Search

Purpose: This study sought to define the tissue responses at different implant-abutment interfaces by studying bone and peri-implant mucosal changes using a 5-year prospective randomized clinical trial design study. The conus interface was compared with the flat-to-flat interface and platform-switched implant-abutment systems. Materials and Methods: One hundred forty-one subjects were recruited and randomized to the three treatment groups according to defined inclusion and exclusion criteria. Following implant placement and immediate provisionalization in healed alveolar ridges, clinical, photographic, and radiographic parameters were measured at 6 months and annually for 5 years. The calculated changes in marginal bone levels, peri-implant mucosal zenith location, papillae lengths, and peri-implant Plaque Index and bleeding on probing were statistically compared. Results: Forty-eight conus interface implants, 49 flat-to-flat interface implants, and 44 platform-switched implants were placed in 141 subjects. Six platform-switched interface and eight flat-to-flat interface implants failed, most of them within 3 months. After 5 years, 33 conical interface, 28 flat-to-flat interface, and 27 platform-switched interface implants remained for evaluation. Calculation of marginal bone level change showed a mean marginal bone loss of -0.16 ± 0.45 (-1.55 to 0.65), -0.92 ± 0.70 (-2.90 to 0.20), and -0.81 ± 1.06 (-3.35 to 1.35) mm for conical interface, flat-to-flat interface, and platform-switched interface implants, respectively (P < .0005). The peri-implant mucosal zenith changes were minimal for all three interface designs (0.10 mm and +0.08 mm, P > .60). Only 16% to 19% of the surfaces had presence of bleeding on probing, with no significant differences (P > .81) between groups. Interproximal tissue changes were positive and similar among the implant interface designs. Conclusion: Over 5 years, the immediate provisionalization protocol resulted in stable peri-implant mucosal responses for all three interfaces. Compared with the flat-to-flat and platform-switched interfaces, the conical interface implants demonstrated significantly less early marginal bone loss. The relationship of marginal bone responses and mucosal responses requires further experimental consideration. [ABSTRACT FROM AUTHOR]

Purpose: The goal of this investigation was to define time-dependent peri-implant tissue changes at implants with different abutment interface designs. Materials and Methods: Participants requiring replacement of single maxillary anterior and first premolar teeth were recruited and treated under an institutional review board (IRB)-approved protocol. Implants, titanium abutments, and provisional crowns were placed in healed ridges 5 months following preservation after tooth extraction with recombinant human bone morphogenetic protein-2 (rhBMP-2). Twelve weeks later, permanent crowns were placed on patient-specific abutments and evaluated at 6, 12, and 36 months following implant placement. Clinical and radiographic assessments of abutments and crowns, peri-implant mucosa, and marginal bone levels were recorded. Results: The 3-year assessment included 45 conical interface (CI), 34 flat-to-flat interface (FI), and 32 platform-switched interface (PS) implants in 111 participants. At 3 years, the mean marginal bone level (MBL) change at CI, FI, and PS implants was -0.12, -1.02, and -1.04 mm, respectively (P = .014). "Zero" MBL loss or gain was measured over the 3-year period at 72.1% CI, 3.0% FI, and 16.6% PS implants. There was a minor change (0.0 to 0.3 mm) in peri-implant mucosal zenith positions over time and between groups. Eighty percent of CI implants, 61% of FI implants, and 84% of PS implants were observed to have a clinically stable periimplant mucosal zenith position with less than 0.5 mm of measured recession. Over the 36-month period, there were no significant changes in the location of mesial or distal papilla in any group. Conclusion: Significant differences in MBLs were observed at different implant interfaces. Conical implant interfaces, but not flat-to-flat or platform-switched implant interfaces, were associated with no MBL changes over 3 years. Peri-implant mucosal stability was generally observed. The relationship of marginal bone responses and peri-implant mucosal stability requires further evaluation. [ABSTRACT FROM AUTHOR]

