Biomechanical interactions in tooth-implant-supported fixed partial dentures with variations in the number of splinted teeth and connector type: a finite element analysis.

Clin Oral Implants Res. 2007 Oct 18;

Authors: Lin CL, Wang JC, Chang WJ

Objective: The aim of this study was to investigate the biomechanical interactions in tooth-implant-supported fixed partial dentures (FPDs) under several loading conditions with different numbers of splinted teeth and connector types (rigid and non-rigid) by adopting the three-dimensional (3D) non-linear finite element (FE) approach. Material and methods: A 3D FE FPD model was constructed containing one Frialit-2 implant in the mandibular second-molar region splinted to the first and second premolars. Frictional contact elements were used to simulate realistic interface conditions within the implant system and the non-rigid connector function. The main effects for each level of the three investigated factors (loading condition, number of splinted teeth and connector type) in terms of the stress values and dissimilar mobility of the natural teeth and implant were computed for all models. Results: The results indicated that load condition was the main factor affecting the stress developed in the implant, bone and prosthesis when comparing the type of connector and the number of splinted teeth. The stress values were significantly reduced in centric or lateral contact situations once the occlusal forces on the pontic were decreased. However, the prosthesis stress for the non-rigid connections was increased more than 3.4-fold relative to the rigid connections. Moreover, the average tooth-to-implant displacement ratios (R(TID)) with a non-rigid connection were obviously larger than those for rigid connections under axial loading forces. Adding an extra tooth to support a three-unit tooth-implant FPD only exploited its function when the prosthesis withstood lateral occlusal forces. Conclusions: The load condition is the main factor affecting stress distribution in different components (bone, prosthesis and implant) of tooth-implant-supported FPDs. Minimizing the occlusal loading force on the pontic area through selective grinding procedures could reduce the stress values obviously. A non-rigid connector may more efficiently compensate for the dissimilar mobility between the implant and natural teeth under axial loading forces but with the risk of increasing unfavorable stresses in the prosthesis.

PMID: 17944965 [PubMed - as supplied by publisher]

Effect of bone conditioning on primary stability of FRIALIT-2((R)) implants.

Clin Oral Implants Res. 2007 Oct 18;

Authors: Proff P, Bayerlein T, Rottner K, Mai R, Fanghänel J, Gedrange T

Background: Primary stability is crucial to implants used for orthodontic anchorage. Bone condensing to enhance primary stability is controversial. Material and methods: Fourteen Frialit-2((R))-stepped screw and cylinder implants were placed in the median palatine sutures of 22 cadaveric human heads. In half of both types, the implant bed was prepared using a Frialit((R)) Bone Condenser. Primary implant stability was evaluated using non-invasive resonance frequency analysis. Moreover, the bone-implant contact area was examined histomorphometrically and radiographically. Results: Bone condensing yielded a slightly, yet not significantly increased implant stability quotient compared with a conventional technique. In spongy bone, a significant histomorphometric increase of bone-implant contact (P<0.0001) and a significant increase of radiographic density was revealed for both implant types, while no significant changes were observed within the compact area. Conclusion: The study shows that bone condensing yields an improved histologic implant-bone contact only in spongy bone, which was paralleled by radiographic-densitometric findings.

PMID: 17944963 [PubMed - as supplied by publisher]

Surface area analysis of dental implants using micro-computed tomography.

Clin Oral Implants Res. 2007 Aug;18(4):459-64

Authors: Schicho K, Kastner J, Klingesberger R, Seemann R, Enislidis G, Undt G, Wanschitz F, Figl M, Wagner A, Ewers R

