Clinical Oral Implants Research
Collaert B, Wijnen L, De Bruyn H. A 2-year prospective study on immediate loading with fluoride-modified
implants in the edentulous mandible. Clin Oral Implants Res 2011;22(10):1111-1116.
Each of 25 patients received five fluoride-modified implants that were immediately functionally loaded with provisional restorations. Marginal bone loss was evaluated at placement and after 3, 6, 12 and 24 months. Implantsurvival was 100%, and mean bone loss values were 0.14 mm, 0.13 mm, 0.11 mm and 0.11 mm after 3, 6, 12and 24 months, respectively. Mean bone loss after 24 months at the patient level was 0.12 ±
0.14 mm, while the mean probing depth and bleeding index were 2.45 ± 0.43 mm and 0.55 ± 0.34%, respectively.Immediate loading of fluoride-modified implants may therefore be a predictable treatment option.
Mangano C, Mangano F, Shibli JA, Ricci M, Sammons RL, Figliuzzi M. Morse taper connection implants
study. Clin Oral Implants Res 2011;22(10):1117-1124.
A total of 60 patients received 288 implants with a Morse taper connection (152 in maxillae and 136 in mandibles), and bar-retained overdentures were planned to be supported by four implants. Implant survival after 5years was 98% (97.4% and 98.6% in the maxilla and mandible, respectively); 98.6% of the surviving implants wereclassified as successful. The mean distance from the implant shoulder to the first crestal bone was 0.7 ± 0.53 mm,and there were few prosthetic complications.
Cordaro L, Torsello F, Morcavallo S, di Torresanto VM. Effect of bovine bone and collagen membranes on healingof mandibular bone blocks: a prospective randomized controlled study. Clin Oral Implants Res
A total of 22 ridges with horizontal alveolar deficiency were treated with multiple mandibular blocks for horizontalaugmentation only (control) or with additional deproteinized bovine bone at the periphery and over the graft (test);collagen membranes were then placed. A total of 55 implants were placed after 4 months: crest width wasmeasured before and after augmentation, and before implant placement. No significant differences in width werenoted between groups at baseline and after grafting, with mean augmentation values of 4.18 mm and 4.57 mmin the test and control groups, respectively. Augmentation values at implant placement were 3.93 mm and 3.67 mmin the test and control groups, respectively. Mean graft resorption was significantly greater in the control group, butslightly more complications were noted in the test group. All implants were successful after 24 months. Graftresorption was therefore minimised by the additional use of bovine bone mineral.
Vasak C, Watzak G, Gahleitner A, Strbac G, Schemper M, Zechner W. Computed tomography-basedevaluation of template (NobelGuide)-guided implant positions: a prospective radiological study. Clin Oral Implants Res 2011;22(10):1157-1163.
Eighteen patients with partially or fully edentulous maxillae and mandibles received a total of 86 implants via
the NobelGuide protocol. Pre- and post-operative CT scans were taken and merged into Procera planning software. Mean deviations at the implant shoulder were 0.43 mm (bucco-lingual), 0.46 mm (mesio-distal) and
0.53 mm (depth) and at the apex were 0.7 mm (bucco-lingual), 0.63 mm (mesio-distal) and 0.52 mm (depth). Themaximum deviation (2.02 mm) was seen in the corono-apical direction. Deviations were significantly lower inthe anterior versus posterior regions and in the mandible versus the maxilla, and there was a significant correlationbetween deviation and mucosal thickness. All maximum deviations were within the recommended safety margins.
van Brakel R, Noordmans HJ, Frenken J, de Roode R, de Wit GC, Cune MS. The effect of zirconia andtitanium implant abutments on light reflection of the supporting tissues. Clin Oral Implants Res
In 11 patients, Ti or ZrO2 abutments were placed on 15 implants and hyper-spectral images were taken. High resolution images at 70 nm intervals were obtained within 30 s, and black-and-white references were used for special and spectral normalisation and correction for motion. Reflection spectra were then obtained from the images from 1 mm above the soft tissue to 3 mm apically. The median soft tissue height was 2.3 mm, and a rapidincrease in buccal mucosa thickness was observed in an apical direction. At a mucosa thickness of 2.0
± 0.1 mm, no difference in mucosal light reflection could be detected between Ti and ZrO2 abutments. The difference in light reflection is therefore no longer noticeable to the human eye for a mucosal thickness of at least 2mm.
Enkling N, Jöhren P, Klimberg V, Bayer S, Mericske-Stern R, Jepsen S. Effect of platform switching on peri-implant bone levels: a randomized clinical trial. Clin Oral Implants Res 2011;22(10):1185-1192.
