear, surgical trauma could play a role. Further studies are necessary to confirm these results and to clarify the precise causes of bone remodelling in fresh extraction sockets., (© 2011 John Wiley & Sons A/S.)

Objective: To carry out a radiological and histomorphometric evaluation of bone response to bovine bone implants inserted in rabbits' tibiae., Materials and Methods: Twenty New Zealand rabbits weighing 3900-4500 g were used. Twenty bovine bone implants (Endobon) in granulated form of 500-1000 μm granulometry were inserted in the proximal metaphyseal area of the animals' right tibia and 20 control areas were located in the proximal metaphyseal area. Following implantation, the animals were sacrificed in four groups of five, after 1 month, 2 months, 3 months and 4 months, respectively. Anteroposterior and lateral radiographs were taken. Samples were sectioned at 5 μm and stained using Hematoxylin-Eosin and Masson's trichromic., Results: After 4 months, radiological images showed complete repair of the bone defects. No healed or residual bone alterations attributable to the presence of the implant were observed. Histomorphometric analysis at 4 months showed the presence of a higher density of newly formed bone with mean values for new bone, residual graft material and non-mineralized connective tissue of 22.8 ± 1.5%, 39.4 ± 2.3% and 37.7 ± 2.5%. There were no statistically significant differences in the length of cortical formation with bovine bone, 98.8 ± 1.1%, compared with the control group, 99.1 ± 0.7%, at the end of the study period., Conclusions: The biomaterial used in the study was shown to be biocompatible, osteoconductive and non-resorbable and as such a possible bone substitute that does not interfere with normal reparative bone processes., (© 2010 John Wiley & Sons A/S.)

Purpose: To carry out a radiological and histomorphometric evaluation of bone response to two xenografts of animal origin, one porcine, and the other bovine, inserted in rabbits' tibiae., Material and Methods: Twenty New Zealand rabbits weighing 3900-4500 g were used. Twenty bovine bone grafts (Endobon) in granulated form of 500-1000 μm granulometry were inserted in the proximal metaphyseal area of the animals' right tibia, and 20 porcine bone grafts (OsteoBiol mp3) in granulated form of 600-1000 μm granulometry were inserted in the proximal metaphyseal area of the animals' left tibia. Following graft insertion, the animals were sacrificed in four groups of five, after 1, 2, 3 and 4 months, respectively. Anteroposterior and lateral radiographs were taken. Samples were processed for observation under light microscopy. Histomorphometric measurements were presented as mean values ± standard deviations., Results: At 4 months after treatment, the bone defects displayed radiological images that showed complete repair of osseous defects. Histomorphometric evaluation showed that for the porcine xenograft, the study averages for newly formed bone represented 22.8 ± 1.8%, for residual graft material 23.6 ± 3% and for connective tissue 53.5 ± 2.5%, while for the bovine xenograft newly formed bone represented 23.1 ± 1.8%, residual graft material 39.4 ± 3% and non-mineralized connective tissue 37.5 ± 2.5%., Conclusions: The biomaterials assessed in the study were shown to be biocompatible and osteoconductive. Collagenized porcine xenografts proved more resorbable than bovine xenografts. Both can be used as possible bone substitutes without interfering with normal reparative bone processes., (© 2011 John Wiley & Sons A/S.)

Objective: The aim of this study was to evaluate the effects of topical application of growth hormone (GH) on the osteointegration of dental implants in dogs at 5 and 8 weeks after surgery., Materials and Methods: Mandibular premolars and molars were extracted from 12 Beagle dogs. Four screw implants were placed in each mandible. Before implant placement, 4 IU of GH were applied to the test sites (TS); no treatment was applied to control sites (CS). Morphometric parameters, bone-to-implant contact (BIC), peri-implant connective tissue, interthread bone and newly formed bone were measured. The Student's t-test for was used for statistical analysis of data obtained., Results: After 5 weeks of treatment, BIC values varied slightly between 34.33 ± 2.35% (CS) and 35.76 ± 2.96% (TS). Interthread bone tissue was 64.08 ± 8.68 at CS and 72.86 ± 2.93 at TS, with statistical significance (P<0.05). Bone neoformation was 72.53 ± 4.54 at the CS and 80.74 ± 1.65 for the GH group, these being statistically significant differences (P<0.05). After 8 weeks, BIC had slightly increased for the GH group (36.47 ± 3.09 vs. 39.61 ± 2.34). Interthread bone was 80.57 ± 2.28 at the CS and 82.58 ± 2.44 at the GH site, which was statistically significant. Bone neoformation was 88.09 ± 1.38 at CS and 91.01 ± 1.52 at TS, showing statistical significance (P<0.05)., Conclusion: Topical application of 4 IU of GH like a biomimetic agent at the moment of implant placement has no significant effects on the BIC at 5 and 8 weeks, although bone neoformation and inter-thread bone values did increase significantly., (© 2010 John Wiley & Sons A/S.)

