Clinical Implant Dentistry and Related Research
Lindgren C, Mordenfeld A, Hallman M. A prospective 1-year clinical and radiographic study of implants placed aftermaxillary sinus floor augmentation with synthetic biphasic calcium phosphate or deproteinized bovine
bone. Clin Implant Dent Relat Res 2012;14(1):41-50.
Bilateral elevation of the sinus membrane was performed in nine edentulous and two partially edentulous patients. Augmentation was performed with synthetic biphasic calcium phosphate (BCP (Straumann BoneCeramic))on one side and deproteinized bovine bone (DBB) on the contralateral side. A total of 62 implants were placedafter 8 months and evaluated for 1 year. One implant in each biomaterial was lost, giving an implant survivalrate of 96.8% for both materials, while the implant success rates were 91.7% and
95.7% in BCP and DBB, respectively. No significant differences in marginal bone loss were found between thematerials. Implant success was therefore independent of the augmentation material in sinus augmentation.
Rasmusson L, Thor A, Sennerby L. Stability evaluation of implants integrated in grafted and nongrafted maxillarybone: a clinical study from implant placement to abutment connection. Clin Implant Dent Relat Res
A total of 260 implants were placed in 35 edentulous patients, 25 of whom had severe maxillary atrophy; of these,19 received lateral onlay block grafts on one side (group A), particulate bone on the other (group B) and sinusaugmentation with particulate bone (group C). A LeFort operation with interpositional bone grafts was performed insix patients (group D), while the remaining 10 received implants without bone augmentation (group E; control). Fourimplants (two each in groups A and D) were removed due to mobility at abutment connection. A slight increase inimplant stability was noted from implant placement to abutment connection in all groups, but the difference was notsignificant. ISQ values were significantly lower in group D compared to all other groups.
Implant Dent Relat Res 2012;14(1):80-87.
In 20 patients, implants were placed to replace single teeth after either 4 or 12 weeks. Clinical and periodontal parameters were recorded at baseline and annually thereafter, while functional and aesthetic outcomes were evaluated after 3 and 10 years. The implant survival rate was 100% after 10 years, and the crown survival ratewas 90%. Mean marginal bone loss was < 1 mm after 10 years in both groups; bone loss was > 1.5 mm in onepatient and between 1-1.4 mm in three patients. Patient satisfaction was observed to decrease over time.
A total of 106 edentulous or partially edentulous patients received 516 implants; augmentation was performed prior toplacement for 153 implants, while 23 implants were placed post-radiation and 64 implants were irradiated afterplacement. For a mean follow-up time of 108 months, the implant survival rate was 89.7%; 83 patients with 403implants were available for follow-up investigation. In 26 patients, implants had been removed due to lack ofosseointegration (22 implants), peri-implantitis (18 implants), implant fracture (nine implants), failing of primary stability (two implants) and placement next to tumours (two implants). The success rate was 76% to 89%,depending on the success criteria used.
Cecchinato D, Bressan EA, Toia M, Araújo MG, Liljenberg B, Lindhe J. Osseointegration in periodontitis
susceptible individuals. Clin Oral Implants Res 2012;23(1):1-4.
In 36 patients who had lost teeth due to periodontitis (19 patients) or other reasons (17 patients), a block of hardtissue was removed by trephine and hard tissue lateral to the biopsy site was prepared for the placementof micro implants (5 mm long, 2.2 mm diameter). The implants and surrounding tissue were removed after 3months and evaluated. Healing was similar in both periodontitis-susceptible and non- susceptible patients, withsimilar bone-to-implant contact (BIC) and mineralized bone between implant threads. At biopsy sites, there was aweak negative correlation between volume of fibrous tissue and length of BIC, and a weak positive correlationbetween volume of bone marrow and BIC.
Fornell J, Johansson L-Å, Bolin A, Isaksson S, Sennerby L. Flapless, CBCT-guided osteotome sinus floorelevation with simultaneous implant installation. I: radiographic examination and surgical technique. A prospective1-year follow-up study. Clin Oral Implants Res 2012;23(1):28-34.
Preoperative CBCT with a titanium screw post in the intended implant position was performed in 14 patients requiring sinus augmentation. A total of 21 implants (10 and 11 in residual bone of 2.6-4.9 mm and 5-8.9 mm, respectively) were placed and evaluated after 3, 6 and 12 months. Permanent prostheses were provided after
8-12 weeks. No marginal bone loss was noted during the follow-up period. Flapless transalveolar sinus lift guided byCBCT can therefore be a successful procedure.
