A prospective multicenter clinical study of the Osseotite implant: four-year interim report

This article reports the 4-year interim results of a multicenter study evaluating the clinical performance of the Osseotite dental implant. At 4 study centers, 485 Osseotite implants were consecutively placed in 181 patients (219 were placed in the mandible and 266 in the maxilla). A total of 355 implants were placed in posterior regions. Short implants (10 mm or less) represented 31.5% (n = 153) of all implants placed in this study. Patients were restored with 210 restorations, distributed as 123 short-span prostheses, 58 single-tooth replacements, 28 long-span prostheses, and 1 maxillary overdenture. At this 4-year interim evaluation, the mean time from implant placement to the most recent evaluation was 52.6 +/- 3.0 months, with a mean loading time of 43.3 +/- 3.8 months. Of the 485 implants placed, there have been 6 failures. All implant failures occurred prior to loading and were categorized as early implant failures. Five of the 6 failures occurred in the maxilla. Only one of the 153 short implants failed to integrate. Baseline radiographs were obtained at prosthesis connection. Radiographic analysis 1 year post-restoration showed a mean bone loss of 0.09 +/- 0.7 mm. From baseline to the end of the second year of function, an overall mean bone loss of 0.13 +/- 0.8 mm was recorded, indicating no additional bone was lost after the first year of implant function. At 4 years, the cumulative implant success rate for all implants placed in this study was 98.7%, with a 99.4% success rate in the posterior mandible and 98.4% success rate in the posterior maxilla. Results of this 4-year interim analysis indicate that this implant achieved a high success rate in posterior regions and that all failures with this implant in this patient population occurred prior to implant loading. When the clinical success of implants 10 mm or shorter was compared to that of implants greater than 10 mm in length, the shorter implants in this study performed similarly to longer implants.     

Long-term results of endosteal implants used for restoration of oral function after oncologic surgery.

The aim of the present study was to analyse the long-term survival rate of endosteal implants used for restoration of oral function in patients having undergone oncologic surgery. Eighty-three consecutive patients, who had received a total of 409 endosteal implants ad modum Br?nemark, subsequent to resections of soft tissue and bone during ablation of oral malignancies, were enrolled into the study. A life-table analysis was used to determine the survival rate of the implants placed during a period of 13 years. Log rank tests and Cox regression analysis were employed to identify relevant effects of surgical parameters on implant survival. A total of 38 implant failures were encountered. Most of the losses (n = 19) occurred during the first year of functional loading. Subsequent failures were evenly distributed across the remaining follow-up period. The cumulative overall survival rate of implants was 56.5%. Previous radiation therapy, insertion into grafted bone or original jaw bone and the technique of grafting did not significantly affect the survival rates. In the Cox regression analysis, the timing of implant placement in the group of patients with bone grafts (primary vs. secondary placement) was significantly related to the survival rate (P = 0.0197), with a lower survival rate of 36.2% for primary insertion of implants and 67.1% for secondary placement.     

Five-year outcome of 111 immediate nonfunctional single restorations

Immediate loading is a surgical-prosthetic procedure extensively used in implant dentistry. Despite its frequent use, minimal data are available on the long-term clinical success rate of immediate functional loading (IFL) and immediate nonfunctional loading (INFL) of implants. The aim of this study was to evaluate the long-term survival and bone loss of immediate nonfunctional single implant restorations in a group of patients that were monitored for 5 years. One hundred and eleven patients (41.4% men) with a median age of 40 years were included in this study. A total of 111 implants were placed. All implants were placed with a minimum insertion torque of 25 Ncm. A temporary restoration was relined with acrylic resin, trimmed, polished, and cemented or screw-retained 1 to 2 hours later. Occlusal contact was avoided in centric and lateral excursions. After provisional crown delivery, a periapical radiograph was performed by means of a customized Rinn holder device. Data were analyzed by means of Kaplan-Meier and life-table algorithms. Stratification of implant survival was performed for the available variables of interest, and comparisons were analyzed using a log-rank test. Investigated parameters were time of implant placement, bone quality, implant site, implant diameter and length, and type of implant surface enhancement. The parameters for overall success rate were defined by bone resorption <1.5 mm after the first year of loading and <0.2 mm thereafter. During the 5-year follow-up period, a survival rate of 95.5% was observed. All failures occurred within 4 months of implant loading. There were statistically significant differences regarding healed vs post-extraction implant sites (100% and 92.5%, respectively, P = .05) and type of bone (D1 vs D4 yielded 100% and 95.5%, respectively, P <.05). No differences were detected for: (1) site (100% for mandible and 94.63% for maxilla, P =-.319); (2) implant diameter (survival rates of 97.26% for <4.5-mm diameter and 92.11% for >4.5mm diameter, P = .206); (3) implant lengths (survival rates of 96.97% for implants >13 mm and 94.87% for implants <13 mm, P =.624); and (4) type of implant surface enhancement (survival rates of 94.03% for 67 cases of grit-blasted and acid-etched surfaces and a failure rate of 4 out of 5, and 94.12% for 17 cases of hydroxyapatite (HA)-coated surfaces with only 1 failure). The success rate (defined as bone resorption >1.5 mm after the first year of loading and >0.2 mm thereafter) was 97.2%. Immediate nonocclusal loading of single implants is a reliable surgical-prosthetic procedure with a low rate of implant loss and a low quantity of peri-implant bone loss over time.     