Each of 25 subjects received two implants (diameter 4 mm) in one side of the posterior mandible. After 3 months,the test implant received an abutment of 3.3 mm diameter, while the control implant received an abutment of 4mm diameter, and provisional single-tooth crowns were placed. Subjects were monitored over
1 year, and radiography and microbiological samples were taken at baseline and 3, 4 and 12 months. Mean verticalbone loss after 12 months was 0.53 ± 0.35 mm and 0.58 ± 0.55 mm for the test and control implants, respectively,and the mean intra-individual difference was 0.05 ±0.56 mm. Changes in crestal bone level were significantlydependent on time but not on platform switching. The internal spaces of the implants in both
groups were contaminated with bacteria, with no significant difference between test and control. The results did notconfirm the hypothesis of reduced bone loss with platform switching.
Calderón JH, Valencia RM, Casasa AA, Sánchez MA, Espinosa R, Ceja I. Biomechanical anchorage
Thirteen patients received a total of 24 orthodontic sandblasted and acid-etched implants for skeletal anchorage,and anchorage measurements were obtained radiographically every month for 6 months. All implants wereeffective for the trial, but 65% showed ≤ 1° of displacement, while 35% showed ≤ 2° of displacement. Lessdisplacement was observed for mandibular compared to maxillary implants, and less displacement wasobserved in the anterior versus the posterior maxilla. Good bone anchorage was therefore observed withsandblasted and acid-etched orthodontic implants.
Bae M-S, Sohn D-S, Ahn M-R, Lee H-W, Jung H-S, Shin I-H. Retrospective multicenter evaluation of taperedimplant with a sandblasted and acid-etched surface at 1 to 4 years of function. Implant Dent 2011;20(4):280-
Patient records of 92 patients who received a total of 294 implants at three centres over a 3-year period were retrospectively evaluated. The mean observation period was 38 months (range 22 to 59 months) and the cumulative survival rate was 97.3%. The mean bone loss after 1 year of functional loading was 0.33 mm. Clinicallyreliable results were therefore obtained.
Sánchez-Pérez A, Moya-Villaescusa MJ, Caffesse RG. Temperature of periimplant tissues in clinicallysuccessful implants: an observational clinical study in humans. Implant Dent 2011;20(4):292-298.
One clinically and radiologically successful implant in each of 51 patients was examined. Peri-implant temperatures were measured and compared to sublingual temperatures. Significant differences in opera-
implant temperature were found between the fourth and fifth sextants, but the differences were not significant incomparison to sublingual temperature. The mean difference between peri-implant and sublingual temperature was0.81.
International Journal of Oral and Maxillofacial Implants
Marković A, Čolić S, Dražić R, Gačić B, Todorović A, Stajčić Z. Resonance frequency analysis as a reliablecriterion for early loading of sandblasted/acid-etched active surface implants placed by the osteotome sinus
floor elevation technique. Int J Oral Maxillofac Implants 2011;26(4):718-724.
SLActive implants were placed in the posterior maxilla of 27 patients using the osteotome sinus floor elevation technique. RFA was measured at surgery and every week for 6 weeks, after which only implants with anRFA value of ≥ 65 were loaded. Of 42 implants placed, 40 were loaded after 6 weeks (early loading), all of which survived for up to 2 years with no clinical or radiographic complications. Early loading is therefore suitable forSLActive implants placed via the osteotome sinus floor elevation technique if adequate stability is confirmed.
Sun HL, Huang C, Wu YR, Shi B. F ailure r ates of s hor t ( ≤ 10 m m ) dental im plants and f ac tors inf luenc in g their failure: a systematic review. Int J Oral Maxillofac Implants 2011;26(4):816-825.
A literature search was conducted for data on failure and risk factors with short dental implants (≤ 10 mm). A totalof 35 studies met the inclusion criteria, but a meta-analysis was not possible due to the heterogeneity and lowquality of the studies. Of 14,722 implants placed in the studies, 659 failed, giving a total failure rate of
4.5%. Most failures (57.9%) occurred prior to prosthesis placement, and no difference in failure rate was foundbetween short or standard implants, or between those placed in single or two stages. Failure rates were slightlyhigher in the maxilla versus the mandible, and for machined versus rough-surfaced implants.
Schnitman PA, Hwang JW. To immediately load, expose or submerge in partial edentulism: a study ofprimary stability and treatment outcome. Int J Oral Maxillofac Implants 2011;26(4):850-859.