Purpose: The implant-abutment interface may affect peri-implant mucosal architecture, and influence health and esthetics. The goal of this 1-year follow-up report of a 5-year clinical investigation was to examine the peri-implant mucosal tissue responses to different implant-abutment interface designs. Materials and Methods: Subjects requiring an anterior maxillary implant were recruited. Tooth extractions, with or without preservation or ridge augmentation procedures, were performed as required. After 5 months of healing, one of three different implant-abutment combinations (conical interface [CI] n = 48); flat-to-flat interface [FI] n = 49); or platform switch interface [PS] n = 44) was placed and provisionalized. Twelve weeks later, permanent crowns were placed and data gathered throughout the first year. Peri-implant mucosal architecture and bone levels were evaluated clinically, photographically, and radiographically. Results: At 1 year, seven FI and six PS implants failed and two FI and two PS implant participants were lost to follow-up, resulting in survival rates of 100% (CI), 85.7% (FI), and 86.4% (PS) (90.8% overall). Marginal bone level changes were -0.22 mm (CI, P < .05), -1.2 mm (FI, P < .05), and -1.32 mm (PS, P < .05) after 1 year. Marginal bone level stability (< 0.5-mm bone loss or gain) was recorded for 87% (CI), 8% (FI), and 27% (PS) of implants. Measurement of midbuccal mucosal zenith and papilla positions revealed no change in the mucosal positions and 0.2 to 0.3 mm of gain in papilla dimensions in all groups. Conclusion: Significant differences in marginal bone loss were observed among the three implant-abutment interfaces. At 1 year follow-up, changes in the buccal mucosal zenith position or papilla dimensions were not discernable. A continued longitudinal evaluation of peri-implant bone and mucosal changes around these different interfaces is ongoing. [ABSTRACT FROM AUTHOR]

This clinical study assessed at 5 years both implant survival and peri-implant tissue architecture of immediately provisionalized implants placed 4 to 6 months following augmentation with demineralized bovine bone allograft and collagen membrane. Of 23 implants in 19 patients, one implant failed prior to loading (95.6% survival). Implant tissue relationships were stable following implant placement; marginal bone level changes from implant placement to 5 years (mean ± SD: -0.18 ± 0.79 mm, range: -1.6 to 1.4 mm, P = .51), the mesial and distal papilla length changes (mesial mean ± SD: 1.14 ± 0.92 mm, P < .001; distal mean ± SD: 0.74 ± 1.46 mm, P = .04), and the unchanged mucosal zenith location (mean ± SD: 0.24 ± 0.93 mm, P = .15) were recorded. There were no major surgical complications during the 5-year period. When augmentation is required, subsequent dental implant placement in the anterior maxilla may be achieved using immediate placement and provisionalization protocol to attain osseointegration success and stable peri-implant tissue responses. [ABSTRACT FROM AUTHOR]

Purpose: This 5-year prospective multicenter study compared implant survival and success, peri-implant health and soft tissue responses, crestal bone level stability, and complication rates following immediate loading of single OsseoSpeed implants placed in anterior maxillary healed ridges or extraction sockets. Materials and Methods: Individuals requiring anterior tooth replacement with single implants were treated and immediately provisionalized. Definitive all-ceramic crowns were placed at 12 weeks. Implant survival, bone levels, soft tissue levels, and peri-implant health were monitored for 5 years. Results: One hundred thirteen patients received implants in fresh sockets (55) and healed ridges (58). After 5 years, 45 and 49 patients remained for evaluation, respectively. During the first year, three implants failed in the extraction socket group (94.6% survival) and one implant failed in the healed ridge group (98.3% survival); this difference was not significant. No further implant failures were recorded. After 5 years, the interproximal crestal bone levels were located a mean of 0.43 ± 0.63 mm and 0.38 ± 0.62 mm from the reference points of implants in sockets and healed ridges (not a significant difference). In both groups, papillae increased over time and peri-implant mucosal zenith positions were stable from the time of definitive crown placement in sockets and healed ridges. Compared to flap surgery for implants in healed ridges, flapless surgery resulted in increased peri-implant mucosal tissue dimension (average, 0.78 ± 1.34 mm vs 0.19 ± 0.79 mm). Conclusion: After 5 years, the bone and soft tissue parameters that characterize implant success and contribute to dental implant esthetics were similar following the immediate provisionalization of implants in sockets and healed ridges. The overall tissue responses and reported implant survival support the immediate provisionalization of dental implants in situations involving healed ridges and, under ideal circumstances, extraction sockets. [ABSTRACT FROM AUTHOR]

