Literatura – Miscellanous

SMALL DIAMETER IMPLANTS

1 – The Clinical Outcomes of Immediate Versus Delayed Restoration Procedures on Immediate Implants: A Comparative Cohort Study for Single-Tooth Replacement

Antonio Barone, DDS, PhD, MSc*†; Paolo Toti, BSc, DDS*†; Alessandro Quaranta, DDS, PhD‡, Giacomo Derchi, DDS*†; Ugo Covani, MD, DDS*†

Clinical Implant Dentistry and Related Research, Volume*, Number*, 2014 © 2014 Wiley Periodicals, Inc.DOI 10.1111/cid.12225

ABSTRACT

Background: Immediate implant placement into fresh extraction sockets is generally considered a reliable procedure that offers several clinical advantages. Purpose: The primary aim of this study was to evaluate and compare the overall clinical outcomes of immediate and delayed restoration procedures for implants placed in fresh extraction sockets by means of a flapless technique and resorbable membrane stabilizing a xenograft. Total costs and operating times were also compared.

Materials and Methods: In this prospective cohort study, changes of marginal bone level, facial soft tissue (?FST), and width of keratinized gingiva (?WKG), in addition to the papilla index, underwent a pairwise comparison; correlations with pristine buccal bone thickness were also investigated.

Results: Although similar results were recorded for the two procedures, with a bone loss of -1.0 1 0.5 mm and -0.9 1 0.7 mm, respectively, for immediate and delayed restoration, negative remodeling in the delayed restoration procedure was seen to occur from 4 to 12 months after implant placement.

No significant differences were recorded between the two procedures in terms of ?FST and ?WKG. A loss of the papillary soft tissues before restoration, followed by a reestablishment after restoration, seemed to be verified for the delayed group, for which the papilla index went from the minimum of 0 at 4months to a value of 2 at 24months.Moreover, the immediate restoration procedure seemed to be more promising in terms of healing times and costs.

Conclusion: Immediate restoration of implants installed in fresh extraction sockets was at least as effective and safe as delayed restoration.

Keywords: alveolar bone resorption, immediate implants, immediately restored implant, soft tissue recession

2 – New Frontiers in Immediate Loading

Vincenzo Bucci Sabattini

This book will guide the reader through the step-by-step methodologies for full-arch reconstruction featuring Intra-Locks FlatOne® System.

ABSTRACT

This book will guide the reader through the step-by-step methodologies for full-arch reconstruction featuring Intra-Locks FlatOne® System. In addition to the rigidity of the framework and the perfectly passive fit, the FlatOne® System enables the creation of emergence profiles and esthetics that render this protocol vastly superior to “screwed-on dentures.”

“New Frontiers in Immediate Loading” is thoroughly documented and exquisitely photographed. It takes the reader from the historical background of immediate loading thru the dynamics of diagnosis, treatment planning, surgical preparation, clinical and laboratory procedures, regeneration techniques, delivery of the prosthesis and case finalization. Of special note is the excellent documentation regarding the scientific basis for Intra-Locks surface treatments, macro architectures and prosthetic components.

Modern implantology has been, and, undoubtedly still is, a scientific catalyst, continually raising the bar for the levels of research and clinical success. For the past 40 years, this has enjoyed unprecedented attention in these fields. The development of new materials, surface treatments, micro and macro architectures and virtual treatment planning capabilities have made it possible to perform rehabilitations rapidly and with high success rates.

The Intra-Lock brand was created at the start of this new century, with this in mind. It was born of a determination to be at the forefront of these disciplines. The company’s mission is to spearhead scientific research and to make its products available to professionals at “realistic” prices.
This is of particular relevance when viewed in the light of the fact that changes and continuous developments can disorient the clinician who, on a daily basis, is subjected to the pressure of new developments not always adequately supported by scientific research.

The Index will provide the reader with an overview of the topics discussed in this book.

  1. Immediate Loading: Historical Background;
  2. Maxillary Anatomy: Aspects Related To Implant Surgery And Surgical Planning;
  3. New Developments In Immediate Loading: Characteristics of implants and prosthetic techniques;
  4. Full-arch restorations with flat abutments: clinical sample at two years;
  5. Guided bone regeneration;
  6. The posture-occlusion relationship and postural assessment in dental treatment;
  7. Implant prosthetics and temporomandibular disorders;
  8. Bruxism as a risk factor in implant prosthetics;
  9. Adverse Events.

3 – Mini Dental Implants: A Retrospective Analysis of 5640 Implants Placed Over a 12-Year Period.