Palmer RM, Howe LC, Palmer PJ, Wilson R. A prospective clinical trial of single Astra Tech 4.0 or 5.0 diameterimplants used to support two-unit cantilever bridges: results after 3 years. Clin Oral Implants Res
Single implants were placed to support two-unit cantilever prostheses in the premolar/molar regions of 29 patients. High patient satisfaction was noted, and the most important complication was abutment screw loosening(single in four patients and recurrent in six patients). Stable bone levels were observed, with no differences betweencantilever and non-cantilever sides. Single implants can therefore be successfully used to support two-unitcantilever prostheses in the premolar region.
Zembić A, Johannesen LH, Schou S, Malo P, Reichert T, Farella M, Hämmerle CHF. Immediately restored one-piece single-tooth implants with reduced diameter: one-year results of a multi-center study. Clin Oral ImplantsRes 2012;23(1):49-54.
A total of 47 patients received 57 one-piece implants, which were immediately restored with provisional resin
crowns. Permanent crowns were placed after 1.9-14.5 months. Radiographs were taken at implant placement andafter 6 and 12 months, and periodontal parameters were assessed. After 1 year, 54 implants in 44
patients were available for follow-up. The implant survival rate was 98%. Significant bone loss was observed between baseline and 6 months and between 6 and 12 months; bone loss was > 3 mm at 18% of implants. Although the survival rate was high, the excessive bone loss indicated that this implant should be used with cautionuntil further data are available.
Schneider D, Witt L, Hämmerle CHF. Influence of the crown-to-implant length ratio on the clinicalperformance of implants supporting single crown restorations: a cross-sectional retrospective 5-year investigation.Clin Oral Implants Res 2012;23(2):169-174.
Clinical and radiographic assessments, including marginal bone level and crown/implant length ratio, were performed in 70 patients with 100 implants supporting single crowns. The mean follow-up period was 6.2 yearsand the cumulative implant survival rate was 95.8% after 5 years. Mean technical and biological crown/implantratios were 1.04 ± 0.26 and 1.48 ± 0.42, respectively, and there was no significant influence on implant survival,marginal bone level or the occurrence of complications; only smoking was significantly associated with implantfailure and complications.
Schwarz F, Sahm N, Becker J. Impact of the outcome of guided bone regeneration in dehiscence-typedefects on the long-term stability of peri-implant health: clinical observations at 4 years. Clin Oral Implants Res2012;23(2):191-196.
Residual defect height (RDH) for dehiscence-type defects at implants was assessed after 4 months of
submerged healing following augmentation with natural bone mineral and either a cross-linked or collagen membrane. RDH vales were 0 mm (control), 1 mm (test 1) and > 1 mm (test 2). Clinical parameters were recorded4 years after prosthesis placement. Mean probing depth was comparable in all groups, and mean mucosal recession and bleeding on probing were increased in the test groups. A higher risk of developing peri-implantdisease was therefore observed for RDH values > 1 mm.
Dierens M, Vandeweghe S, Kisch J, Nilner K, De Bruyn H. Long-term follow-up of turned single implants placedin periodontally healthy patients after 16-22 years: radiographic and peri-implant outcome. Clin Oral Implants Res2012;23(2):197-204.
From an original 134 patients, implant survival could be assessed after at least 16 years in 101 patients, and
50 were clinically examined. Bone level was assessed at 1-4 years, 5-8 years and 16-22 years, and periodontalparameters were recorded. Of 166 implants, 11 failed, giving a cumulative implant survival rate of
91.5%. Mean bone level was 1.7 ± 0.88 mm after 16-22 years, and changes in bone level were significant betweenbaseline and 1-4 years. Bone level ≤ 2nd thread was present at 81.4% of the implants and probing depth > 5 mmwas present at 91.5% of implants; 76.3% of implants had both. A steady-state bone level was generally observed,but progressive bone loss was observed at a minority of implants.
Hämmerle CHF, Jung RE, Sanz M, Chen S, Martin WC, Jackowski J; On behalf of the multicenter study group,Ivanoff C-I, Cordaro L, Ganeles J, Weingart D, Wiltfang J, Gahlert M. Submerged and transmucosal healing yieldthe same clinical outcomes with two-piece implants in the anterior maxilla and mandible: interim
1-year results of a randomized, controlled clinical trial. Clin Oral Implants Res 2012;23(2):211-219.
Implant placement with either submerged or transmucosal healing was performed in the anterior maxilla and/ormandible in 127 patients. Clinical and radiographic measurements were taken at implant placement and after 6 and12 months. The mean change in crestal bone level from baseline to 6 months was -0.32 mm and -0.29 mm in thesubmerged and transmucosal groups, respectively, while the change from baseline to 12 months was -0.47 mm and-0.48 mm in the submerged and transmucosal groups, respectively; the differences between the groups were notsignificant. Good results for soft tissue parameters and patient satisfaction were obtained. The results indicatedthat submerged and transmucosal healing of implants were equally successful.
Urban T, Kostopoulos L, Wenzel A. Immediate implant placement in molar regions: risk factors for earlyfailure. Clin Oral Implants Res 2012;23(2):220-227.