Purpose: Buccal bone responses following dental implant placement are considered significant determinants of esthetic outcomes. The aim of this pilot study was to evaluate whether cone beam computed tomography (CBCT) could be used to measure buccal alveolar bone changes following implant placement. The second aim of this investigation was to determine both qualitatively and quantitatively if changes could be determined 1 year postoperatively at the buccal aspect of implants placed in healed ridges or extraction sockets. Materials and Methods: Twenty patients in need of a single tooth in the maxillary anterior or first premolar region were recruited under an institutional review board-approved protocol. Patients were allocated into two groups: those missing a tooth with a healed alveolar ridge and those needing an extraction. Following treatment planning, implants were placed and immediately loaded. Zirconia abutments and all-ceramic crowns were delivered 16 weeks following implant placement. CBCT images of the maxilla were obtained at three different time points; 2 weeks before surgery, immediately after surgery, and 12 months after implant placement. A single examiner measured each implant three times in four different sites. The data between different implants or subjects were compared among groups by the nonparametric sign test. Results: Evaluation of the CBCT images revealed that it was possible to discern the presence or absence of the buccal bone plate both prior to and 1 year following implant placement in the majority of subjects. The median alteration after 1 year for the vertical distance from the abutment/implant interface to the buccal alveolar bone crest for all subjects was -1.12 mm (P = .018). The horizontal alteration of the buccal bone measured 1 mm apical to the implant/abutment interface was -0.62 mm (P = .004). At the midimplant and apical regions of the implants, the 1-year horizontal bone alteration was -0.57 mm (0.004) and -0.19 mm (P = .059), respectively. Conclusions: Buccal bone and alterations following implant placement may be visualized by CBCT in both extraction sockets and healed ridges. When the implant was appropriately displaced from the buccal wall of the socket, bone changes could be qualitatively evaluated by CBCT 1 year following placement. [ABSTRACT FROM AUTHOR]

Prosthodontic and implant treatment for a patient with polymyalgia rheumatica can be complicated not only by its symptoms, but also by the side effects of long-term use of certain medications, particularly systemic glucocorticoids. This clinical report presents a polymyalgia rheumatica patient who required full-mouth rehabilitation with dental implants. The patient had a sensitive gag reflex and refused the use of any removable prostheses. She presented clinically with a skeletal Class II malocclusion with severe overbite and overjet. All her remaining dentition was determined to be unrestorable. Full-mouth extractions and immediate placement of implants followed by early implant loading were performed. The use of systemic glucocorticoids might have exacerbated her type 4 maxillary bone and compromised her healing capacity and consequently made implant surgery challenging. Her treatment with full-arch fixed implant-supported dentures to correct her severe overbite and overjet and manage misaligned dental implants is summarized here. The effects of polymyalgia rheumatica in prosthodontic and dental implant treatments are reviewed and discussed. Int J Oral Maxillofac Implants 2010;25:1241-1245. [ABSTRACT FROM AUTHOR]

Purpose: The primary goal of this study was to compare implant survival 12 months after immediate loading of single implants placed in healed ridges versus extraction sockets. Secondary outcomes were to compare marginal bone adaptation and soft tissue changes over time. Materials and Methods: A prospective multicenter clinical investigation was initiated to assess clinical performance of immediately loaded implants in the maxilla. Implant survival was ascertained at the time of impression making (8 to 10 weeks) and after 1 year by clinical stability. Radiographic marginal bone levels, soft tissue levels, and plaque and bleeding scores were compared with baseline values (implant placement and provisionalization). Results: One hundred thirty-nine patients received 157 implants in the maxilla. Single implants with provisional crowns were placed in extraction sockets of 55 patients (58 implants) and in healed ridges of 60 patients (65 implants). In addition, 19 patients (23 implants) required bone grafting prior to implant placement, and 11 implants in 10 patients among all groups were not immediately loaded because of insufficient initial stability after surgery. Three implants (5.2%) failed in extraction sites and one implant (1.5%) failed in a healed ridge. The mean change in marginal bone level 1 year after implant placement was 1.30 mm (SD 2.52) (gain) in extraction sockets and -0.40 mm (SD 1.43) (loss) in healed ridges. The mucosal zenith was stable or moved incisally following definitive crown placement in 83.7% of immediate implants and 87.0% of implants placed in healed ridges. Plaque and inflammation scores were low and did not differ between groups. Conclusions: The responses of local bone and soft tissues at immediately loaded implants placed in extraction sockets or healed ridges were similar. Furthermore, these 1-year results suggest that clinical management of esthetically critical soft tissue may be predictably achieved in both indications. Int J Oral Maxillofac Implants 2010;25:1222-1232. [ABSTRACT FROM AUTHOR]