Shatkin Todd E, Petrotto Christopher A.

Comped Contin Educ Dent. 2012 Sept; 33, Spec 3:2-9. PMID: 23029781

ABSTRACT

Mini dental implants are becoming increasingly popular in dental care today. Because of their smaller size they are often used in cases of limited bone anatomy. Mini dental implants have diameters ranging from 1.8 mm to 3 mm and are suitable for long-term use.

This article describes a retrospective analysis of 5640 mini dental implants placed into 1260 patients over a 12-year period. The mean length of follow-up was 3.5 years. The implants placed supported removable (2319) and fixed prostheses (3321), with placement in the maxilla (3134) and mandible (2506). The overall implant survival was 92.1%. Failures of implants (445) were attributed to mobility of the implant; the mean time to failure for these implants was 14.4 months.

The small size of these implants has led to the development of techniques that enable placement and use in a short amount of time for both the doctor and patient. The high rates of success show that mini dental implants are suitable for use in supporting fixed and removable prosthetics.

4 – Insertion torque in different bone models with different screw pitch: an in vitro study.

Orlando B, Barone A, Giorno TM, Giacomelli L, Tonelli P, Covani U

Int J Oral Maxillofac Implants. 2010 Sep-Oct;25(5):883-7. PMID: 20862400 [PubMed – in process]

ABSTRACT

Purpose: Orthopedic surgeons use different types of screws for bone fixation. Whereas hard cortical bone requires a screw with a fine pitch, in softer cancellous bone a wider pitch might help prevent micromotion and eventually lead to greater implant stability. The aim of this study was to validate the assumption that fine-pitch implants are appropriate for cortical bone and wide-pitch implants are appropriate for cancellous bone.

Materials and Methods: Wide-pitch and fine-pitch implants were inserted in both hard (D1 and D2) bone and soft (D3 and D4) bone, which was simulated by separate experimental blocks of cellular rigid polyurethane foam. A series of insertion sites in D1-D2 and D3-D4 experimental blocks were prepared using 1.5-mm and 2.5-mm drills. The final torque required to insert each implant was recorded.

Results: Wide-pitch implants displayed greater insertion torque (20% more than the fine-pitch implants) in cancellous bone and were therefore more suitable than fine-pitch implants.

Conclusion: It is more appropriate to use a fine pitch design for implants, in conjunction with a 2.5-mm osteotomy site, in dense cortical bone (D1 or D2), whereas it is recommended to choose a wide-pitch design for implants, in conjunction with a 1.5-mm osteotomy site, in softer bone (D3 or D4). Int J Oral Maxillofac Implants 2010;25:883-887.

5 – Biomechanical Evaluation of Endosseous Implants at Early Implantation Times: A Study in Dogs

Paulo G. Coelho, DDS, PhD*, Rodrigo Granato, DDS, MSc†, Charles Marin, DDS, MSc‡, Estevam A. Bonfante, DDS, MSc, PhD§, Jose N.O. Freire, DDS, PhD,_ Malvin N. Janal, PhD, Jose N. Gil, DDS, MSc, PhD#, and Marcelo Suzuki, DDS**

© 2010 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 68:1667-1675, 2010

ABSTRACT

Purpose: This study tested the null hypothesis that differences in surgical instrumentation, macrogeometry, and surface treatment imposed by different implant systems do not affect early biomechanical fixation in a canine mandible model.

Materials and Methods: The lower premolars of 6 beagle dogs were extracted and the ridges allowed to heal for 8 weeks. Thirty-six (n _ 12 each group) implants were bilaterally placed, remaining for 1 and 3 weeks in vivo. The implant groups were as follows: group 1, Ti-6Al-4V with a dual acid-etched surface with nanometer scale discrete crystalline deposition (Nanotite; Certain Biomet-3i, West Palm Springs, FL); group 2, Ti-6Al-4V with a titanium oxide-blasted fluoride-modified surface chemistry (Osseospeed 4.0 S; Astra Tech, Mölndal, Sweden); group 3: Ti-6Al-4V with a bioceramic microblasted surface (Ossean; Intra-Lock International, Boca Raton, FL). Following euthanasia, implants were torqued to interface failure and histologically evaluated. General linear modeling (ANOVA) at 95% level of significance was performed.

Results: Histology showed that interfacial bone remodeling and initial woven bone formation were observed around all implant groups at 1 and 3 weeks. Torque values were significantly affected by time in vivo, implant group, and their interaction (P _ .016, P _ .001, and P _ .001, respectively). Regarding torque values, group 3, group 2, and group 1 ranked highest, intermediate, and lowest, respectively.

