Multivariate analysis of the influence of peri-implant clinical parameters and local factors on radiographic bone loss in the posterior maxilla: a retrospective study on 277 dental implants

Clinical Oral Investigations - The aim of the present study was to investigate whether peri-implant clinical parameters (modified plaque index (mPI), bleeding and/or suppuration on probing (B/SOP))...     

A radiographic assessment of progressive loading on bone around single osseointegrated implants in the posterior maxilla

OBJECTIVES: The aim of this clinical study was to determine the effectiveness of progressive loading procedures on preserving crestal bone height and improving peri-implant bone density around maxillary implants restored with single premolar crowns by an accurate longitudinal radiographic assessment technique. MATERIALS AND METHODS: Twenty-three HA-coated, endosseous dental implants were placed in 20 subjects and permitted to heal for 5 months before surgical uncovering. The implants were randomly assigned to either an experimental or control group. Following a conventional healing period, the control group implants were restored with a metal ceramic crown and the experimental group implants underwent a progressive loading protocol. The experimental group was progressively loaded by increasing the height of the occlusal table in increments from a state of infraocclusion to full occlusion by adding acrylic resin to a heat-processed acrylic crown. The progressively loaded crowns were placed in infraocclusion for the first 2 months, light occlusion for the second 2 months, and full occlusion for the third 2 months. At this point, a metal ceramic crown replaced the acrylic crown. Standardized radiographs of each implant were made at the time of restoration, then after 2, 4, 6, 9, and 12 months of function. Digital image analysis and digital subtraction radiography were used to measure changes in crestal bone height and peri-implant bone density. RESULTS: The mean values of crestal bone height loss at 12 months were 0.2+/-0.27 mm for the progressively loaded implants and 0.59+/-0.27 for the conventionally loaded implants, and when tested with repeated-measure ANOVA across the time periods, the differences were statistically significant (P< or =0.05). The progressively loaded group showed a trend for higher bone density gain in the crestal area than the conventionally loaded group, but the conventionally loaded group showed a trend for higher bone density gain at the apex of the implants. CONCLUSION: The peri-implant bone around progressively loaded implants demonstrates less crestal bone loss than the bone around implants placed conventionally into full function. The peri-implant density measurements of the progressively loaded implants show continuous increase in peri-implant bone density by time.     

下颌后牙区软组织水平种植体边缘骨吸收相关因素的临床研究

目的研究下颌后牙软组织水平种植体边缘骨吸收的影响因素,为减少种植体边缘骨吸收量,提高种植体存留率提供理论依据。方法 选择76例患者行下颌后牙区软组织水平种植,共植入种植体116枚。记录患者的一般情况、种植体特征、种植体植入部位特征及修复体特征,在术后即刻、种植后3个月、修复后3个月、修复后12个月行锥形束CT检查,利用One Vlume Viewer软件测量并计算边缘骨吸收量,采用SPSS 20.0软件进行统计学分析。结果 吸烟、骨密质厚度、种植体长轴与牙冠长轴夹角、种植体局部卫生情况在各组间的差异有统计学意义（P<0.05）,患者性别、年龄、种植体长度、种植体直径、种植体系统、种植体边缘骨高度和修复体类型在各组间的差异无统计学意义（P>0.05）。结论 吸烟、骨密质较厚、种植体长轴与牙冠长轴夹角较大、种植体局部卫生差是引起种植体边缘骨吸收的危险因素,其中,局部卫生差与种植体边缘骨吸收的相关性较强。     

短种植体在骨高度不足后牙区种植修复的临床短期观察

目的：观察、分析BICON短种植体在后牙区骨高度不足病例种植修复的临床效果。方法：上、下颌后牙区骨高度3-9mm的病例57例,共植入BICON短种植体101枚,长度5.7mm的种植体15枚,长度6mm的种植体20枚,长度8mm的种植体66枚。下颌共植入59枚种植体,上颌共植入42枚种植体,其中上颌窦窦底牙槽骨高度不足的患者行上颌窦底冲击术同期植入种植体和人工植骨材料（天博骨粉）。3-6个月行二期手术,二期术后3-4周完成基台一体化冠永久修复。结果：55例99枚BICON短种植体均获得了良好的骨结合,经12个月的临床观察,种植修复取得了较好的临床效果,X光片及牙科CT检查,种植体颈部骨组织及种植体周围骨组织稳定.上颌2例2枚种植体二期手术时松动脱落,种植成功率98.02%。结论：在后牙区骨高度不足的病例,通过植入BICON短种植体,不仅可以简化植骨术,缩短患者的治疗时间,并且能减少手术风险,使种植体能获得较理想的种植成功率。     