OBJECTIVES: In this study, we present and evaluate a micro-computed tomography (micro-CT)-based method for the calculation of the potential bone/implant contact area (p-BICA) on the surface of dental implants. MATERIAL AND METHODS: For seven commercially available implants (Ankylos implant, Br&#xE5;nemark System, Frialit CELLplus, Replace((R)) Select Tapered, Straumann Solid screw, XiVE S CELLplus, 3i Osseotite XP Threaded Miniplant, the p-BICA surface is determined by means of three-dimensional X-ray computed-tomography and computer-based data processing. Measurements were repeated two times, and the stability and repeatability of the measurement method were evaluated. RESULTS: Our analysis revealed a p-BICA of 118 mm(2) for the XiVE S CELLplus implant, 134 mm(2) for the Ankylos, 136 mm(2) for the Frialit CELLplus, 138 mm(2) for the Brånemark System, 139 mm(2) for the Replace((R)), 159 mm(2) for the 3i Osseotite XP and 199 mm(2) for the Straumann Solid screw implant. The measurement method proved to be stable and led to reproducible results. CONCLUSIONS: The micro- and macrostructure of dental implants define the surface and the p-BICA. Precise determination of this parameter can be achieved by means of the micro-CT-based method as presented in this study. The value of p-BICA lies in the predictability of industrial design before preclinical and clinical testing. Based on this method, dental implant properties become comparable even if geometrical details are not disclosed by the manufacturer.

PMID: 17587336 [PubMed - indexed for MEDLINE]

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

J Prosthet Dent. 2007 Feb;97(2):78-84

Authors: Ozkan Y, Ozcan M, Akoglu B, Ucankale M, Kulak-Ozkan Y

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.

PMID: 17341375 [PubMed - indexed for MEDLINE]

Implant-prosthetic treatment in HIV-infected patients receiving highly active antiretroviral therapy: report of cases.

Int J Oral Maxillofac Implants. 2006 Nov-Dec;21(6):951-6

Authors: Strietzel FP, Rothe S, Reichart PA, Schmidt-Westhausen AM

PURPOSE: Since 1997, the use of highly active antiretroviral therapy (HAART) has significantly improved systemic health and life expectancy of patients who test positive for the human immunodeficiency virus (HIV) in industrialized countries. Therefore, although implant-supported prosthetic rehabilitation has been restricted to immunocompetent individuals, it may be considered for these patients. CASE REPORTS: The treatment course of implant-prosthetic rehabilitation in 3 patients is reported. Patient 1 (male, age 64 years) was under 4-drug therapy; patient 2 (male, age 38 years) and patient 3 (female, age 49 years) were under 3-drug therapy. Two patients had suffered from AIDS-defining diseases prior to HAART. Oral manifestations of HIV infection were not diagnosed throughout the observation period. Patients had CD4+ cell counts between 250 and 800/mL, and viral load was below 50/mL. Perioperative antibiotic treatment was not applied. Two patients presented with edentulous mandibles. In the third patient, single-tooth replacement of both mandibular first molars was performed. A total of 10 Frialit-2 implants were placed without augmentation procedures. RESULTS: One implant failed after 3 months and was successfully replaced. Two patients received magnet-retained overdentures in the mandible, and 1 patient was treated with single crowns. All implants and restorations are successfully in function. Neither radiographic nor clinical signs of inflammation were detected during the observation period (range, 7 to 32 months). CONCLUSIONS: The outcomes of the 3 patients suggest that immunologically stable HIV-positive patients on HAART may be considered for implant-prosthetic rehabilitation.

PMID: 17190306 [PubMed - indexed for MEDLINE]

[Application of implant-supported telescopic overdenture in edentulous cases]

Zhonghua Kou Qiang Yi Xue Za Zhi. 2006 Jul;41(7):391-4

Authors: Hu XL, Cui HY, Wang T, Li JH, Qiu LX, Lin Y

OBJECTIVE: To evaluate clinical results of implant supported telescopic overdenture. METHODS: 21 patients with edentulous jaws underwent telescopic overdenture restoration. A total of 28 prostheses were fabricated. Of them, 13 were in the upper jaws, 15 in the lower jaws. Among 139 placed implants, 74 were Camlog, 28 IMZ, and 37 Frialit-2. The secondary crown was fabricated by electroforming technique and wax-lost cast method. Clinical examination and radiographs were conducted. Changes in the marginal bone level around the implants were evaluated with radiograph. The mean follow-up time was 26.5 months (range 12 - 39 months). RESULTS: This type of restoration could provide sufficient stability and maintain peri-implant hygiene easily. Peri-implantitis and prosthetic complications were not observed. Marginal bone around implants was stable. No implant was lost during the loading time. CONCLUSIONS: The preliminary clinical results of this research showed that implant supported telescopic overdentures were predictable for edentulous patients.

PMID: 17067451 [PubMed - in process]

Clinical report with up to 4 years of follow-up on a cervically modified stepped screw-type implant.