Data from 18 patients who requested immediate loading of implants in areas other than the anterior mandible wereretrospectively analysed. A total of 58 implants were placed, which were loaded immediately, left exposed orsubmerged after surgery based on bone density and primary stability. The implant survival rate was 88%; sevenimplants failed. Mean bone density for the surviving implants was 983 ± 83 for immediately loaded implants, 803 ±29 for exposed implants and 480 ± 23 for submerged implants, and was significantly different between failed andsurviving implants. Primary stability measurements at insertion correlated with bone density and with bone density prior to surgery. Mean insertion torque was also higher for successful implants than failed implants. Stability andbone density measurements may therefore provide a suitable algorithm for decisions on implant loading.
Morea C, Hayek JE, Oleskovicz C, Dominguez GC, Chilvarquer I. Precise insertion of orthodontic miniscrews witha stereolithographic surgical guide based on cone beam computed tomography data: a pilot study. Int J OralMaxillofac Implants 2011;26(4):860-865.
In the dental arches of four patients, acrylic splints were adapted and radiopaque reference points were filled
with gutta percha for CBCT imaging (both with the splint alone and in place in the patient). The placement of miniscrews was then planned using software where the implant position could be visualised in three dimensions and all planes. Stereolithographic drilling guides were then fabricated, and CBCT was performed once more toassess the accuracy of miniscrew placement. Mean differences between the planned and actual positions atthe coronal end, centre and apical tip were 0.86 mm, 0.71 mm and 0.87 mm, respectively, and the mean angulardiscrepancy was 1.76°. Accurate placement could therefore be obtained using stereolithographic surgical guides.
Al-Omiri MK, Hammad OA, Lynch E, Lamey P-J, Clifford TJ. Impacts of implant treatment on daily living. Int J OralMaxillofac Implants 2011;26(4):877-886.
A Dental Impact on Daily Living questionnaire was administered to 80 patients who received dental implants,
and personality profiles were assessed using the NEO Five Factor Inventory (NEO-FFI). The questionnaires were completed prior to implant surgery and 3 months after prosthetic rehabilitation. Satisfaction with
dentition was greater after implant treatment. Satisfaction and impact on daily living were significantly influenced byneuroticism and conscientiousness before and after treatment, were significantly influenced by openness andagreeableness only after treatment, and were significantly influenced by extraversion only before treatment.Daily living and satisfaction were positively influenced by implant-supported prostheses, and may be influenced bythe patients’ personality traits.
Lethaus B, Kälber J, Petrin G, Brandstätter A, Weingart D. Early loading of sandblasted and acid-etchedtitanium implants in the edentulous mandible: a prospective 5-year study. Int J Oral Maxillofac Implants
A total of 60 implants were placed in 14 patients and loaded after 6 weeks; peri-implant bone and mucosal conditions were assessed over 5 years. There were two implant failures and four implants lost to follow-up, so
13 patients with 54 implants were evaluated after 5 years. The 5-year cumulative success rate was 96.7%
and the mean crestal bone loss was 0.77 mm. Early loading of implants after 6 weeks was therefore highly predictable.
International Journal of Periodontics and Restorative Dentistry
Ludovichetti M, Di Stefano DA, Pagnutti S, Vaccari E, Ludovichetti FS, Celletti R. Vertical ridge augmentation
using a flexible heterologous cortical bone sheet: three-year follow-up. Int J Periodontics Restorative Dent
A total of 18 patients received 49 implants in atrophic maxillary or mandibular ridges and simultaneous augmentation with flexible cortical bone sheets. The ridge volume was restored in all patients after 4 months, andall implants were osseointegrated. After 3 years of follow-up, the situation remained unchanged.
El-Chaar ES. Immediate placement and provisionalization of implant-supported, single-tooth restorations: aretrospective study. Int J Periodontics Restorative Dent 2011;31(4):409-419.
A total of 206 implants placed in fresh extraction sockets (with immediate provisionalization and definitive restoration after 2 weeks) were retrospectively evaluated. After a mean follow-up time of 23.1 months, the cumulative survival rate was 98.77%. The outcomes did not appear to be adversely affected by periodontitis and were similar to those achieved for delayed implants.
Pommer B, Frantal S, Willer J, Posch M, Watzek G, Tepper G. Impact of dental implant length on early failure
rates: a meta-analysis of observational studies. J Clin Periodontol 2011;38(9):856-863.
From an electronic and hand search for observational trials on the impact of implant length, 54 studies with a total of19,083 implants were selected. For mandibular implants, implant length appeared to have no effect on implantfailure; however, length had a significant effect for short machined implants in the anterior and posterior maxilla,and a significant effect for short rough-surfaced implants in the anterior maxilla. No influence was observed fordiameter or denture type.
Charalampakis G, Rabe P, Leonhardt Å, Dahlén G. A follow-up study of peri-implantitis cases after treatment.
J Clin Periodontol 2011;38(9):864-871.