Osseotite implant: 3-year prospective multicenter evaluation

Purpose : This prospective multicenter study evaluates the cumulative success rate of the Osseotite® implant after 3 years of prosthetic loading.
Materials and Methods : A total of 413 Osseotite® implants (Implant Innovations®) were placed in 142 patients (completely or partially edentulous) in five dental offices exclusively devoted to implants. The average age of the patients was 58.3 years. Of the 413 implants, 191 were placed in the maxilla and 222 in the mandible; 271 (65.6%) were posterior implants and 142 (34.4%) were anterior implants. Clinical and radiographic evaluations were made after completion of the prosthetic restoration, after 6 months of loading, at 1 year, and at 3 years.
Results : A cumulative success rate of 95.3% was obtained after 3 years of prosthetic loading. The success rate was similar in both arches: 95.1% in the maxilla and 96.8% in the mandible. Early failures (before prosthetic loading) were greater (n = 12) than late failures (n = 2). After 3 years of prosthetic loading, the marginal bone level of 385 (93.2%) implants were evaluated radiographically. Bone level was at the first thread for 91.4% of the implants. A slightly increased loss was observed around 26 implants (6.7%). Including survival implants, the cumulative implant success rate after 3 years was 96%. A success rate of 98.4% was obtained with 187 short implants (8, 5 and 10 mm) reported in this multicenter evaluation.
Conclusion : This multicenter evaluation demonstrates excellent predictability for Osseotite implants.     

Success and survival of single dental implants placed in sites of previously failed implants

BACKGROUND: The aim of this study was to assess the clinical effectiveness of single dental implants placed in sites of previously failed implants. METHODS: The study consisted of a consecutive cohort of 1,215 patients who received 1,387 single implants for single-tooth replacement during a 6-year period (1999 to 2005). Inclusion criteria were a single implant replacing a previously failed implant and follow-up data > or =6 months. Data were recorded and analyzed regarding implant survival and location, need for bone augmentation, and implant dimensions. RESULTS: A total of 75 patients experienced the failure of 96 implants. Of those, 31 implants in 28 patients were replaced by a similar implant placed in the same location. Nine of the replacement implants failed, resulting in an overall survival rate of 71%. Follow-up ranged from 6 to 46 months (mean, 19.4 +/- 11.4 months). Replacement of maxillary and mandibular failed implants was similar. All failures occurred during the first year after implant replacement. On average, implant replacement occurred 5.8 +/- 5.2 months after original implant removal; three implants were placed immediately after implant removal. A third attempt for single implant replacement was made in two patients. However, one failed. CONCLUSIONS: Replacement of a failed implant presents a challenge to achieve osseointegration in a healed bone site and may result in a decline in the survival rates. Patients and clinicians should be aware of these results before a replacement attempt is considered. The success of replacement may be increased by the use of wider implants or with improved surfaces.     