Heterotopic ossification is defined as the formation of bone in sites where it does not normally exist. Myositis ossificans is classified as a type of heterotopic ossification, where bone formation occurs following soft tissue trauma. A case is presented of a 65-year-old female patient, diagnosed with maxillary and mandibular atrophy, in whom myositis ossificans developed secondary to iliac crest bone harvesting for preprosthetic augmentation prior to placement of maxillary and mandibular implants. Approximately 3 months after bone was harvested from the right anterior iliac crest, and despite a routine recovery from the bone grafting procedure, the patient developed persistent pain, described in her own words as "incapacitating," in the right lower quadrant of her abdomen. She was evaluated by a number of different specialists before a diagnosis of myositis ossificans was reached by her orthopedist. Management of the pain proved difficult, but eventually the symptoms improved to the extent that there was minimal disruption to her daily activities. Implant placement and prosthodontic treatment concluded to the patient's satisfaction. It may be advisable to include the possibility of occurrence of heterotopic ossification and resultant pain as a specific preoperative warning when iliac crest bone harvesting is planned to prepare patients for this potentially serious complication and to avoid litigation. [ABSTRACT FROM AUTHOR]

The rehabilitation of failing implant-supported overdentures often can become a complicated endeavor. The task of restoring a case in which the implant(s) is fractured or is old and has been discontinued with no replacement parts available frequently is quite problematic. This article describes the use of the LOCATOR® Overdenture Implant (LODI) to rehabilitate a patient with a mandibular implant-retained overdenture following the failure of her 32-year-old transosteal implant. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 29 year old male complaining on a comprised ability to deliver the maximum amount of air pressure to mouth pieces of musical instruments. On oral examination, the absence of several teeth was found. The patient's missing mandibular incisors are replaced with a cast metal removable partial denture. It was confirmed radiographically that he suffers from moderate generalized periodontitis and a unilateral cleft of the hard palate and right alvelous.

Aim The purpose of this prospective multicenter clinical study was to compare 3 years implant survival, bone and soft tissue changes following immediate loading using single Osseospeed™ implants (Astra Tech AB, Mölndal, Sweden) installed in healed ridges or extraction sockets. Material and methods Implants were provisionally restored the day of surgery using cemented acrylic crowns out of full occlusion. The provisional crowns were replaced after 12 weeks by full-ceramic crowns. Implant survival, bone levels, soft tissue levels and peri-implant health were monitored up to 3 years. Results 55 patients (22 men, 33 women; mean age 45) had the implant installed in extraction sockets and 58 patients (25 men, 33 women; mean age 42) received conventional implant treatment in healed ridges. Three implants failed in the extraction group and one implant failed in the healed group, all failures occurred before the final crown placement. No further losses occurred during 3 years, giving a statistically comparable survival rate of 94.6% and 98.3%, respectively. The total bone loss after 3 years, compared to implant placement was 0.4 mm ( SD 1.5) in healed sites, whilst the immediate sites showed a bone gain of 1.6 mm ( SD 2.4) due to bone fill in the alveolus. Papillae retracted with 0.3 and 0.0 mm in the period of provisionalization, but grew back after final crown was placed with 0.3 and 0.5 mm in extraction and healed sites respectively after 3 years. Plaque and inflammation scores were very low throughout the study time, irrespective of treatment modality. Conclusions Immediate implants restored at the day of surgery show comparable risk for implant failure, bone loss and midfacial soft tissue recession compared to conventionally installed implants. The 3-years results suggest both hard and soft tissue stability. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction Methods Results Conclusion Palateless overdentures (PLODs) provide advantages of improved taste perception and retention over conventional dentures. We aimed to evaluate 5‐year outcomes of four implant maxillary PLODs.In this prospective observational study, edentulous participants were enrolled. A new conventional maxillary denture was prepared followed by implant placement and insertion of four implant retained maxillary PLOD. Oral health quality of life was assessed using the 49‐item Oral Health Impact Profile (OHIP‐49) at multiple intervals over 5 years along with biological and mechanical outcomes.Nine patients were evaluated at year 5. The mean age was 68 years, and six of the nine patients were males. The cumulative survival rate of implants was 100% while the implant success rate was 86%. Nylon retentive replacement was the most common encountered complication noted approximately four times per patient over 5 years. From a mean OHIP‐49 severity score of 71.2 at baseline, severity scores decreased to 23.9 (p < 0.001) at year 1, denoting a clinically meaningful and statistically significant improvement in oral health quality of life. The lowered OHIP‐49 severity scores remained stable throughout 5 years of follow‐up.Four implant supported maxillary overdenture appears to have good patient perceived, biological and mechanical outcomes over 5 years. Fully powered studies are needed to replicate these findings. [ABSTRACT FROM AUTHOR]