Journal of Oral Rehabilitation
J Oral Rehabil. 2012 May 19. doi: 10.1111/j.1365-2842.2012.02315.x. [Epub ahead of print]
Prognosis of immediately loaded implants and their restorations: a systematic literature review.
Key words: Review, immediate loading
This review evaluated the prognosis of immediately loaded implants by considering 9 publications. 5 studies dealt withfixed restorations, 2 with removable overdentures of edentulous patients and two with partially edentulous patients.Implant survival rates ranged from 95.8 - 100%. Implants success rates were in the range of 79.0 - 100.0% (mandible)and restoration survival rates were in the range of 96.4 - 100.0% (both jaws). The authors conclude that appropriatepatient selection, primary implant stability, splinting of implants and the expertise of surgeons seem to be importantfactors for the prognosis of immediately loaded implants and their restorations. However, due to the low evidence levelof some of the reviewed articles, careful interpretation is required. Especially for the outcome of immediately loadedimplants in the maxilla and immediate loading of immediately placed implants.
J Oral Rehabil. Article first published online: 4 JUN 2012
Effect of veneering technique on the fracture resistance of zirconia fixed dental prostheses
Chaar MS, Witkowski S, Strub JR, Att W. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2842.2012.02323.x/citedby Keywords: Zirconia, Fixed dental prosthesis, CAD7CAM
The fracture resistance of zirconia 3-unit frameworks of posterior fixed dental prosthesis (FDPs) was measuredbefore and after artificial aging (through dynamic loading and thermocycling to simulate 5 years of use). The zirconiaframeworks were veneered with different veneering materials and randomly assigned to 3 groups: group LV (layeringtechnique/Vintage ZR), group LZ (layering technique/ZIROX) and group PP (CAD/CAM and press-overtechniques/PressXZr. All specimens survived artificial ageing except for one minor chipping event in group LV1.Artificial ageing significantly reduced the fracture resistance in groups
veneered with the layering technique, whereas no significant effect was found in specimens veneered with the
CAD/CAM and press-over techniques.
Take-home message: All veneered zirconia frameworks have the potential to withstand occlusal forces of theposterior region. The combination of CAD/CAM and press-over techniques for the veneering seems to provide thebest overall stability after artificial ageing.
Clinical Oral Implants Research
Clin Oral Implants Res. 2012 May 17. doi: 10.1111/j.1600-0501.2012.02498.x. [Epub ahead of print]
Impact of implant surface topography: a clinical study with a mean functional loading time of
Key words: Long-term results, Peri-implant bone loss
47 edentulous patients (with a mean age of 72 years) received a total of 188 dental implants with a moderately roughor a machined surface. Peri-implant bone level and soft tissue integration was investigated in the anterior mandibleafter a mean functional loading time of 85 months. Two patients lost 4 implants in total (97.9% survival). Nodifferences were found between implant surfaces for the periodontal parameters. However, the moderately rough-surfaced implants showed significantly less peri-implant bone loss than machine-surfaced implants.
Clin Oral Implants Res. 2012 May 9. doi: 10.1111/j.1600-0501.2012.02482.x. [Epub ahead of print]
Short-term complications of implant-supported and combined tooth-implant-supported fixed dental prostheses.
Key words: Ceramic veneer, Complications, Fixed dental prosthesis
166 fixed dental prostheses (FDPs) were evaluated in 132 patients as part of a retrospective study (91 implant-supported FDPs, 27 implant-supported cantilever FDPs and 48 tooth-implant supported FDPs). All restorations wereveneered with ceramic. 26 had a zirconia framework and 140 had a metal framework. Within a medium follow-up of 14months, two failures were caused by a failed implant and one by extended chipping of the veneer. In contrast to thefailures, complications had a higher incidence and included chipping (n=29), loss of retention (n=35) and abutmentfractures (n=2). Therefore, a tendency towards increased incidence of chipping was determined for zirconia-basedFDPs and for males.
Clin Oral Implants Res. 2012 Jul;23(7):789-96. doi: 10.1111/j.1600-0501.2011.02332.x. Epub 2011 Oct 21. Alveolarprocess preservation at implants installed immediately into extraction sockets using deproteinized bovinebone mineral - an experimental study in dogs.