Int J Oral Maxillofac Implants. 2006 Sep-Oct;21(5):795-800

Authors: Weibrich G, Streckbein P, Krummenauer F, Wagner W

PURPOSE: In 1998, a modification of the macrostructure of the Frialit-2 implant in the cervical region was introduced to stabilize peri-implant bone. Limited data are available on the clinical effect of this modification. Therefore, the soft-tissue situation, marginal bone loss, and implant failure rate were analyzed after 4 years of clinical experience with the modified Frialit-2 Synchro implant. MATERIALS AND METHODS: From 1998 to 2001, 190 cervically modified implants were placed and documented prospectively in 58 patients. Of these implants, 147 were placed in original jaw bone, 22 in areas augmented with local osteoplasty, and 21 in iliac crest bone graft. The main indications for implantation were an atrophic edentulous alveolar crest (n = 99) and support for a partial denture (n = 39), followed by restoration of a shortened dental arch (n = 28) and single tooth replacement (n = 24). In a special clinical examination, 39 patients with 134 implants were investigated. RESULTS: The average in situ time of the 134 implants was 23.1 months. Failing osseointegration (n = 10), peri-implantitis (n = 1), and tumor resection (n = 3) in 8 patients resulted in the failure of 14 of 190 implants (7.4%). One patient with 4 implants died (2.1%). Currently, 3 patients with a total of 6 implants have been lost to follow-up (3.1%), and 166 implants remain in situ (87.4% of 190). DISCUSSION: Using different implant success criteria, success rates of 88.8% and 82.8% were calculated. CONCLUSION: Based on the results, the Frialit-2 Synchro implant appears to be a useful implant system for the indications analyzed.

PMID: 17066643 [PubMed - indexed for MEDLINE]

Comparative evaluation of the peri-implant bone tissue mineral density around unloaded titanium dental implants.

J Dent. 2007 Jan;35(1):84-92

Authors: Traini T, Degidi M, Iezzi G, Artese L, Piattelli A

OBJECTIVE: The mechanical properties of bone are greatly influenced by the percentages of organic and mineral constituents. Nevertheless, the information about the mineral content on a microscopic scale in peri-implant bone is scarce. The aim of this work was to analyze the bone mineral density of peri-implant bone under different techniques. DESIGN: Five unloaded titanium dental implants with a micro-structured surface (three XiVE plus and two Frialit 2, DENTSPLY-Friadent, Mannheim, Germany) were retrieved from the mandible of five patients after a 6-month period. scanning electron microscopy with backscattered electron signal (BSE), light microscopy (LM) with a double staining technique, fluorescence microscopy and confocal laser microscopy were used for measuring microscopic mineral content variations in peri-implant bone. Histomorphometry and image intensity (grey level) were evaluated using a software package for image analysis. RESULTS: The low mineral density index (LMDI) for LM was of 29.2+/-3.1 (mean+/-S.D.), while the high mineral density index (HMDI) was of 88.2+/-3.6 (mean+/-S.D.). The one-way ANOVA analysis showed a significant difference (P<0.001) among the groups. The pairwise Holm-Sidak test identified the differences among HMDI indexes for both LM and SEM values and also for cross-evaluation of the LMDI and HMDI values. The comparison between LMDI indexes for both SEM and LM did not show any significance. The fluorescence microscopy analysis showed clearly the difference between old (high mineralized) and new (low mineralized) bone tissue near the implant surface. Under confocal laser microscopy the same sections showed the area of bone modelling closest to implant surface. CONCLUSION: In this study it was found that bone around unloaded implants showed a low mineral density index under all the investigation methods used. It was also found that the conventional LM technique with the double staining method was able to intensely stain the bone area with a low mineral content.

PMID: 16979279 [PubMed - indexed for MEDLINE]

Sinus elevation with alloplasts or xenogenic materials and implants: an up-to-4-year clinical and radiologic follow-up.