The study enrolled 92 patients requiring single implants to replace a molar. Following immediate implant placement, the remaining defects were filled using autologous bone, Ossix membrane, or a combination of
both. After 4 months of submerged healing, healing abutments were connected. Implants with dehiscences on ≥ 2sites and ≥ 50% visible threads were deemed failures, and regression analyses were performed to identify the riskfor failure. There were 15 implant failures. Failure was not influenced by treatment group, but the risk factorsidentified for failure were smoking > 10 cigarettes/day and infection.
European Journal of Oral Implantology
Esposito M, Cannizarro G, Soardi E, Pellegrino G, Pistilli R, Felice P. A 3-year post-loading report of a
implants in vertically augmented bone? Eur J Oral Implantol 2011;4(4):301-311.
A total of 60 patients with residual crest 7-8 mm high and ≥ 5.5 mm thick received one to three short implants orlonger implants in vertically augmented bone. Provisional acrylic prostheses were placed after 4 months andreplaced by definitive metal-ceramic prostheses after another 4 months. Augmentation failed in two patients, soshort implants had to be used. No significant differences in prostheses or implant failures were noted between thegroups, but there were significantly more complications in the augmented patients. Mean bone loss after 3 yearswas 1.24 mm in the short implant group and 1.76 mm in the augmented group; the difference was significant. Shortimplants may therefore be a suitable alternative to vertical augmentation.
De Angelis N, Felice P, Pellegrino G, Camurati A, Gambini P, Esposito M. Guided bone regeneration with and withouta bone substitute at single post-extractive implants: 1-year post-loading results from a pragmatic multicentrerandomised controlled trial. Eur J Oral Implantol 2011;4(4):313-325.
Bone augmentation at single immediate post-extractive implants was performed in 80 patients using either resorbable barrier alone or in combination with a bone substitute. Implants were loaded after 4 months. There wereseven implant failures (five and two in the membrane and combination groups, respectively). The mean bone levelover 1 year changed from -0.21 mm to -1.04 mm in the combination group and from -1.92 mm to -
1.76 mm in the membrane group. Patients were equally satisfied with both treatments. The aesthetic outcomesappeared to be improved by the use of the bone substitute material.
Felice P, Soardi E, Piattelli M, Pistilli R, Jacotti M, Esposito M. Immediate non-occlusal loading of immediate post-extractive versus delayed placement of single implants in preserved sockets of the anterior maxilla: 4- month post-loading results from a pragmatic multicentre randomised controlled trial. Eur J Oral Implantol
A total of 106 patients received single immediate post-extraction implants in the maxilla or socket preservation using anorganic bovine bone and a collagen membrane, with delayed implants placed after 4 months.The implants were restored with provisional non-occlusive crowns, replaced by definitive crowns after 4 months.Immediate loading was not possible for 19 implants in the immediate placement groups and
39 implants in the delayed placement group, due to insertion torque > 35 Ncm not being obtained. There were twoimplant failures in the immediate group and none in the delayed group, and there were significantly more minorcomplications in the immediate group. No significant differences were found between the groups for aesthetics, andpatients in both groups were equally satisfied.
Hosseini M, Worsaae N, Schiodt M, Gotfredsen K. A 1-year randomised controlled trial comparing zirconia versusmetal –ceramic implant supported single-tooth restorations. Eur J Oral Implantol 2011;4(4):347-361. Implants wereplaced in 36 patients with premolar agenesis to support all-ceramic (38) or metal-ceramic (37) restorations, andbiological and technical outcomes were recorded after 1 year. No implants failed and there was no significantdifference in marginal bone loss between the groups. Marginal adaptation at all-ceramic crowns was less optimalthan at metal-ceramic crowns, but the colour match of all-ceramic crowns was significantly better than metal-ceramic crowns. In addition, more inflammatory reactions were recorded at all- ceramic restorations (sevencompared to three for metal-ceramic).
Perelli M, Abundo R, Corrente G, Saccone C. Short (5 and 7 mm long) porous implant in the posterior atrophicmandible: a 5-year report of a prospective study. Eur J Oral Implantol 2011;4(4):363-368.
A total of 55 short implants (5 or 7 mm in length) were placed in 40 patients and left to heal for 4 months beforebeing loaded with single crowns (21 implants), splinted to adjacent implants (32 implants), or loaded withoverdentures (two implants). The follow-up period was 5 years. Nine implants were removed and there
were four crown failures, but no complications were noted during the healing period. Severe peri-implantitis occurredat two implants, necessitating implant removal. After 5 years, survival rates were 84% and 80% at the implant andpatient levels, respectively.
Babbush CA, Brokloff J. A single-center retrospective analysis of 1001 consecutively placed NobelActive
implants. Implant Dent 2012;21(1):28-35.