Key words: alveolar process; augmentation; bony crest; DBBM; Geistlich Bio-Oss®; deproteinized bovine bonemineral; dimensional changes; extraction socket; immediate implantation; implant dentistry; soft tissue
alterations; Sweden & Martina Zirti® Premium®
Third premolars in six dogs were hemisectioned and the distal roots removed. Implants were placed and the residualdefects were then filled with demineralized bovine bone mineral (DMMB) and covered by a collagen membrane (test) orleft unfilled (control). After 4 months of non-submerged healing, histological analysis was performed. There was nodifference in soft tissue dimensions between test and control sites, but soft tissue at the buccal aspect was morecoronal at test sites. There was significantly less buccal shrinkage at the test compared to the control sites, indicatingpreservation of the alveolar process.
Take-home message: The use of DBBM and a collagen membrane at immediate implants can help to preservethe alveolar process.
Clin Oral Implants Res. 2012 Jul;23(7):805-13. doi: 10.1111/j.1600-0501.2011.02223.x. Epub 2011 Dec 12. PEGmatrix enables cell-mediated local BMP-2 gene delivery and increased bone formation in a porcine criticalsize defect model of craniofacial bone regeneration.
Key words: BMP-2; bone regeneration; critical size defect; gene transfer; PEG; Straumann MembraGel®; Straumann BoneCeramic
Cylindrical critical-sized defects in pig calvariae were filled with Straumann BoneCeramic (SBC) covered by
MembraGel (group 1), SBC with PEG matrix (group 2), SBC with BMP-2 transfected osteoblasts and PEG matrix(group 3), or BMP-2/4 gene transfer (group 4). Histomorphometric and immunohistochemical analysis were performedafter 2, 4 and 12 weeks. New bone formation was significantly higher for group 3 versus
groups 1 and 2 after 4 and 12 weeks, and BMP-2 expression was higher in group 3 compared to all other groupsafter 2 and 4 weeks.
Take-home message: The PEG matrix can act as a scaffold for cell-mediated BMP-2 gene delivery, and localBMP-2 gene delivery can lead to increased bone formation.
Clin Oral Implants Res. Article first published online: 3 JUN 2012
Radiographic and clinical outcomes of implants placed in ridge preserved sites: a 12-month post- loadingfollow-up
Patel K, Mardas N, Donos N.
Key words: Straumann, Standard Plus implants, SLActive®, Bone Ceramic®, BioOss®, Bio-Gide®, Alveolar ridgepreservation
This prospective controlled clinical study evaluated radiographic bone levels in alveolar ridges previously preserved witha bone substitute or a bovine xenograph. Alveolar ridge preservation of extraction sockets was performed withStraumann Bone Ceramic® (test group, n=14) or Bio-Oss® (control group, n=13). Bio-Gide® was used as a membranein both groups. Implants were placed after 8 months and loading was performed after another 4 months. Standardizedperiapical radiographs were performed at loading and 1 year post- loading. No statistically significant differences in anyof the clinical and radiographic measurements were detected between the two groups. The survival rate of the implantswas 100 % (both groups). The success rate was 84.6 % (Bone Ceramic®) and 83.3 % (Bio-Oss®).
Take-home message: It seems that Bone Ceramic® and Bio-Oss® are equally capable of preserving alveolarridges prior to implant placement. From the implant point of view, survival and success rates are similar after boneregeneration with both materials.
Clin Oral Implants Res. Article first published online: 3 JUN 2012
A prospective, controlled clinical trial evaluating the clinical radiological and aesthetic outcome after
5 years of immediately placed implants in sockets exhibiting periapical pathology JungRE, Zaugg B, Philipp AO, Truninger TC, Siegenthaler DW, Hämmerle CH http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0501.2012.02491.x/abstract
Key words: Straumann, Standard Plus implant, Tapered Effect implant, BioOss®, Bio-Gide®, Extraction sockets
This prospective controlled clinical trial evaluated the clinical, esthetic and radiological outcome of immediatelyplaced implants in extraction sockets with or without periapical pathologies. 27 patients were followed for 5 yearsafter immediate implant placement (12 test patients with periapical pathologies vs. 15 control patients withoutperiapical pathologies). The implant survival rate was 100 % for all 27 implants. No statistical significant differencecould be found in the esthetic evaluation between the two groups. Radiographical evaluation revealed that verticaldistance between the implant shoulder and the first bone to implant contact was comparable between the twogroups. No peri-implantitis was discovered.
Take-home message: The replacement of teeth exhibiting periapical pathologies with implants immediately aftertooth extraction can be a successful treatment procedure without compromising on the clinical, esthetical orradiographical outcome.
Clin Oral Implants Res. 2012 Jul;23(7):767-74. doi: 10.1111/j.1600-0501.2011.02228.x. Epub 2011 Jun 2. Doesbone mineral density influence the primary stability of dental implants? A systematic review. Marquezan M,Osório A, Sant'anna E, Souza MM, Maia L.