Factors associated with dental implant survival: a 4-year retrospective analysis

Background: Dental implants are a predictable treatment option for replacing missing teeth and have strong survival and success outcomes. However, previous research showed a wide array of potential risk factors that may have contributed to dental implant failures. The objectives of this study are to study if implant survival rates were affected by known risk factors and risk indicators that may have contributed to implant failures. The secondary outcome measures were whether the level of expertise of the periodontal residents affected success rates and how the rate of implant success at the Harvard School of Dental Medicine (HSDM) compared to published standards. Methods: A retrospective chart review of patients at the HSDM who had one of two types of rough‐surface implants (group A or B) placed by periodontology residents from 2003 to 2006 was performed. Demographic, health, and implant data were collected and analyzed by multimodel analyses to determine failure rates and any factors that may have increased the likelihood of an implant failure. Results: The study cohort included 341 dental implants. The odds ratio for an implant failure was most clearly elevated for diabetes (2.59 implant surface group B (7.84), and male groups (4.01). There was no significant difference regarding the resident experience. The success rate for HSDM periodontology residents was 96.48% during the 4‐year study period. Conclusions: This study demonstrates that implant success rates at HSDM fell within accepted published standards, confirmed previously identified risk factors for a failure, and potentially suggested that other acknowledged risk factors could be controlled for. Furthermore, the level of experience of the periodontology resident did not have an impact on survival outcomes.     

Long‐term evaluation of non‐submerged ITI implants. Part 1: 8‐year life table analysis of a prospective multi‐center study with 2359 implants.

In the present multi-center study. non-submerged ITI implants were prospectively followed to evaluate their long-term prognosis in fully and partially edentulous patients. In a total of 1003 patients, 2359 implants were consecutively inserted. Following a healing period of 3–6 months, the successfully integrated implants were restored with 393 removable and 758 fixed restorations. Subsequently, all consecutive implants were documented annually up to 8 years. At each examination, the clinical status of all implants was evaluated according to predefined criteria of success. Therefore, the data base allowed the evaluation of 8-year cumulative survival and success rates for 2359 implants. In addition, cumulative success rates were calculated for implant subgroups divided per implant type, implant length. and implant location. Furthermore, the actual 5-year survival and success rates could be determined for 488 implants. During the healing period, 13 implants did not successfully integrate, whereas 2346 implants fulfilled the predefined criteria of success. This corresponds with an early failure rate of 0.55%. During follow-up, 19 implants were classified as failures due to several reasons. In addition, 17 implants (= 0.8%) demonstrated at the last annual examination a suppurative periimplant infection. Including 127 drop out implants (= 5.4% drop out rate) into the calculation, the 8-year cumulative survival and success rates resulted in 96.7% and 93.3%, respectively. The analysis of implant subgroups showed slightly more favorable cumulative success rates for screw type implants (> 95%) compared to hollow-cylinder implants (91.3%). and clearly better success rates for mandibular implants (= 95%) when compared to maxillary implants (= 87%). The actual 5-year survival and success rates of 488 implants with 98.2% and 97.3%. respectively, were slightly better than the estimated 5-year cumulative survival and success rates of 2359 implants indicating that the applied life table analysis is a reliable statistical method to evaluate the long-term prognosis of dental implants. It can be concluded that non-submerged ITI implants maintain success rates well above 90% in different clinical centers for observation periods up to 8 years.     

A clinical report on the 18-month cumulative survival rates of implants and implant prostheses with an internal connection implant system

Titanium implants have been successful in both dentulous and edentulous patients. The original Br?nemark titanium implants were introduced with external hex connections between implants and abutments. Successes and failures/complications with both the biology and mechanics of this connection system have been reported. In an attempt to improve the predictability and success of implant/abutment connections, internal connections between implants and abutments were developed significantly differently from external implant/abutment connections in terms of size, surface area, and geometry. Forty-five consecutive partially edentulous patients were treated with 83 implants (Osseotite Certaina). The implants were allowed to heal for at least 8 weeks without occlusal loading. All were restored with single, nonsplinted restorations. The implants were loaded with fully functional occlusions for at least 1 year. Recall appointments were scheduled at 1, 6, 12, 18, 24, and 36 months after implant placement. Eighty-two of the 83 implants were clinically stable and considered to be osseointegrated 18 months after occlusal loading for a cumulative survival rate (CSR) (implants) of 100%. All of the abutment screws and restorations were non-mobile 18 months after occlusal loading for a CSR (prostheses) of 100%. This internal implant/abutment connection was clinically successful and should benefit restorative dentists involved in implant dentistry by decreasing the number of maintenance visits and problems associated with dental implant treatment.     