From a total of 281 cases of peri-implantitis, 245 were followed up after treatment from between 9 months to
13 years. Peri-implantitis progression was not stopped in 54.7% of the patients, and failure of peri-implantitis treatment was significantly correlated with smoking and early development of the disease. Bone plasty and antibiotics were significantly associated with arrested peri-implantitis lesions. A regression analysis showed development of the disease to be the only independent significant predictor of treatment success.
Sahm N, Becker J, Santel T, Schwarz F. Non-surgical treatment of peri-implantitis using an air-abrasivedevice or mechanical debridement and local application of chlorhexidine: a prospective, randomized, controlledclinical study. J Clin Periodontol 2011;38(9):872-878.
Oral hygiene and either amino acid glycine powder (AAD) or mechanical debridement and chlorhexidine (MDA)were administered to 30 patients with at least one implant with initial to moderate peri-implantitis. Clinicalparameters were assessed at baseline and after 3 and 6 months. The change in mean bleeding on probing wassignificantly higher in the AAD group, while probing depth reduction and clinical attachment level gain werecomparable in both groups.
Cortellini P, Stalpers G, Mollo A, Tonetti MS. Periodontal regeneration versus extraction and prostheticreplacement of teeth severely compromised by attachment loss to the apex: 5-year results of an ongoingrandomized clinical trial. J Clin Periodontol 2011;38(10):915-924.
In 50 patients with at least one hopeless tooth scheduled for extraction, 25 teeth were extracted and replaced with fixed partial dentures (conventional or implant-supported) as the control group, and 25 were treated via a regenerativestrategy. All but one tooth was replaced in the control group; all FPDs survived up to 5 years and
83% were free from biological complications. Clinical improvements were noted in 23 of 25 teeth in the test group;the remaining two were extracted after 1 year. The successfully regenerated teeth remained healthy and functionalup to 5 years and 84% remained free from biological complications. Comfort and function were reported by patientsin both groups and most regenerated teeth showed a reduction in tooth mobility. Regenerative therapy can thereforechange the prognosis of hopeless teeth.
Data were collected from 302 women with a total of 967 implants to assess the relationship between self- reportedosteoporosis and implant success rate. Occurrence of peri-implantitis and late implant failures were the primaryoutcome parameters. The subjects were classified into three groups: osteoporosis (47 subjects), osteopenia (16subjects) and healthy controls (140 subjects). No association was found between peri- implantitis or implant failureand systemic bone loss.
Stavropoulos A, Becker J, Capsius B, Açil Y, Wagner W, Terheyden H. Histological evaluation of maxillarysinus floor augmentation with recombinant human growth and differentiation factor-5-coated β -tricalciumphosphate: results of a multicentre randomized clinical trial. J Clin Periodontol 2011;38(10):966-974. Maxillary sinus floor augmentation was performed in 31 patients using rhGDF-5/β-TCP with a 3- or 4-month healing period,or with β-TCP/corticocancellous autologous bone and a 4-month healing period. A total of 66 implants were placedin 30 patients; one patient withdrew from the study prior to implant placement. Similar proportions of newly formedbone were found between the groups (31.4 ± 17%, 28 ± 15.5% and 31.8 ± 17.9% for rhGDF-5/β-TCP/3 months,rhGDF-5/β-TCP/4 months and β-TCP/autologous bone, respectively), but more β-TCP was found in the β-TCP/autologous bone group (16.5 ± 12.3% compared to 12.6 ± 14.4% and
6.6 ± 6.3% in the rhGDF-5/β-TCP/3 month and rhGDF-5/β-TCP/4 month groups, respectively). The amount andquality of new bone with rhGDF-5/β-TCP was similar to that with β-TCP/autologous bone.
Journal of Oral Implantology
Şençimen M, Gülses A, Özen J, Dergin C, Okçu KM, Ayyıldız S, Altuğ HA. Early detection of alterations in the
In 19 patients, the recipient site for dental implants was evaluated for bone density and subdivided from D1 to D5.Implant stability (ISQ) was measured by resonance frequency analysis for 106 implants at placement and after 21and 60 days. Mean ISQ decreased from baseline to 21 days and increased back to baseline levels at
60 days. No significant relationship between stability changes and bone type were observed, suggesting that bonequality does not influence implant stability in the early stages of osseointegration.
Babbush CA, Kutsko GT, Brokloff J. The All-on-Four immediate function treatment concept with NobelActiveimplants: a retrospective study. J Oral Implantol 2011;37(4):431-445.
A total of 708 implants with an immediately loaded fixed prosthesis (each supported by four implants) in 165 patients were retrospectively reviewed. For a follow-up time of up to 29 months, the cumulative survival rate was99.6% (99.3% and 100% in the maxilla and mandible, respectively). The survival rate for definitive
prostheses was 100%.