Key words: bone implant interactions; CT Imaging; prosthodontics; orthodontics
A database search was performed to identify papers relating to the influence of bone mineral density on primarystability of dental implants. The selected studies were classified into low, moderate or high methodological quality, anddata were tabulated. Although 10 articles were identified, only seven were included due to overlapping patientpopulations. The methodological quality and control of bias was judged to be low or moderate. A positive associationwas observed between bone mineral density and implant primary stability, but the methodological quality and bias of such studies should be improved.
Take-home message: There appears to be a positive association between bone mineral density and primary implantstability, but the level of evidence is not high.
Clin Oral Implants Res. 2012 Jul;23(7):846-52. doi: 10.1111/j.1600-0501.2011.02209.x. Epub 2011 May 12. Theexperimental research on two-generation BLB dental implants - Part I: surface modification and osseointegration.
Key words: Beijing Leide Biomaterial; BLB dental implant; electrophoresis deposition; micro-arc oxidation;
osseointegration; plasma spraying
Surface properties of BLBI and BLBIII implants were assessed and a total of 36 implants were placed in mandibularpremolar areas in six dogs and analyzed after 2, 4 and 8 weeks. A cloud-form microstructure was evident on BLBIimplants, while a highly porous layer was seen on BLBIII implants; a significant difference in surface roughness wasfound between the two surfaces. The BLBIII group showed more osteoid and bone tissue, and a significantly higherBIC after 2 and 4 weeks; however, the difference after 8 weeks was not significant.
Take-home message: The BLBIII implants, which have a highly porous layer, showed greater early osseointegration potential.
Clin Oral Implants Res. 2012 Jul;23(7):873-81. doi: 10.1111/j.1600-0501.2011.02231.x. Epub 2011 Jun 24. A pilotstudy to evaluate the success and survival rate of titanium-zirconium implants in partially edentulouspatients: results after 24 months of follow-up.
Key words: dental implant; human study; mini-implant; reduced diameter implant; titanium–zirconium alloy;
zirconium; Straumann Roxolid®; Straumann Standard Plus
Each of 22 patients received one 3.3 mm diameter Roxolid implant (test) and one 4.1 mm diameter Standard Plusimplant (control); the test implants were splinted to the control implants. One test implant was lost due to infection andone patient was lost to follow-up; 20/22 patients therefore had a surviving implant after 2 years. The mean change inbone level was -0.33 ± 0.54 mm after 2 years and healthy peri-implant soft tissues were noted.
Take-home message: The new implant material was found to be safe and reliable in partially edentulous patientsafter 2 years.
Clin Oral Implants Res. 2012 Jul;23(7):820-6. doi: 10.1111/j.1600-0501.2011.02224.x. Epub 2011 Jun 2. Fracturestrength of yttria-stabilized tetragonal zirconia polycrystals crowns with different design: an in vitro study.
Key words: core design; crowns; design; fracture load; fully-sintered; pre-sintered; support; veneer; Y-TZP;
Cores of fully sintered or pre-sintered zirconia (40 of each) were made; half of each had a core of even thicknessshapes (ES) and half had a core with an anatomical shape (AS). An extra group consisted of anatomical pre-sinteredzirconia cores veneered with glass-ceramic on titanium abutments. The cores were then veneered with porcelain orglass-ceramic material, cemented to resin abutments and underwent thermocycling and mechanical pre-load tofracture. Significantly higher loads could be withstood by AS crowns and crowns on titanium abutments. Fracturetypes were minor or major fracture of the veneering ceramic, or complete fracture through veneer and core.Significantly more veneering ceramic fractures were observed with ES crowns.
Take-home message: The crown core design and abutment support both significantly influence fracture load for Y-TZPcrowns.
Clin Oral Implants Res. 2012 Jul;23(7):853-60. doi: 10.1111/j.1600-0501.2011.02211.x. Epub 2011 Jun 21. Dentalimplant suprastructures using cobalt-chromium alloy compared with gold alloy framework veneered withceramic or acrylic resin: a retrospective cohort study up to 18 years.
Key words: cobalt–chromium; dental implant; gold alloy; suprastructure; veneering material
A total of 198 patients who received 270 implant-supported FDPs on 1,117 implants prior to 1996 were identifiedand retrospectively evaluated, and data recorded for FDPs made from four alloy framework
combinations. The average follow-up period was 120 months. Success, survival and complications were similarfor cobalt-chromium and gold alloy frameworks veneered with ceramic or acrylic teeth. The suprastructurebiomaterial combination therefore had no influence on clinical performance.