Are Short Dental Implants (<10 mm) Effective? A Meta‐Analysis on Prospective Clinical Trials

Background: This study aims to compare the survival rate of short (<10 mm) and standard (≥10 mm) rough‐surface dental implants under functional loading. Methods: An electronic literature search using PubMed and Medline databases was conducted. Prospective clinical human trials, published in English from January 1997 to July 2011, that examined dental implants of <10 mm with a 12‐month follow‐up were included in this meta‐analysis. The following data were retrieved from the included articles: the number of implants, implant dimensions, implant locations, types of prostheses, follow‐up periods, and implant survival rates. Kaplan‐Meier survival estimates and the hazard rates were analyzed and compared between short and standard implants. Results: Thirteen studies were selected, examining 1,955 dental implants, of which 914 were short implants. Short dental implants had an estimated survival rate of 88.1% at 168 months, when standard dental implants had a similar estimated survival rate of 86.7% (P = 0.254). The peak failure rate of short dental implants was found to occur between 4 and 6 years of function. This occurred at an earlier time point compared with standard dental implants, where the peak failure rate occurred between 6 and 8 years of function. Conclusions: This study shows that in the long term, implants of <10 mm are as predictable as longer implants. However, they fail at an earlier stage compared with standard implants.     

Evaluating the clinical performance of the Osseotite implant: defining prosthetic predictability

A 5-year prospective, multicenter study is in progress at four private dental practices to determine the cumulative implant survival rate and prosthetic outcome when using the Osseotite dental implant in posterior maxillary and mandibular areas. An interim evaluation after 34.4 months of study progress is presented. A total of 219 Osseotite implants were placed in 74 patients (34 women and 40 men with a mean age of 57.8 +/- 15.2 years) using a conventional two-stage surgical protocol and 3- to 6-month healing time. Subsequently, patients were restored with fixed or removable restorations. Nineteen of the 74 patients reported smoking an average of 13.2 cigarettes per day. Restorative treatments included 40 single-unit restorations; 53 splinted 2-, 3-, 4-, and 5-unit implant-supported maxillary and mandibular prostheses; 4 full-arch fixed maxillary prostheses; 1 mandibular fixed/detachable hybrid prosthesis; and 1 mandibular overdenture. The mean time from implant placement to second stage surgery was 6.2 +/- 2.0 months; from restoration and implant loading to the most recent follow-up evaluation was 20.9 +/- 6.8 months. Of the 219 implants placed, three posterior maxillary implants developed infections and were removed prior to second stage surgery. No implant failures occurred at second stage surgery or after implant loading. Using the Kaplan-Meier method, the cumulative implant survival rate was 100% for anterior implants and 98.4% for posterior implants at 28.5 +/- 5.7 months. The cumulative postloading implant survival rate was 100% for both anterior and posterior implants. The results of this study indicate that the Osseotite dental implant achieved a high rate of integration that remained stable during nearly 2 years of implant function. In addition, because no postloading implant failures have occurred, the Osseotite implant has provided a high level of prosthetic predictability.     

Dental implant treatment in diabetic patients

The purpose of the present study was twofold: (1) to investigate how many diabetic patients and types of cases that are treated with dental implants in our clinic; and (2) assess the outcome of such treatment. Medical records from 782 patients were examined in patients treated by the Br?nemark method for partial or total edentulism with implant supported bridges. From these records, 25 patients (3.2%) with diabetes before implant treatment (136 implants) were identified and further studied with respect to age, gender, type of diabetes, treated jaw, degree of edentulism, bone graft, implant survival, periimplant inflammation, bleeding on probing, and radiographic bone loss. Furthermore, the patients' opinion about the outcome of the treatment was registered. The implant success rate was 96.3% during the healing period and 94.1% 1 year after surgery. Of all 38 bridges, one was lost. Few complications occurred and all patients, except for one, were satisfied with the treatment. Today, diabetic patients are being treated successfully for all types of edentulism, including bone-grafting treatment. Diabetics that undergo dental implant treatment do not encounter a higher failure rate than the normal population, if the diabetics' plasma glucose level is normal or close to normal as assessed by personal interviews.     