Objective: The aim of this study was to present a series of clinical cases on glossopharyngeal neuralgia as well as the therapeutic approach used., Patients and Methods: This observational, descriptive, and retrospective study was carried out on 14 patients who were diagnosed with glossopharyngeal neuralgia between the years 1997 and 2007 at the Oral-Facial and Implant Surgery Department and at the Otorhinolaryngology, Neurology, and Neurosurgery Departments of the Madrid University Hospital., Results: The study consisted of 8 women and 6 men. The neuralgia was found predominantly on the left side, and considering the 4 areas of topographical distribution into which the distribution of the ninth nerve is divided, the results of our study showed that the maximum of the areas affected was 3, with 2 areas being the most common. Accompanying symptoms were only recorded in 4 of the cases. In 12 of the cases, initial treatment was with prescription drugs consisting of different doses of carbamazepine. In the remaining cases, or once the other course of treatment was proven to be unsuccessful, surgical treatment was used, applying different techniques and obtaining a high rate of success with them., Conclusions: Glossopharyngeal neuralgia is an uncommon pathology that is treated with medicine or surgery, with carbamazepine and vascular microdecompression being the treatments of choice., (Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

This study evaluated the suitability of femtosecond laser for microtexturizing cylindrical zirconia dental implants surface. Sixty-six cylindrical zirconia implants were used and divided into three groups: Control group (with no laser modification), Group A (microgropored texture), and Group B (microgrooved texture). Scanning electron microscopy observation of microgeometries revealed minimal collateral damage of the original surface surrounding the treated areas. Optical interferometric profilometry showed that ultrafast laser ablation increased surface roughness (R(a), R(q), R(z), and R(t)) significantly for both textured patterns from 1.2 x to 6 x-fold when compared with the control group (p < 0.005). With regard to chemical composition, microanalysis revealed a significant decrease of the relative content of contaminants like carbon (Control 19.7% ± 0.8% > Group B 8.4% ± 0.42% > Group A 1.6% ± 0.35%) and aluminum (Control 4.3% ± 0.9% > Group B 2.3% ± 0.3% > Group A 1.16% ± 0.2%) in the laser-treated surfaces (p < 0.005). X-ray diffraction and Raman spectra analysis were carried out to investigate any change in the crystalline structure induced by laser processing. The original predominant tetragonal phase of zirconia was preserved, whereas the traces of monoclinic phase present in the treated surfaces were reduced (Control 4.32% > Group A 1.94% > Group B 1.72%) as the surfaces were processed with ultrashort laser pulses. We concluded that femtosecond laser microstructuring offers an interesting alternative to conventional surface treatments of zirconia implants as a result of its precision and minimal damage of the surrounding areas., (© 2010 Wiley Periodicals, Inc.)