Take-home message: Cobalt-chromium or gold alloy FDP frameworks with ceramic or acrylic teeth show comparable clinical performance.
Clin Oral Implants Res. 2012 Jun 15. doi: 10.1111/j.1600-0501.2012.02521.x. [Epub ahead of print] Implant-supported single tooth restoration in the aesthetic zone: transmucosal and submerged healing providesimilar outcome when simultaneous bone augmentation is needed.
Key words: Straumann® Bone Level, Bone regeneration, Tissue regeneration
The clinical outcome was investigated 2 years after placement of a Straumann Bone Level implant to restore a singlemissing tooth in the esthetic zone that needed simultaneous augmentation. A total of 52 implants were assessed inpatients in need of bone augmentation for a moderate peri-implant defect (these patients are involved in an ongoingprospective multicenter randomized trial). 27 patients received implants with submerged healing while 25 patients weretreated with a non-submerged protocol. A small amount of bone resorption was found in both groups, although nostatistical difference could be detected. Also, periodontal parameters were comparable between the two cohorts. Theauthors conclude that similar outcome is achieved with submerged and transmucosal healing when single implants areplaced in the esthetic zone in conjunction with bone augmentation.
Take-home message: There is no need for submerged healing when a Bone Level implant is placed after boneaugmentation in a single tooth position in the esthetic zone.
Clin Oral Implants Res. 2012 Jun 18. doi: 10.1111/j.1600-0501.2012.02503.x. [Epub ahead of print] Clinical,radiographic, microbiological, and immunological outcomes of flapped vs. flapless dental implants: aprospective randomized controlled clinical trial.
Key words: Astra Tech® Osseo Speed, flap surgery, flapless surgery
A randomized control was performed to investigate clinical outcomes of flapped versus flapless implant placement. 20patients received 30 implans (15 placed with a surgical flap and 15 placed flapless) and follow- up examinations wereperformed after 1, 2, 6 and 12 weeks. Peri-implant sulcus depth was significantly greater in flapped implants, whichalso shoed crestal bone loss (no bone loss was detected when the implant was placed flapless). Also, immunologicalparameters were significantly worse in the cohort that received flapped implant placement. However, particular germswere significantly increased in the cohort that received flapless implant placement. Patients reported more pain afterflapped implant placement.
Take-home message: Flapless implant placement may yield in improved clinical, radiographic and immunologicaloutcomes compared with flapped implantation. In contrast, the microbiological situation seems to be less favorableafter flapless surgery.
Clin Oral Implants Res. 2012 Jun 18. doi: 10.1111/j.1600-0501.2012.02514.x. [Epub ahead of print]
A 3-year prospective study of implant-supported, single-tooth restorations of all-ceramic and metal- ceramicmaterials in patients with tooth agenesis.
Key words: Astra Tech®, All-ceramic crowns, Metal-ceramic crowns
This prospective clinical trial aimed to investigate 3-year outcome variables of all-ceramic and metal-ceramic implant-supported restorations. 59 patients with tooth agenesis were treated with 98 implant-supported
single-tooth restorations, of which 64 were all-ceramic and 34 were metal-ceramic crowns. After 3 years,
100% of the implants and 97% of the abutments and crowns survived. The frequency of biological complications washigher for all-ceramic restorations than for metal-ceramic restorations. The most frequent technical complication wasloss of retention and was only observed with metal-ceramic crowns. However, the marginal adaptations of all-ceramiccrowns were significantly less optimal than metal-ceramic crowns. The professional-reported esthetic outcome (colormatch) showed significantly increased results for all-ceramic crowns. In contrast, the patient-reported estheticoutcome did not reveal any differences.
Take-home message: In this prospective trial, all-ceramic crowns demonstrated better color match but higherfrequency of marginal discrepancy compared to metal-ceramic crowns. However, patients did not notice estheticdifferences between the two restorations.
Clin Implant Dent Relat Res. 2012 Jun 12. doi: 10.1111/j.1708-8208.2012.00463.x. [Epub ahead of print] Healingof Fresh Extraction Sockets Filled with Bioactive Glass Particles: Histological Findings in Humans.
Key words: Bone graft, Bioactive glass (BioRestoreTM), Histology
In this clinical study, extraction sockets from a total of 13 patients were filled with bioactive glass and allowed to healfor 6 months. This socket ridge preservation procedure (RPP) was the basis for 22 bone cores that were obtained atimplant insertion and processed for histomorphometric and immunohistochemical analysis. Newly formed bone aroundresidual bioglass particles was found in all 22 biopsies. Histomorphometry&