Three-year evaluation of single-tooth implants restored 3 weeks after 1-stage surgery

PURPOSE: The possibility of expediting dental implant therapy by early or immediate loading protocols requires long-term clinical investigation. The aim of this prospective cohort trial was to determine the 3-year implant success rate and prosthesis complications associated with functional loading 3 weeks after 1-stage placement of Astra Tech single-tooth implants replacing maxillary anterior teeth. A secondary objective was to determine peri-implant tissue responses at these implants. MATERIALS AND METHODS: The peri-implant bone and mucosal conditions of 43 implants in 39 subjects were radiographically and clinically measured 3 years after implant placement. RESULTS: Of the 48 patients originally treated, 39 patients and 43 implants were examined at the 3-year time point. Three of 54 implants failed within the first year. No additional failures were recorded since the 12-month reporting period. Peri-implant bone levels were stable for the 3-year period following implant placement. The change in marginal bone levels after 3 years was 0.42 +/- 0.59 mm. Papilla growth was measured at 1 and 3 years (0.61 +/- 0.95 mm and 0.74 +/- 0.79 mm, respectively). The buccal peri-implant tissue dimensions at the gingival zenith also increased at 1 and 3 years (0.34 +/- 0.94 mm and 0.51 +/- 1.42 mm, respectively). No abutment screw loosening or fracture occurred. DISCUSSION AND CONCLUSIONS: Early loading of endosseous dental implants placed in healed ridges offers select benefits to clinicians and their patients.     

Dental endosseous implant assessments in a type 2 diabetic population: a prospective study

Diabetes mellitus, a prevalent disorder worldwide, is associated with systemic adverse sequelae, such as wound healing alterations, which may affect osseointegration of dental implants. This prospective multicenter study assessed the success of 2-stage endosseous root-form implants (3 different implant systems) placed in the mandibular symphysis of 89 male type 2 diabetic subjects. The implants were uncovered approximately 4 months after placement, restored with an implant-supported, Hader bar clip-retained overdenture, and maintained at scheduled follow-up data collection examinations for 60 months after loading. Sixteen (9.0%) of the 178 implants failed. Life table methods calculated implant survival at approximately 88%, from prosthesis placement through the 60-month follow-up, and at approximately 90% from implant placement through the observation period. No implants failed between surgical placement and uncovering, 5 failed at uncovering, 7 failed after uncovering before prosthesis placement, and 4 failed after prosthesis placement. Fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) values were determined before implant placement (baseline) and approximately 4 months later at surgical uncovering (follow-up). The 5-year implant outcomes (successes versus failures) were analyzed against the following predictor variables: (1) baseline and follow-up FPG values, (2) baseline and follow-up HbA1c values, (3) subject age, (4) duration of diabetes (years), (5) baseline diabetic therapy, (6) smoking history, and (7) implant length. Regression analysis found only duration of diabetes (P < .025) and implant length (P < .001) to be statistically significant predictors of implant failure. There was no statistically significant difference in failure rates between the 3 different implant systems used. This study supports the use of dental implants in type 2 diabetic patients.     

Retrospective clinical review of dental implants placed in a university training program

Many dental schools offer implant clinical training at the pre- and postdoctoral levels, but little has been published on the clinical outcomes of implants placed in those programs. A post-entry chart review was conducted of all Branemark and Taper-Lock implants placed in a university clinic by faculty-student teams. Case information was gathered on data reporting forms and entered into a computer spreadsheet program. Survival rates were calculated as percentages. Cumulative implant survival was 96% for all 303 implants placed. Eight of the 12 implants that failed were placed by 2 operators, only 1 of whom was in the early stages of implant training. Branemark implant survival was 94.9% (n = 198) at 36 months; failures occurred between stage 2 and 3 months (n = 8) in mandibles and after 12 months (n = 2) in maxillae. Taper-Lock implant survival was 98.1% (n = 105) at 24 months; no mandibular failures occurred, but maxillary failures occurred before stage 2 (n = 1) and after 12 months of loading (n = 1). Taper-Lock implants exhibited a slightly higher (3.2%) cumulative survival rate at 24 months compared to Branemark implants. Differences in the numbers of implants placed (105 vs 198) and follow-up times (24 months vs 36 months) may have skewed the comparative results of Taper-Lock and Branemark implants, respectively, in this study. Implant survival for both systems was similar at 24 months of follow-up, and clinician experience did not appear to be an influencing variable on implant survival.     

