Osseointegrated dental implants

Endosseous implants of commercially pure titanium have been demonstrated to give success rates of more than 90 per cent over 10 years of follow-up. This high level of clinical function depends on an implant direct anchorage in bone without any interposed soft tissue layers and on a reaction-free soft tissue surrounding the abutments. Provided a correct protocol is followed, such osseointegrated dental implants may be looked upon as a routine procedure in the treatment of edentulousness.     

Preliminary study on HA-coated titanium implants used as anchorage for protraction of dog molar teeth]

HA-coated titanium implants were placed surgically into dog mandible to protract the mandibular second molars with an orthodontic force of 150 g. During the force application period of 3 months, the movement of the molars was tested periodically and relevant reasons of movement were analysed. The results showed that the mesial moving distances of the second molar were respectively 1.04 mm, 1.68 mm and 1.76 mm at the first, second and third month, and the main reason of tooth mobility was ascribed to the implant anchorage. It can be concluded tiat HA-coated titanium implant can be used as anchorage for moving and fixing posterior teeth in the orthodontic treatment.     

Osseointegrated implants in post-surgical prosthodontic rehabilitation.

The advent of osseointegrated implants and their use in dentistry has been well documented and continues to become more and more a part of conventional dental treatment. Apart from their use in simple situations they can prove invaluable when there is little hope of success with the other options. Two cases are presented here that involve multiple tooth loss as a result of surgical intervention and treatment of pathological lesions.     

Osseointegrated implants. Core-Vent and Screw-Vent

51 variously edentolous patients have been treated by placing 143 Core-Vent and Screw-Vent osteointegrated implants. The follow-up ranges from 8 to 20 months. Just one implant was removed. The Authors explain their surgical method and their considerations about the two different kinds of implants. Some clinical cases are reported.     

种植体支抗口内控制猴上颌骨生长发育的实验研究

目的 研究种植体支抗口内控制上颌生长发育的可行性及效果.方法 选用33～39月龄混合牙列雄性恒河猴4只,随机分为对照组,5周组,10周组,15周组.于双侧颧骨及上颌骨分别种植L形钛板及种植钉,两侧钛板与种植钉间分别用镍钛拉簧进行加力.对治疗前后面相、模型测量及X线头影测量的结果进行对比研究.结果 实验期间,种植体保持稳定;各实验组前牙均出现覆盖的显著性减少;硬腭中点至上切牙中点距离减小;ANB角减小.结论 口内应用种植体支抗控制生长发育期猴上颌骨生长的方法具有一定的可行性.为临床中对生长发育期上颌前突畸形的矫形治疗提供了一种新思路.     

Effect of titanium maxillofacial implants and osteosynthesis materials on platelet function

The use of titanium implants and osteosynthesis materials in orthopaedics, neurosurgery, and maxillofacial surgery has increased considerably, and they may be retained in patients for a long time. We could find no papers in English that provided data about the effect of titanium osteosynthesis materials on platelet function, and the purpose of this study was to evaluate those effects. Platelet function was tested in 33 patients with titanium maxillofacial implants using the PFA-100 (platelet function analyser) system and these results were compared with those of a control group of 34 healthy volunteer blood donors. Platelet function was measured in each group using collagen/adrenaline and collagen/adenosine diphosphate (ADP) as agonists for assessment of platelet function. There were no significant differences between the groups (collagen/adrenaline p = 0.1, collagen/ADP p = 0.09). Titanium maxillofacial osteosynthesis materials have no significant effect on platelet function as assessed by the PFA-100 system.     

Osseointegrated implants for partially edentulous patients. Interim considerations

Osseointegration is a clinical application of a biologically investigated host bone response to the placement of threaded unalloyed titanium implants using a meticulous surgical procedure. Its documented successful use as an analogue for the periodontal ligament in endentulous patients has already profoundly altered the predicament of being edentulous. Its application as a treatment modality for partial edentulism offers exciting challenges for the dentist. This article reviewed preliminary experiences from the University of Toronto's Clinical Osseointegration Unit in this area. Although it is tempting to extrapolate the successful longitudinal clinical applications with edentulous patients to partially edentulous ones, discretion and prudence demand that dentists remember that osseointegration for routine treatment of partially edentulous patients is still in its infancy. Until the results from long-term clinical trials in different centres are published, the dental profession cannot yet subsume the versatility and routine application of this exciting technique.     

Osseointegrated dental implants in conjunction with bone grafts

This paper relates to the experience with 12 patients who received osseointegrated dental implants of the Branemark design associated with bone grafts. 4 patients had iliac crest grafts, 2, of which were inserted together with the implants. Two had metatarsal reconstruction of the anterior mandible with the implants installed at a later date. 2 patients had particulate marrow grafts with immediate installation of the implants. Of the remainder, 1 had a late implantation of a myo-osseous flap utilizing the clavicle and the other delayed implantation of a split rib graft. The mean age of the patients in this series is 49.5 years. The mean loading time for completed cases is 18 months. 7 patients have had their dentition successfully restored, 3 lost the initial implants, 2 of which have been re-operated. One patient died prior to loading and one awaits the final surgical procedure. The results of the particulate marrow and split rib grafts were disappointing. The remainder suggest that osseointegrated dental implants may be utilized with appropriate bone grafting techniques to restore the dentition in patients with severe bone loss or following the surgical ablation of malignant disease.     

Endosseus titanium implants in extraction sockets. An experimental study in monkeys

In a series of monkeys, titanium implants (Xenodent) were installed in the sockets of mandibular incisors. The animals were sacrificed 7 and 12 weeks after the implantations. The healing was studied by histological and microradiographical techniques. A gradual osseointegration free from adverse interference could be noticed.     

Osseointegrated implants in craniofacial application: current status

The success rates of craniofacial osseointegrated implants are not uniform throughout the craniofacial area. A better understanding of their clinical behaviour is needed. This article investigates current perspectives on the application of endosseous implants in the restoration of craniofacial defects. An online search was completed for the time period from 1966 to 2007, along with a manual search, to locate relevant peer-reviewed articles and textbooks published in English. A review of published reports of craniofacial application of endosseous implants in irradiated and nonirradiated tissue sites showed a strong correlation between anatomic sites and clinical success. Maxillofacial prosthetic considerations are also reviewed.     

Osseointegrated implants in adolescents. A three year study

In 15 adolescents (age 13.2 to 19.4 years) in the late dental stage implants (n = 27) were chosen to replace missing teeth due to congenital absence or trauma. The patients were followed for at least 3 years. No fixture losses occurred. Only minor loss of bone support at the fixture was observed, while adjacent tooth surfaces showed some loss. Infra-occlusion of the implant restorations was noticed in patients with residual craniofacial growth. Thus, the dental and skeletal maturation, and not the chronological age, must be taken into account to avoid infra-occlusion. Furthermore it is important to gain enough space for the fixture in the mesio-distal direction in order to avoid the risk of marginal bone loss at teeth adjacent to the implants.