The aim of the present experimental study was to evaluate the physiologic bone remodeling in beagle dogs following the placement of small-diameter (3.25 mm) implants in fresh extraction sites. Five 1-year-old beagle dogs that weighed approximately 10 to 13 kg each were used in this study. The third and fourth premolars (P3, P4) were used as experimental teeth, which were hemisected using a fissure bur; the distal roots were removed carefully using forceps. Implants (3.25-mm wide, 10- or 11.5-mm long) were placed in the fresh extraction sockets with the neck of the implant at the level of the buccal bone crest. The dogs were subsequently put to sleep according to the following schedule: one dog 15 days after implant placement, two dogs after 1 month, and the remaining two dogs after 3 months. The distance from the implant shoulder to the bone wall crest was measured at both the buccal and lingual sites. The width of the buccolingual bone crest was measured using a caliper. Assessments were made immediately after root extraction and at 2, 4, and 12 weeks after implant placement. The mean width of the buccolingual bone crest was 4.5 ± 0.5 mm at the time of root extraction. Subsequently, at 2, 4, and 12 weeks after implant placement, the buccolingual bone width was 4.1 ± 0.5 mm, 3.7 ± 0.3 mm, and 3.5 ± 0.7 mm, respectively. Two weeks after implant placement, the lingual bone crest was measured at 0.2 ± 0.3 mm from the implant shoulder, while the buccal bone crest was 0.3 ± 0.3 mm. After 4 weeks of healing, the mean distance from the implant shoulder to the lingual bone crest was 0.1 ± 0.9 mm, compared to 0.4 ± 0.9 mm for the buccal bone crest. After 12 weeks of healing, the bone crest at the lingual sites was -0.3 ± 0.5 mm from the implant shoulder, compared to 0.8 ± 0.3 mm at the buccal sites. The findings from this study show that although vertical bone remodeling was indeed observed, the mean vertical buccal bone resorption was 0.5 mm. It might be suggested, therefore, that the implant position along the lingual wall and the use of implants with a narrow diameter in relation to the extraction socket width play a key role in reducing the rate of vertical bone resorption at the buccal aspect of implants placed in fresh extraction sockets.

Background: The authors conducted a retrospective study to determine the prevalence of supernumerary premolars in sample of patients from Madrid, as well as the possible complications associated with the presence of such supernumerary premolars., Methods: The study included a data assessment of all patients seeking dental care at a hospital's department of oral surgery across four years. The authors studied data from patients who had supernumerary premolars., Results: The authors identified supernumerary premolars in the records of 43 patients (0.32 percent) of the total population studied. These patients had 73 hyperdontic premolars (65 mandibular premolars [89 percent] and eight maxillary premolars [11 percent])., Conclusions: Supernumerary premolars usually are diagnosed as a coincidental radiographic finding without an associated pathology. However, the authors found a higher percentage of comorbidity than they initially expected., Clinical Implications: Mechanical or obstructive pathology was associated with 2.7 percent of the premolars, and enlargement of the follicular sac of more than 3 millimeters was present in 26.0 percent of the sample.

This study evaluated the effect of the topical application of melatonin in accelerating bone formation associated with implants 2 months after their application to the tibiae of rabbits. Twenty New Zealand rabbits were used. Twenty implants treated with melatonin and 20 control implants without melatonin were placed in the proximal metaphyseal area of each tibia. Studies of new bone formation were subsequently made at 15, 30, 45 and 60 days. Cortical width and cortical length of new bone formation were measured. Following implantation, an anteroposterior and lateral radiologic study was carried out. Collected samples were sectioned at 5 μm and stained using hematoxylin-eosin, Masson's trichromic and Gordon-Switt reticulin stains. After a 60 day treatment period, melatonin increased the length of cortical bone (95.13±0.42%) versus that around control implants (62.91±1.45%). Related to the perimeter of cortical bone of the tibiae, melatonin induced new bone 88.35±1.56% versus 60.20±1.67% in the control implants. Melatonin regenerated the width and length of cortical bone around implants in tibiae of rabbits more quickly than around control implants without the addition of melatonin., (© 2010 The Authors. Journal of Pineal Research © 2010 John Wiley & Sons A/S.)

This study evaluated the effect of the topical application of melatonin mixed with collagenized porcine bone on the osteointegration on the rough discrete calcium deposit (DCD) surface implants in Beagle dogs 3 months after their insertion. In preparation for subsequent insertion of dental implants, lower molars were extracted from 12 Beagle dogs. Each mandible received two parallel wall expanded platform implants with a DCD surface of 4 mm in diameter and 10 mm in length. The implants were randomly assigned to the distal sites on each mandible in the molar area and the gaps were filled with 5 mg lyophilized powdered melatonin and porcine bone and collagenized porcine bone alone. Ten histological sections per implant were obtained for histomorphometric studies. After a 4-wk treatment period, melatonin plus porcine bone significantly increased the perimeter of bone that was in direct contact with the treated implants (P < 0.0001), bone density (P < 0.0001), and new bone formation (P < 0.0001) in comparison with porcine bone alone around the implants. Melatonin plus collagenized porcine bone on DCD surface may act as a biomimetic agent in the placement of endo-osseous dental implants and enhance the osteointegration. Melatonin combined with porcine bone on DCD implants reveals more bone in implant contact at 12 wk (84.5 +/- 1.5%) compared with porcine bone alone treated area (67.17 +/- 1.2%).