For a follow-up period of up to 31 months, the cumulative survival rate for 1001 implants was 97.4% (97.1 %
and 98% in the maxilla and mandible, respectively.
Degidi M, Nardi D, Daprile G, Piattelli A. Buccal bone plate in the immediately placed and restored maxillary singleimplant: a 7-year retrospective study using computed tomography. Implant Dent 2012;21(1):62-66. Patient recordsfor patients with a CT scan taken within 24 hours of single, immediate post-extraction implant placement werescanned, and a CBCT scan was performed after 7 years. A total of 2,980 records were reviewed, of which 16met the inclusion criteria. There were 13 eligible patients, 12 of whom agreed to follow- up. One implant failed;CBCT was performed for the remaining 11 implants. Vertical mean resorption of 0.5 mm at the buccal aspectwas observed, and the mean thickness of the buccal bone plate was 0.9 mm; moderate vertical and horizontalreabsorption was therefore observed,
International Journal of Oral and Maxillofacial Implants
Roe P, Kan JYK, Rungcharassaeng K, Lozada JL. Immediate loading of unsplinted implants in the anterior
mandible for overdentures: 3-year results. Int J Oral Maxillofac Implants 2011;26(6):1296-1302.
Each of eight patients received two unsplinted implants to support a mandibular overdenture. Clinical and radiographic evaluations were performed at implant placement and after 3 months and 1, 2 and 3 years. All implants were in place after 3 years, and the mean marginal bone level change was -0.58 ± 0.39 mm. Plaque indexshowed an improvement in the first year but some relapse thereafter, and there was a high incidence of complete orpartial fracture of the overdentures; however, peri-implant tissue responses were favourable.
Al-Nawas B, Kämmerer PW, Morbach T, Ophoven F, Wagner W. Retrospective clinical evaluation of aninternal tube-in-tube dental implant after 4 years, with special emphasis on peri-implant bone resorption. Int J OralMaxillofac Implants 2011;26(6):1309-1316.
A total of 382 implants were placed in 127 patients. For the 4-year follow-up, 104 patients with 318 implants
were contactable. Of 318 implants, 307 were still in place, giving an implant survival rate of 96.5% for a mean follow-up time of 32 months. Implant success rates were 94% (according to the Albrektsson criteria) and 97% (according tothe Buser criteria), calculated from 75 patients with 240 implants. Significantly less bone resorption was observedfor subcrestally placed implants. Promising long-term results were therefore observed.
Butz F, Bachle M, Ofer M, Marquardt K, Kohal RJ. Sinus augmentation with bovine hydroxyapatite/syntheticpeptide in a sodium hyaluronate carrier (PepGen P-15 Putty): a clinical investigation of different healing times. Int JOral Maxillofac Implants 2011;26(6):1317-1323.
Bilateral sinus augmentation was performed with PepGen P-15 in 24 edentulous patients, and biopsies were takenafter 2, 4, 6 and 9 months for histologic and histomorphometric evaluation. Distinct trabecular bone encompassing remnants of PepGen P-15 was observed, and osteoblasts and osteoid with osteocytes were observed in thevicinity of the PepGen P-15 particles at all healing stages. An increase in newly formed bone fraction was observed over time. The results indicated that PepGen P-15 may be suitable for maxillary sinus augmentation.
Cochran DL, Jackson JM, Bernard J-P, ten Bruggenkate CM, Buser D, Taylor TD, Weingart D, Schoolfield JD,Jones AA, Oates TW Jr. A 5-year prospective multicenter study of early loaded titanium implants with asandblasted and acid-etched surface. Int J Oral Maxillofac Implants 2011;26(6):1324-1332.
A total of 439 implants were placed in 135 partially and fully edentulous patients, with abutments connected after 6weeks in type II and III bone and after 12 weeks in type IV bone. Evaluations were performed for up to
5 years, after which the cumulative implant survival and success rates were 99.1% and 98.8%, respectively; alimplant failures were between surgery and 1 year. SLA-surfaced implants can therefore be loaded after 6 weeks intype II and III bone and maintain high survival and success over 5 years.
Norton MR. The influence of insertion torque on the survival of immediately placed and restored single-toothimplants. Int J Oral Maxillofac Implants 2011;26(6):1333-1343.
Failing teeth were extracted and 68 implants immediately placed using a low insertion torque protocol (≤ 25
Ncm) in 61 patients. The 5-year implant survival rate was 95.5% and the mean marginal bone loss for 54 implantsfollowed for 24 months was 0.23 ± 0.60 mm and 0.20 ± 0.72 mm mesially and distally, respectively. No significantcorrelations were observed between insertion torque, age, gender, implant size, tooth position and marginal boneloss. A low insertion torque protocol can therefore result in high survival rates.
International Journal of Periodontics and Restorative Dentistry