Peri-implant bone changes following tooth extraction, immediate placement and loading of implants in the edentulous maxilla

The aim of this study was to clinically and radiographically evaluate peri-implant bone level changes after rehabilitation of a fully edentulous maxilla by placement of six implants in either fresh extraction sites or healed edentulous ridges up till 18 months after implant placement. Twenty patients with a terminal dentition in the maxillae (11 men, 9 women) received a total of 120 OsseoSpeed implants; 118 implants could be loaded immediately of which 59 were placed in extraction sockets and 59 were placed in healed sites. Within 24 h after surgery, all patients received a chairside-assembled, fibre-reinforced temporary fixed prosthetic reconstruction in occlusion. Six months post-surgery, final screw-retained CoCr (15) or Ti (5) computer numerical control-milled and acrylic-veneered frameworks were placed directly at implant level without interposing abutments. Intraoral radiographs were taken 6 and 18 months after implant placement. Implant survival rate was 100%. Mean marginal bone level was located on average -0.35 mm below the reference point (standard deviation 0.29, range -1.20 to +0.02 mm) 18 months after loading. Whether implants were placed in healed bone sites or fresh extraction sockets did not significantly affect the bone level changes. Furthermore, the use of either CoCr or Ti at the implant level did not significantly affect marginal bone loss. Within the limits of this prospective clinical trial, results seem to indicate that immediate placement and occlusal loading of five to six implants in the edentulous maxilla can be carried out successfully. Whether or not those implants are placed in fresh extraction sockets does not seem to alter the outcome. The present data show a successful 1-year outcome of a treatment protocol involving tooth extraction immediately combined with implant placement and loading.     

双皮质骨种植在下颌后牙区萎缩牙槽骨中的应用

目的:评价双皮质骨种植应用于下颌后牙区萎缩牙槽骨的临床效果。方法:15例下颌磨牙区牙槽骨中重度萎缩病例,倾斜双皮质骨植入22枚种植体,随访2年,行X线片、问卷调查等随访。结果:第1年骨丧失为(0.635±0.139)mm,第2年骨丧失为(0.141±0.032)mm;15名患者均没有疼痛不适、口唇麻木或感觉减退,满意率达93%。结论:双皮质骨种植应用于下颌后牙区萎缩牙槽骨取得了满意的治疗效果。     

Stability of bone grafting and placement of implants in the severely atrophic maxilla

A severely atrophic maxilla can be restored by bone grafts to allow the insertion of implants. We present 30 consecutive patients treated with autogenous inlay and onlay bone grafts from the iliac crest to the floor of the maxillary sinus and the alveolar crest. A total of 200 implants were inserted 4-6 months after bone grafting. A mean vertical increase in bone thickness of 14mm was achieved. After a mean bone loss of 1.3mm during the first year after bone grafting only minimal resorption was observed during the second and third year. Seven implants failed to integrate and a further four implants were lost during follow-up.     

Early loading of Osseotite implants 2 months after placement in the maxilla and mandible: a 5-year report

PURPOSE: In this multicenter study, the performance of Osseotite implants after a 1-stage surgery and abbreviated healing period of 2 months is reported. The implants were followed for up to 5 years. MATERIALS AND METHODS: Partially or completely edentulous patients treated at 10 private practice centers were included in the study. Oral hygiene was assessed using the plaque index and the gingival index prior to surgery and at recall visits at 6 months, 1, 2, 3, 4, and 5 years after initial loading. Bone density and implant/bone fit were evaluated at the time of surgery. Implants were loaded after a healing period of about 2 months. RESULTS: The mean age of the patients at time of enrollment was 60.4 +/- 13.0 years; 44% (86) of the patients were men and 56% (109) were women. In all, 526 implants were placed, 65.4% in the mandible and 34.6% in the maxilla, with 23.0% placed in anterior locations and 77.0% in the posterior. The cumulative success rate of these 526 implants was 97.9% at 5 years. Eight of the 11 implant failures occurred during nonsubmerged healing prior to prosthetic loading. Provisional restorations were placed at 2.1 +/- 0.5 months, at which time implants were evaluated for mobility, gingival health, symptomology, and radiolucency. The distribution of prosthesis types included 118 single-tooth restorations (118 implants), 134 short-span prostheses (327 implants), and 16 long-span restorations (81 implants). DISCUSSION: The benefits of early loading cannot be fully appreciated if there is a substantive increase in implant failures. In this study, a cumulative success rate greater than 97% was maintained throughout 5 years of observation. CONCLUSION: These results suggest that success can be expected with Osseotite implants after a nonsubmerged reduced healing period of 2 months in this patient population.     