Unlabelled: The aim of this study was to carry out a bibliographic review of all available literature addressing the issue of whether or not the connection of teeth to implants by means of a prosthesis is a viable treatment alternative. Twenty articles from a variety of sources were analyzed and classified in order to draw conclusions. Articles were classified by type and an analysis was made of the different variables considered in each study, obtaining percentages of implant survival ranging from 84.4% to 100%, prosthetic complications ranging from 80% to 90%, and the incidence of dental intrusion ranging from 0 to 5.6%. Biomechanical studies: Some articles studied models in order to assess different connections subjected to force, in which varying results were obtained. Rigid connections appeared to produce the most stress to the natural tooth, periodontal ligament and peri-implant bone; non-rigid connections reduced the stress to the bone, but increased stress to the prosthesis., Clinical Studies: The results obtained were disparate. Studies in the medium or short-term show this as a viable treatment alternative, whereas some studies point to a greater risk of complications, although the use of rigid connection decreases the percentage of intrusion. Other bibliographic reviews have concluded that there is a need for more longitudinal studies on the viability of tooth-implant connection, also concluding that complications are greater when this is the chosen treatment. As a viable alternative with an acceptable success rate, this course of treatment is always associated with rigid connection rather than non-rigid connection. Although intrusion is avoided with rigid connection, this nevertheless remains inadvisable as the primary treatment choice.

Purpose: The aim of this study was to evaluate crestal bone resorption and bone apposition resulting from immediate post-extraction implants in the canine mandible, comparing a conditioned sandblasted acid-etched implant surface with a non-conditioned standard sandblasted implant surface., Material and Methods: In this experimental study, third and fourth premolars and distal roots of first molars were extracted bilaterally from six Beagle dog mandibles. Each side of the mandible received three assigned dental implants, with the conditioned surface (CS) on the right side and the non-conditioned surface (NCS) on the left. The dogs were sacrificed at 2 (n=2), 4 (n=2) and 12 weeks (n=2) after implant placement., Results: The microscopic healing patterns at 2, 4 and 12 weeks for both implant types (CS and NCS) yielded similar qualitative bone findings. The mean crestal bone resorption was found to be greater for all implants with NCS (2.28+/-1.9 mm) than CS (1.21+/-1.05 mm) at 12 weeks. The mean percentage of newly formed bone in contact with implants was greater in implants CS (44.67+/-0.19%) than with the NCS (36,6+/-0.11%). There was less bone resorption with the CS than the NCS., Conclusion: The data show significantly more bone apposition (8% more) and less crestal bone resorption (1.07 mm) with the CS than with the NCS after 12 weeks of healing. This CS can reduce the healing period and increase bone apposition in immediate implant placements.

Bisphosphonates inhibit bone resorption and are used to treat a range of pathologies, including Paget disease, osteoporosis, multiple myeloma and metastases associated with breast or prostate cancer. At present, there is no effective treatment for bisphosphonate induced osteonecrosis, so prevention is extremely important. Since quality of life deteriorates for those suffering osteonecrosis, maximum precautions should be taken with patients at risk, and especially whenever oral surgery, including dental implant placement, is contemplated. Dentists and oral or maxillofacial surgeons must keep up to date with the latest approaches to prevention, particularly when treating patients who are presently taking, or who will be taking bisphosphonates and are also candidates for dental implants.

Purpose: To review published articles dealing with platform switched implants in order to assess survival rates and clarify their influence both on marginal bone loss around the cervical region of the implant and on soft tissue aesthetics., Material and Methods: PubMed and GallileUM databases were used to identify any studies or clinical cases involving implant platform switching published between January 2000 and August 2008. Studies both of human beings and animals were reviewed whenever they included the relevant implant diameter, length, surface and connection data., Results: Twelve studies of platform switching in humans (75%) and in animal models (25%) were evaluated. Mean implant length was found to be 11.66 +/- 0.2 SD mm and mean diameter was 4.9+/- 0.52 SD mm., Conclusion: It was shown that platform switching helps to prevent crestal bone loss after implant placement and helps obtain satisfactory aesthetic results.