Int J Oral Maxillofac Implants. 2006 May-Jun;21(3):426-32

Authors: Maiorana C, Sigurt&#xE0; D, Mirandola A, Garlini G, Santoro F

PURPOSE: The clinical and radiologic results of bone substitute application in the sinus elevation procedure were evaluated for up to 4 years after a grafting procedure followed by implant placement. MATERIALS AND METHODS: Between 1997 and 2001, augmentation of the maxillary sinus floor with alloplastic or xenogenic materials was performed in 34 nonsmoking patients with generally good health. However, only 18 patients attended all of the required annual clinical and radiographic examinations and thus were included in the study. Mean follow-up after implantation was 29 months. RESULTS: At the second-stage surgery all the implants were osseointegrated, except for 1 Frialit-2, which was removed. Following prosthetic rehabilitation no implant was lost after 4 years of function, for a prosthetic success rate of 100%. The cumulative implant survival rate after 48 months was 97% (36 of 37 implants). DISCUSSION: Osseointegrated implants are a reliable treatment option for restoring the posterior maxilla, and final predictability was not influenced by their placement in augmented areas after sinus elevation with bone substitutes. CONCLUSIONS: The survival rate obtained with this study is similar to that expected for implants placed in nongrafted areas. This study showed that alloplasts and xenogenic materials are reliable for bone regeneration in the subantral cavities, as they showed very low resorption in the present study.

PMID: 16796286 [PubMed - indexed for MEDLINE]

[Clinical application of implant supported magnet-retained overdenture]

Zhonghua Kou Qiang Yi Xue Za Zhi. 2006 Apr;41(4):193-5

Authors: Di P, Lin Y, Li JH, Qiu LX, Chen B, Wang X

OBJECTIVE: To evaluate the clinical effects of implants supported magnet-retained overdenture. METHODS: From November 1999 to March 2005, 25 cases with edentulous jaws underwent implant-supported magnet-retained overdenture. Among them, 14 patients were male, 11 patients were female. The average age of the patients was 67.6 years. (Range 45 - 79 years). Ninety-five implants used included Komet (18), IMZ (11), Frialit-2 (12), Ankylos (10), Camlog (44). The fellow-up time was from 6 months to 70 months. Clinical examination and radiographs were conducted. RESULTS: No infections, nerve or sinus damage or other sequelae occurred. The overdentures were stable and functioned effectively. From November 1999 to March 2005, One Komet abutment was fracture and 1 Frialit-2 implant was lost because of overloading during follow-up. The remaining implants achieved successful osseointegration. Patients were satisfied with the treatment. CONCLUSIONS: Implant-supported magnet-retained overdenture was a predictable and reliable method, especially for old patients with edentulous jaws.

PMID: 16784577 [PubMed - in process]

[A clinical retrospective study of 10 years implant results]

Zhonghua Kou Qiang Yi Xue Za Zhi. 2006 Mar;41(3):131-5

Authors: Lin Y, Li JH, Qiu LX, Di P, Hu XL, Wang X

OBJECTIVE: To evaluate ten years clinical results of dental implant treatment. METHODS: A total of 5,590 endosseous implants were consecutively placed from Aug. 1994 to Aug 2004 in Center of Implantation, Peking University School and Hospital of Stomatology. Among them, 161 were Br&#xE5;nemark implants, 1,436 were Frialit-2 implants, 1,012 were IMZ implants, 767 were Ankylos implants, 2,189 were Camlog implants, and 25 were Komet implants. A total of 2,629 prostheses were delivered, including 2,314 fixed prostheses and 315 implant-supported removable dentures. The patient age range was between 17 and 82. The mean follow-up time was 77.2 months (7 to 121 months). Clinical examination and X-ray films were conducted. The results were evaluated with Wheeler's survival criteria. RESULTS: With the final prostheses, 2,624 patients were satisfied. Five patients were unsatisfied with the prostheses. With refabricating the prostheses, 4 patients were satisfied and one expressed as acceptable. Peri-implantitis was observed in 178 implants of 105 cases. Prostheses loose was observed in 21 cases and fracture in 4 cases. Ceramic crack was observed in 51 cases. The documented implants lost were 68. The implant survival rate was 96.7% according to Wheeler's survival criteria. CONCLUSIONS: Implant prostheses were with high satisfaction. The implant survival rate was as highly as 96.7%. Implant prostheses were indicated for almost all the partial and complete edentulous cases due to modern implant surgical technique.

PMID: 16777015 [PubMed - in process]

Finite element analysis of biomechanical interactions of a tooth-implant splinting system for various bone qualities.