Peri-implant bone loss around posterior mandible dental implants placed after distraction osteogenesis: preliminary findings

BACKGROUND: The present study evaluates implant survival and peri-implant bone loss around posterior mandible dental implants placed at sites of distraction osteogenesis. METHODS: On removal of the distraction devices, 34 dental implants were inserted into 14 posterior mandible sites in 10 healthy, non-smoking female patients. Prosthetic treatment was performed 4 months after implant placement using fixed implant prostheses. After 6 to 16.5 months, periapical radiographs were taken and evaluated for peri-implant bone loss and radiolucency. The distance between the implant margin and the first visible bone-implant contact was measured on the mesial and distal aspects of the implants using imaging software. Radiographic dimensional distortion was corrected as a function of the known true dimension of the implant. RESULTS: Of the 34 implants placed, two (5.9%) failed to integrate at reentry surgery. Both were replaced and restored during the course of the study so that a total of 34 implants was followed for 12.1 +/- 3.8 months post-restoration and 16.1 +/- 3.8 months post-insertion. Mean loss of marginal bone height was 2.6 +/- 1.0 mm. During the follow-up period, radiolucent lines along the implant surface were absent. CONCLUSIONS: The mean peri-implant bone loss in areas of alveolar bone distraction was 1.9 mm/year. A high implant survival rate was observed.     

BIB与ITI种植系统周边骨质吸收对比的研究

目的：放射线片评估BLB种植系统(HA涂层非螺纹柱状种植体)和ITI种植系统(TPS涂层螺纹柱状种植体)负载初期及负载后48个月种植体边缘骨吸收的差别。方法：87例患者116颗种植体按负载时间分五组进行X片牙槽骨边缘高度测定。结果：BLB种植系统骨吸收呈缓慢上升趋势，而TIT系统相对平稳，负载初TIT种植体周骨吸收高于BLB种植体，负载后36～48个月BLB种植体高于TIT种植体，两组均有统计学差异。结论：BLB种植系统骨结合更早，TIT种植系统远期骨吸收更少，更有利于保证种植的远期效果。     

One-year clinical and radiographic assessment of fluoride-enhanced implants on immediate non-functional loading in posterior maxilla and mandible: a pilot prospective clinical series study

Objective: The functional, esthetic, and psychological problems of 3–6 months of edentulousness and also discomfort of two‐stage surgery might cause many patients to avoid implant‐supported restorations. Therefore, the immediate non‐functional loading protocol might be of value. Methods: Twenty Astra Tech implants, 11–13 mm in length and 3.5–4 mm in diameter, were placed in maxillary and mandibular posterior sites of 10 healthy patients (two for each) with adequate alveolar bone. Temporary prostheses were relieved of all centric and eccentric contacts. Functional permanent prostheses were fabricated 13 weeks postoperatively. Clinical and radiographic examinations (including the implant stability quotient [ISQ]) were carried out immediately after implantation and 3, 6, and 12 months postoperatively. Results: A 100% success rate was observed within 1 year. The plaque and bleeding indices, and pocket‐probing depths did not show a significant change throughout the study. The ISQ values after implant insertion, and 3, 6, and 12 months later were respectively 76.6 ± 6.57, 77.6 ± 10.54, 81.8 ± 6.8, and 82.43 ± 3.7. The increase was statistically significant (P=0.004) according to the Freidman test. The ISQ values measured after the implant insertion were significantly different from those measured in the sixth and 12th postoperative months (P<0.008) according to the Wilcoxon signed‐ranks test. The mean crestal alveolar bone resorption values in the third, sixth, and 12th postoperative months were 0.4 ± 0.55, 0.48 ± 0.37, and 0.48 ± 0.21 mm, respectively; and the change in marginal alveolar bone loss was not significant according to the Freidman test. Conclusion: Within the limitations of this pilot study, non‐functional immediate loading might meet the expectations of both the patients and clinicians. To cite this article:
Rismanchian M, Fazel A, Rakhshan V, Eblaghian G. One‐year clinical and radiographic assessment of fluoride‐enhanced implants on immediate non‐functional loading in posterior maxilla and mandible: a pilot prospective clinical series study.
Clin. Oral Impl. Res. xx , 2011; 000–000.
doi: 10.1111/j.1600‐0501.2010.02134.x     