The aim of this study was to evaluate the effect of the topical application of melatonin mixed with collagenized porcine bone to accelerate the osteointegration on the rough discrete calcium deposit (DCD) surface implants in Beagle dogs 3 months after their insertion. In preparation for subsequent insertion of dental implants, lower premolars and molars were extracted from 12 Beagle dogs. Each mandible received three parallel wall implants with discrete calcium deposit (DCD) surface of 4 mm in diameter and 10 mm in length. The implants were randomly assigned to the distal sites on each side of the mandible in three groups: group I implants alone, group II implants with melatonin and group III implants with melatonin and porcine bone. Prior to implanting, 5 mg lyophylized powdered melatonin was applied to one bone hole at each side of the mandible. None was applied at the control sites. Ten histological sections per implant were obtained for histomorphometric studies. After a 4-wk treatment period, melatonin significantly increased the perimeter of bone that was in direct contact with the treated implants (P < 0.0001), bone density (P < 0.0001), new bone formation (P < 0.0001) in comparison with control implants. Topical application of melatonin on DCD surface may act as a biomimetic agent in the placement of endo-osseous dental implants and enhance the osteointegration. Melatonin combined with porcine bone on DCD implants reveals more bone to implant contact at 12 wk (84.5 +/- 1.5%) compared with melatonin treated (75.1 +/- 1.4%) and nonmelatonin treated surface implants (64 +/- 1.4%).

Objective: The objective of this study was to test whether or not there is an association between generalized joint hypermobility (measured using the Beighton score) and temporomandibular joint disk displacement in women who had sought medical attention for temporomandibular disorders (TMD)., Study Design: We studied 66 women who were attending the clinic for TMD. The patients were examined for joint hypermobility, and Beighton scores were calculated. When it was suspected that a patient suffered arthropathic complaints, magnetic resonance imaging of both temporomandibular joints was performed with the mouth closed and at maximal opening. The Pearson chi-squared test was used to test for an association between generalized joint hypermobility and disk displacement., Results: We were unable to confirm the existence of an association between generalized joint hypermobility and temporomandibular joint disk displacement in women (chi(2) = 1.523; P = .02)., Conclusion: Generalized joint hypermobility may be a factor related to TMD, but we did not find an association between generalized joint hypermobility and anterior disk displacement in women.

In this third article we describe the pharmacological interactions resulting from the use of anti-microbial agents. Although the antimicrobials prescribed in odontology are generally safe they can produce interactions with other medicaments which can give rise to serious adverse reactions which are well documented in clinical studies. Antibiotics with grave and dangerous life threatening consequences are erythromycin, clarithromycin and metronidazol and the anti-fungal agents are ketoconazol and itraconazol. Regarding the capacity of the anti-microbials to reduce the efficacy of oral anti-contraceptives the clinical studies to date are inconclusive, however, it would be prudent for the oral cavity specialist to point out the risk of a possible interaction. Therefore the specialist should be aware of possible interactions as a consequence of administering an antibiotic together with other medicaments the patient may be taking.

In this second article we describe the more interesting pharmacological interactions in dental practice based on the prescription of analgesic narcotics, paracetamol and non-selective non-steroid anti-inflammatory drugs (NSAI) (which inhibit cyclooxigenase 1 -COX 1- and cyclooxigenase 2 -COX 2-) and selective NSAIs (COX 2 inhibitors). The importance of preventing the appearance of these pharmacological interactions is because these are medicaments prescribed daily in odontology for moderate pain treatment and inflammation in the oral cavity. Paracetamol can interact with warfarin and therefore care should be taken with chronic alcoholic patients. All NSAIs reduce renal blood flow and consequently are capable of reducing the efficacy of medicaments used for treating arterial hypertension, which act via a renal mechanism. Especial attention should be taken considering the risk of interaction between the antagonists of AT1 receptors of angiostensin II (ARAII) and the NSAIs.