Conclusion: Early biomechanical fixation at 1 and 3 weeks was affected by surgical instrumentation, macrogeometry, and surface treatment present for one of the implant systems tested. The null hypothesis was rejected.

6 – Early Bone Healing around Different Implant Bulk Designs and Surgical Techniques: A Study in Dogs

Paulo G. Coelho, DDS, PhD; Marcelo Suzuki, DDS; Marcia V.M. Guimaraes, DDS, MS, DSc; Charles Marin, DDS, MS; Rodrigo Granato, DDS, MS; Jose N. Gil, DDS, MS, DSc; Robert J. Miller, DMD

Clinical Implant Dentistry and Related Research.
Published Online: 12 May 2009 in Wiley InterScience (www.interscience.wiley.com).
© 2010 Wiley Periodicals, Inc.

ABSTRACT

Purpose: To evaluate the bone healing response to different implant root shape designs in a dog model. Materials and

Methods: Three by eight millimeter screw-type short-pitch (SP) and large-pitch (LP) implants (Intra-Lock International, Boca Raton, FL, USA), and 4.5 ¥ 6 mm plateau (P) implants (Bicon LLC, Boston, MA, USA) were placed along the proximal tibia of six dogs for 2 and 4 weeks. The combination of implant design and final osteotomy drilling resulted in healing chambers for the LP and P implants. The implants were nondecalcified processed to plates of ~30-mm thickness and were evaluated by optical microscopy for healing patterns and bone-to-implant contact (BIC). One-way analysis of variance at 95% level of significance and Tukey’s test were utilized for multiple comparisons among the groups’ BIC.

Results: Microscopy showed a ~150-mm region of newly deposited bone along the whole perimeter of SP implants, near the edge of the LP implant threads, and plateau tips for P implants. Rapid woven bone formation and filling was observed in regions where surgery and implant design resulted in healing chambers. No significant differences in BIC were observed (p > .75).

Conclusions: Different implant design/surgical protocol resulted in varied bone healing patterns. However, the BIC and bone morphology evolution between implant designs were comparable. Regardless of the combination between implant design and final osteotomy drilling, bone morphology evolution from 2 to 4 weeks was comparable.

7 – Changes in Bone Levels Around Mini-Implants in Edentulous Arches

Torsten Mundt, DMD, Dr Med Dent / Christian Schwahn, Dr Rer Med/ Reiner Biffar, DMD, Dr Med Dent/Friedhelm Heinemann, DMD, Dr Med Dent

Int J Oral Maxillofac Implants. 2015 Sep-Oct;30(5):1149-55. doi: 10.11607/jomi.4012.

ABSTRACT

Purpose: To evaluate changes in marginal bone levels around maxillary and mandibular mini-implants stabilizing complete dentures and to explore possible risk factors associated with bone loss.

Materials & Methods: All eligible patients from nine private dental practices were invited to participate. Panoramic radiographs were obtained postoperatively and at the follow-up examination. The changes in bone level were estimated with linear mixed models that included the factors sex, age, jaw, region (anterior versus posterior), smoking habits, and loading concept.

Results: Of the 180 invited patients, 133 participated in the follow- up (response rate: 73.9%). Of 336 mini-implants in 54 maxillas and 402 mini-implants in 95 mandibles, 15 maxillary implants and 11 mandibular implants were lost after insertion, and 4 mandibular implants fractured. Radiographic evaluations in 11 participants were not possible. The mean marginal bone loss at the remaining 634 mini-implants in 122 patients was 0.8 mm in the maxilla and 0.5 mm in the mandible over a mean observation time of 2.2 ± 1.0 years. This difference in univariate estimation lost significance after adjusting for the other variables. Implants in former smokers showed more bone loss than implants in participants who had never smoked. Implants that were loaded 3 to 4 months after placement (delayed loading) showed more marginal bone loss than immediately loaded implants. No statistically significant differences were found between men and women, different age groups, or anterior and posterior implants.

Conclusions: Mean marginal bone loss around mini-implants used to stabilize complete dentures was insignificantly higher in the maxilla than in the mandible after a mean observation period of 2.3 years. These values are comparable with marginal bone loss around standard-diameter implants. A previous smoking habit and delayed loading after implant placement with a low insertion torque were shown to be possible risk factors for bone loss. Int J Oral MaxIllOfac IMplants 2015;30:1149–1155. doi: 10.11607/jomi.4012

Keywords: bone loss, edentulism, mini-implant, overdenture, risk factor.