上颌后牙区骨量不足应用短种植体的临床疗效观察

目的:观察上颌后牙区失牙后骨量不足时应用短种植体修复的临床疗效。方法:31例上颌后牙区缺牙患者,采用34颗ITI短种植体修复。随访5 a,对种植体效果进行评价。结果:种植体修复负重后,定期门诊复诊,将临床测量及患者使用感知情况作为标准,根据Albreksson等提出的种植体成功标准,5年累计成功率为100%。1例患者失访,另外30例患者均对种植修复效果满意。结论:短种植体作为解决上颌后牙区骨量不足的方法之一,易于医师掌握,易被患者接受,临床疗效确切。     

Marginal bone loss of tissue- or bone-level implants after simultaneous guided bone regeneration in the posterior mandibular region: A retrospective cohort study

The cover image is based on the Original Article Marginal bone loss of tissue- or bone-level implants after simultaneous guided bone regeneration in the posterior mandibular region: A retrospective cohort study by Xiaoting Shen DDS et al., https://doi.org/10.1111/cid.13144 .

     

Rehabilitation of the anterior portions of the maxilla and mandible by means of implants and bone grafts

This article describes the possibilities and difficulties of reconstruction in the front regio by means of implants and bone transplants in five patients. First of all, planning is the most important step. Sometimes the class III relationship is a real challenge. Different bone transplants, the inlay and onlay technique, the number of the implants, the importance of the way the implants are uncovered in the second stage are discussed. In the front region, we aim for functional and esthetic reconstruction.     

Three-year treatment outcomes with three brands of implants placed in the posterior maxilla and mandible of partially edentulous patients

STATEMENT OF PROBLEM: Survival rates of implants in posterior regions vary among clinical studies. Problems occur more often in the posterior segment of the maxilla due to proximity of the maxillary sinus and reduced quality or quantity of alveolar bone. PURPOSE: This clinical study evaluated the treatment outcomes of 3 brands of implants in the posterior maxillae and mandibles of 63 patients. Treatment outcomes of all implants were assessed according to implant type, location, patient gender, periodontal status, and prosthesis type. MATERIAL AND METHODS: A total of 203 implants-105 ITI (ITI), 53 Camlog (CAM), and 45 Frialit (FRI)-were placed in 63 patients (38 women, 25 men). One hundred twelve implants were located in the posterior mandible and 91 in the posterior maxilla. All implants were longer than 10 mm and had a diameter larger than 3.5 mm. Implants in the ITI group were placed in a 1-stage surgery. The CAM and FRI groups were treated with a 2-stage surgical protocol. Implants were not loaded until osseointegration was complete, which was determined clinically and radiographically. At that point, implants were restored with 50 single crowns and 81 fixed partial dentures (FPDs). While 11 FPDs connected implants to natural teeth, 70 FPDs were supported by implants only. Standardized radiographs were made, and clinical parameters were recorded at prosthesis insertion (baseline) and at each recall evaluation (6, 12, 24, and 36 months). Plaque index (PI), sulcus bleeding index (SBI), peri-implant probing depth (PD), and radiographic marginal bone loss (MBL) levels were recorded at baseline, along with any biological and mechanical complications. Repeated-measures ANOVA, Kruskal-Wallis test, Wilcoxon signed rank test, and paired samples tests were used for statistical analysis (alpha=.05). RESULTS: One implant was lost during the osseointegration period in 1 woman due to infection. The cumulative implant treatment outcome was 99.3%. At the 3-year recall, plaque accumulation was significantly higher than baseline scores (P=.01, Wilcoxon signed rank test). Eight percent of the patients presented>2 mm PD at 2-year recall. The influence of observation time was found to be significant for the mean MBL values between groups (P=.001). When MBL values were compared between groups, no significant differences were found. For 1 patient in the FRI group, abutment loosening was observed and both the crown and the abutment were replaced. Patient satisfaction in all groups was high. CONCLUSION: The 3 brands of implants evaluated in this study exhibited similar positive treatment outcomes after 3 years.