This article is the first of a series on pharmacological interactions involving medicaments commonly prescribed and/or used in odontology: vasoconstrictors in local anaesthetics and anti-inflammatory and anti-microbial analgesics. The necessity for the odontologist to be aware of adverse reactions as a result of the pharmacological interactions is due to the increase in medicament consumption by the general population. There is a demographic change with greater life expectancy and patients have increased chronic health problems and therefore have increased medicament intake. The presence of adrenaline (epinephrine) and other vasoconstrictors in local odontological anaesthetics is beneficial in relation to the duration and depth of anaesthesia and reduces bleeding and systemic toxicity of the local anaesthetic. However, it might produce pharmacological interactions between the injected vasoconstrictors and the local anaesthetic and adrenergic medicament administered exogenically which the odontologist should be aware of, especially because of the risk of consequent adverse reactions. Therefore the importance of conducting a detailed clinical history of the general state of health and include all medicaments, legal as well as illegal, taken by the patient.

Objective: The aim of this study was to report on our experience and outcomes with Certain Prevail Implants and immediate loading via the Diem System after a 16-month follow-up period., Materials and Methods: Over a 16-month period, 105 (14 maxilla, 91 mandible) expanded-platform implants were placed in 18 patients (15 females, 3 males; 55.97 +/-7.25 SD years). Resonance frecuency analysis (RFA) was measured on the day of placement and at 3, 12 and 16 months. All prostheses were screw mounted on IOL DIEM standard abutments. The follow-up time varied between 3 up to 16 months., Results: One implant (0.9%) failed during final prothetic placement (3 months).The RFA (ISQ) measurements at 16 months evalution for 4 mm- and 5 mm diameter implants were: 76.13 +/- 5.0 SD and 76 +/-7.7 SD respectively. The RFA data related to mandible and maxilla, the day 0 mean was 76.47 +/- 4.75 SD and 70.13 +/- 1.35 SD, at 3 months 70.53 +/- 4.0 SD and 66.07 +/-2.9 SD, at 12 months 68.23+/- 3.6 SD and 66.40 +/-2.7 SD and 16 months 68.23+/- 3.6 SD and 66.60 +/- 2.5 SD respectively. The crestal bone resorption was 0.6 mm at 16 months in platform switching implants., Conclusions: The cumulative implant survival rate during the follow-up period was 99.1% Immediate loading on IOL Diem abutments is a reliable and effective technique for edentulous patients in the maxilla and mandible.

Background: The preservation of bone volume immediately after tooth removal might be necessary to optimize the success of implant placement in terms of esthetics and function. The objectives of this randomized clinical trial were two-fold: 1) to compare the bone dimensional changes following tooth extraction with extraction plus ridge preservation using corticocancellous porcine bone and a collagen membrane; and 2) to analyze and compare histologic and histomorphometric aspects of the extraction-alone sites to the grafted sites., Methods: Forty subjects who required tooth extraction and implant placement were enrolled in this study. Using a computer-generated randomization list, the subjects were randomly assigned to the control group (EXT; extraction alone) or to the test group (RP; ridge-preservation procedure with corticocancellous porcine bone and collagen membrane). The following parameters were assessed immediately after extraction and 7 months prior to implant placement: plaque index, gingival index, bleeding on probing, horizontal ridge width, and vertical ridge changes. A bone biopsy was taken from the control and test sites 7 months after the surgical treatment. Histologic and histomorphometric analyses were also performed., Results: A significantly greater horizontal reabsorption was observed at EXT sites (4.3+/-0.8 mm) compared to RP sites (2.5+/-1.2 mm). The ridge height reduction at the buccal side was 3.6+/-1.5 mm for the extraction-alone group, whereas it was 0.7+/-1.4 mm for the ridge-preservation group. Moreover, the vertical change at the lingual sites was 0.4 mm in the ridge-preservation group and 3 mm in the extraction-alone group. Forty biopsies were harvested from the experimental sites (test and control sites). The biopsies harvested from the grafted sites revealed the presence of trabecular bone, which was highly mineralized and well structured. Particles of the grafted material could be identified in all samples. The bone formed in the control sites was also well structured with a minor percentage of mineralized bone. The amount of connective tissue was significantly higher in the extraction-alone group than in the ridge-preservation group., Conclusions: The ridge-preservation approach using porcine bone in combination with collagen membrane significantly limited the resorption of hard tissue ridge after tooth extraction compared to extraction alone. Furthermore, the histologic analysis showed a significantly higher percentage of trabecular bone and total mineralized tissue in ridge-preservation sites compared to extraction-alone sites 7 months after tooth removal.