A multicenter report on 1,022 consecutively placed ITI implants: a 7-year longitudinal study

The aim of this multicenter study was to evaluate cumulative success and survival rates of ITI implants after 7 years. A complete medical report was obtained for all 440 patients enrolled in this investigation, which involved 10 different private practices. The 1,022 consecutively placed implants were distributed between completely edentulous, partially edentulous, and single-tooth replacement cases. During the annual follow-up visit, each implant was examined both clinically and radiographically using predefined success criteria. The cumulative survival and success rates were calculated for all implants. Implant subgroups were defined according to the medical history of the patients or pooled according to various indications, locations, implant designs, or implant lengths. In each subgroup, the related cumulative success rate was statistically compared to the global cumulative success rate. Fifteen implants (1.4%) were regarded as early failures, and at the end of the follow-up, the global failure rate reached 6.6%; 30 implants (3%) were lost to follow-up. At 5 years, the cumulative survival rate was 95.4%; this declined to 92.2% at 7 years. The weakest success rates were observed for implants placed in older patients, periodontally treated patients, and completely edentulous arches. Conversely, cumulative success rates that were significantly above average were observed for patients between 40 and 60 years old without pathology, implants placed after bone regeneration, solid-screw implants, implants placed in edentulous spaces, and implants placed as single-tooth replacements. This investigation has demonstrated that in these 10 private practice settings, the success rate for ITI implants remained high for up to 5 years and declined slightly between 5 and 7 years. It should be noted that in later year intervals, a relatively small number of implants remained for the analysis of cumulative success rates.     

Failing factors associated with osseointegrated dental implant loss

PURPOSE: Dental implants are currently the aesthetic and functional alternative for tooth replacement. Despite the high success rate shown by longitudinal studies, failures do occur, even in patients who present appropriate clinical conditions. The aim of the present study was to identify factors related to, or determinant of, dental implant loss in patients of the Latin-American Dental Research Institute, Curitiba, PR, Brazil. MATERIALS AND METHODS: Retrospective analysis of 3578 records of patients who had implants placed in this institute during the period of 1996 to 2006 was performed. Beyond records, panoramic and periapical radiographs were analyzed. RESULTS: Of the 3578 individuals implant treated, failures occurred in 126 (3.5%) patients (mean age 52.2 +/- 10.6 years). Men lost more implants (4.5%) than did women (3.1%) (P = 0.05). Most failure occurred before loading (88.2%). Failure was more frequent when the implant was installed in the posterior jaw (58.5%). The main detectable causes of implant loss were evaluated. Most implant losses (75%) did not have an apparent clinical cause. Identified causes were 17.5% iatrogenic conditions (surgical technique, contamination, and/or occlusal trauma), poor bone quality and quantity (3%), peri-implantitis (1%), and 3.5% missing data. CONCLUSIONS: The results obtained in this study suggest that host factors can be contributing to the failure of implants.     

A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation

Objectives: The objectives of this systematic review were to assess the survival rate of grafts and implants placed with sinus floor elevation.
Material and Methods: An electronic search was conducted to identify studies on sinus floor elevation, with a mean follow-up time of at least 1 year after functional loading.
Results: The search provided 839 titles. Full-text analysis was performed for 175 articles resulting in 48 studies that met the inclusion criteria, reporting on 12,020 implants. Meta-analysis indicated an estimated annual failure rate of 3.48% [95% confidence interval (CI): 2.48%–4.88%] translating into a 3-year implant survival of 90.1% (95% CI: 86.4%–92.8%). However, when failure rates was analyzed on the subject level, the estimated annual failure was 6.04% (95% CI: 3.87%–9.43%) translating into 16.6% (95% CI: 10.9%–24.6%) of the subjects experiencing implant loss over 3 years.
Conclusion: The insertion of dental implants in combination with maxillary sinus floor elevation is a predictable treatment method showing high implant survival rates and low incidences of surgical complications.
The best results (98.3% implant survival after 3 years) were obtained using rough surface implants with membrane coverage of the lateral window.     