Narrow alveolar ridges remain a serious challenge for the successful placement of endosseous implants. This article reports a technique for widening the atrophic ridge by splitting the alveolar bone longitudinally and filling the bone gap with collagenised pig bone, treatment of ridges as thin as 2.5mm at the alveolar crest and simultaneous placement of dental implants. Treatment of a 22-year-old female patient with a severely resorbed anterior maxilla is described. 4mm wide by 13mm long threaded Osseotite implants were immediately placed within the split ridge and surrounded with a mixture of autogenous tuberosity and collagenised pig bone. The advantages of this technique for patients include less surgical trauma and reduced treatment time.

Purpose: This article describes how the concept of platform switching has been incorporated into a new implant design as a method of reducing crestal bone loss and maintaining the gingival papillae. A 6-month study of the effects of this implant on bone loss is described., Materials: Ten new platform switched implants were placed into fresh anterior maxillary extraction sites in 3 men and 7 women, ranging in age between 29 and 45 years old, and immediately provisionalized. The adjoining bone height was evaluated with digital radiography on the day after implant placement, and at 15 days, 1, 2, 3, and 6 months later., Results: After 6 months, the mean bone loss on the mesial of the central-incisor implants was 0.05 mm. The mean bone loss was 0.07 mm on the distal of the central incisor implants, 0.07 mm on the mesial of the lateral-incisor implants, and 0.06 mm on the distal of the lateral-incisor implants., Conclusions: An implant design that incorporates the concept of platform switching is a simple and effective way to control circumferential bone loss around dental implants, helping to ensure a predictable esthetic result.

Aim: The aim of this article is to assess the efficiency of the technique for the posterior alveolar expansion and elevation of the upper maxillary alveolar ridge through the use of compressive osteotomes (Quirurgical Bontempi, España) which have been specifically designed for Osseotite NT and Osseotite NT Certain of 3i implants (Implants Innovations, USA)., Materials and Methods: 24 adult patients (16 female and 12 male), who were selected according to Albrektsson's inclusion and exclusion criteria, took part in the study. All the patients presented bone deficiency in the width and height of the upper maxilla. 48 Osseotite implants were performed (four Osseotite Standard; six Osseotite NT; 38 NT Certain (3i, Implants Innovations, CA, USA)). Implant diameters were 4 mm in 44 cases and 5 mm in 4 cases with lengths varying between 11.5 (n = 4) and 13 mm (n = 44). The alveolar ridges of the 24 patients had initial widths from 1.5 mm to 5 mm and heights between 5 and 13 mm., Results: The data obtained were analysed using the SPSS 11.0 program. In the 48 areas treated with immediate implants, an increase in bone height of 6.75 mm -/+ 1.25 mm was achieved. In the case of the alveolar expansion for the 48 implants, the average was 3.2 mm -/+ 0.15 mm., Conclusions: The technique for alveolar expansion and elevation of the upper maxilla with compressive osseotomes can lead to a 100% success rate after a 9-month follow-up of the implants and insertion of prostheses. It is a highly predictable surgical procedure which allows implants to be performed at the same time as surgery, thus reducing the number of such interventions while recovering aesthetic and functional losses in the patient.

Maxillary alveolar atrophy often limits the placement of dental implants. This article reports on a refinement of a technique for widening the atrophic ridge by splitting the alveolar bone longitudinally. Treatment of a patient with a severely resorbed edentulous maxilla is described. Six 4-mm wide by 13-mm long threaded Osseotite implants were placed immediately within the split ridge and surrounded with a mixture of autogenous tuberosity and bovine bone. The advantages of this technique for patients include less surgical trauma and condensed treatment time.

Implant dentistry has evolved from a functional replacement of teeth to an aesthetically driven replacement of the natural tooth system. An immediate implant insertion after extraction may maintain the crestal bone and the interdental gingival soft tissue. With proper design, the implant gingival complex will heal to restore the correct gingival environment. In this prospective study, 18 Osseotite (3i, USA) implants were placed in 13 patients (8 women and 5 men with an average age of 32 years), using an immediate implant placement protocol and immediate loading by provisional crowns. Using the life table analysis method, the cumulative implant success rate was calculated at 100 per cent. A one-year interim report indicates that the implant developed and extended; functional osseous state show a predictable and reliable method after one year follow up period.