A 5-year prospective multicenter clinical trial of non-submerged dental implants with a titanium plasma-sprayed surface in 200 patients

Background: Endosseous dental implants are a popular treatment to replace missing teeth. Although many advances have occurred and affected the macrogeometry and surface characteristics of dental implants, among other aspects, it is important to document how the implants perform in patients over time. Such evaluations are helpful not only to document the clinical survival of the implants but also patient satisfaction over an extended period. Methods: A formal prospective multicenter human clinical was performed at five centers involving 200 patients and 626 implants. Specific inclusion and exclusion criteria were used and detailed data collected at specified times using case report forms. An independent study monitor reviewed all study data before entry into the study database. Two implant designs were used in two different clinical indications. A non‐submerged titanium plasma‐sprayed (TPS) hollow cylindrical implant with a smooth transgingival collar was evaluated in the maxillary anterior sextant and a non‐submerged TPS solid screw implant with similar collar in the mandible. Results: Over the course of the 5‐year clinical trial, there was one early failure occurring before definitive prosthesis delivery. Three late failures were documented, one occurring at each of the 6, 12, and 18 months postoperative visits. Life table analysis at 5 years revealed a 99.4% survival rate and a 92.5% success rate. Patient satisfaction was rated as good to excellent for 96.1% of implants in regards to esthetics after 5 years; 98.8% for appearance; and 99.4% for prosthesis comfort, ability to chew and taste, fit, and general satisfaction. No serious adverse events were reported. Conclusions: Implant success and survival was over 92% and 99%, respectively, in a formal 5‐year prospective multicenter clinical trial involving 200 patients and 626 non‐submerged TPS implants. These implants included hollow cylinder implants in the anterior maxilla and solid screw implants placed in the mandible. These findings document the predictability and patient satisfaction of tooth replacement using a non‐submerged surgical technique involving a tissue‐level, rough surfaced endosseous dental implant.     

A long-term follow-up study of non-submerged ITI implants in the treatment of totally edentulous jaws. Part I: Ten-year life table analysis of a prospective multicenter study with 1286 implants

In this prospective multicenter study, non-submerged ITI implants were followed in order to evaluate their long-term prognosis in fully edentulous jaws. A total of 1286 implants were inserted in 233 consecutive patients and, after a healing period of three to six months, the successfully integrated implants were restored with 163 overdentures and 95 fixed full-arch bridges. This prospective study not only calculated the 10-year cumulative survival and success rates for the 1286 implants by life table analysis, but also evaluated the actual survival and success rates for 498 implants after at least five years of functional loading. In addition, cumulative success rates were calculated for implant subgroups according to implant length and location. Additional analyses were performed to evaluate the estimated and actual survival and success rates of the implants in relation to various prosthetic rehabilitation techniques. The 10-year cumulative survival and success rates were 95.9% and 92.7%, respectively. The actual 5-year survival and success rates of the first 498 implants that were inserted were 97.7% and 95.0%, respectively. The analysis of implant subgroups showed slightly more favourable cumulative success rates for 12 mm long implants (93%), in comparison to 10 mm and 8 mm long implants (91.6% and 89.6%, respectively). The cumulative success rate for mandibular implants (approximately 94%) was also more favourable than that for maxillary implants (approximately 91%). Patients who were loaded with both maxillary and mandibular prostheses maintained success rates well above 90%; while only implants that were inserted to support maxillary overdentures that were retained by Dolder bars showed a success rate below 90%.     

种植联合血管化髂骨移植重建14例下颌骨缺损的长期疗效观察

目的: 通过临床及影像学方法,评估种植联合血管化髂骨移植重建下颌骨缺损的长期疗效。方法: 对上海交通大学医学院附属第九人民医院1995—2005年收治的14例患者47颗植入血管化髂骨的种植体进行随访,其中10例30颗种植体为下颌骨血管化髂骨重建术中同期植入,4例17颗种植体为术后二期植入,上部结构均采用种植支持式固定义齿修复。评估分析种植体15年累积生存率及修复体生存率,修复完成后5年及10年分别进行临床评价。采用SPSS 26.0软件包对数据进行统计学分析。结果: 种植体均未发生愈合期内失败。种植体10年、15年累积生存率分别为90.44%和86.67%,修复体15年累积生存率为78.32%。种植体5年及10年边缘骨吸收分别为（2.08±0.27）mm和（4.22±0.48）mm,两者有显著差异（P<0.0001）。生物学并发症主要为种植体周围炎及软组织增生,机械并发症主要为修复体磨耗。结论: 种植联合血管化髂骨移植重建下颌骨缺损的长期疗效较为稳定,是下颌骨缺损重建的有效方法;但种植体周围炎发生率较高,维护种植体周围软、硬组织的稳定是种植体远期疗效的重要保证。