Chang Gung Med J. 2006 Mar-Apr;29(2):143-53

Authors: Lin CL, Chang SH, Wang JC

BACKGROUND: The splinting of an implant and tooth is a rational alternative in some clinical situations. The complex biomechanical aspects of a tooth-implant system are derived from the dissimilar mobility between the osseointegrated implant and the tooth. The aim of this study was to analyze the biomechanics in a tooth-implant splinting system for various bone qualities with different occlusal forces using non-linear finite element (FE) analysis. METHODS: A 3D FE model containing one Frialit-2 implant splinted to the mandibular second premolar and a simplified bony segment was constructed. Four bone quality categories were established by varying the elastic parameters assigned to the bone volumes. Contact elements (frictional surface) were used to simulate the realistic frictional interface condition within the implant system. The stress distributions in the splinting system were observed for four loading types. RESULTS: The simulated results indicated that the lateral occlusal forces significantly increased the implant system (sigmaI, max), alveolar bone (sigmaAB, max) and prosthesis (sigmaP, max) stress values when compared with the axial occlusal forces. The sigma1, max and sigmaP, max values did not exhibit significant differences between the four bone qualities. Conversely, the sigmaAB, max values increased with reduction in bone quality, in particular for type IV bone quality. The sigmaI, max, sigmaAB, max and sigmaP, max stress values were significantly reduced in centric or lateral contact situations once the occlusal forces on the pontic were decreased. CONCLUSIONS: This study suggests that implants connected to natural teeth should be used with caution in softer bone regions. Utilizing occlusal adjustment to minimize the occlusal loading force on the pontic could reduce the stress/strain values in the splinting system.

PMID: 16767962 [PubMed - indexed for MEDLINE]

Immediate placement of implants in periapical infected sites: a prospective randomized study in 50 patients.

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Jun;101(6):705-10

Authors: Lindeboom JA, Tjiook Y, Kroon FH

OBJECTIVE: To determine clinical success when implants are placed in chronic periapical infected sites. STUDY DESIGN: Fifty patients (25 females, 25 males, mean age 39.7 +/- 14.5 years) were included in this prospective controlled study. After randomization, 25 Frialit-2 Synchro implants were immediately placed (IP) after extraction, and 25 Frialit-2 Synchro implants were placed after a 3-month healing period (DP). Thirty-two implants were placed in the anterior maxilla and 18 implants were placed in the premolar region. Implant survival, mean Implant Stability Quotient (ISQ) values, gingival aesthetics, radiographic bone loss, and microbiologic characteristics of periapical lesions were evaluated for both groups. RESULTS: Overall, 2 implants belonging to the IP group were lost, resulting in a survival rate of 92% for IP implants versus 100% for DP implants. Mean ISQ, gingival aesthetics and radiographic bone resorption, and periapical cultures were not significantly different with the IP and DP implants. CONCLUSIONS: Immediate implant placement in chronic periapical lesions may be indicated.

PMID: 16731387 [PubMed - indexed for MEDLINE]

[Sinus floor elevation and implantation--a retrospective study]

Schweiz Monatsschr Zahnmed. 2006;116(2):142-9

Authors: Lindenm&#xFC;ller IH, Lambrecht JT

A retrospective analysis of sinusfloor elevation and implantation should evaluate in a sense of quality control the clinical results and complications during or after sinusfloor elevation. In our institution we performed 98 sinusfloor elevations in 80 patients (44 women, 36 men) between August 9, 1995 and November 18, 2002. In those elevated sinuses, 201 implants were inserted till October 16, 2003. Dates were sampled from the patient medical histories. Sinusfloor elevation and implantation in posterior maxillary bone have a good prognosis. Nevertheless implant survival depended on the chosen implant system (Kaplan-Meier-analysis). Implant survival was 98% for Straumann implants and 80% for Frialit-II implants after two years. A significant correlation between Frialit-II implants and Straumann implants (p=0.0119) was identifiable. There was no difference in healing between different augmentation materials (autogenous bone, Ceros 82, Algipore), but case numbers were too small for a relevant validity. In one-stage procedures implant loss was 8%, in two-stage procedures it was 18%. Implant losses in smokers were generally higher than in non-smokers. The period of consolidation of the augmentation's material introduced in two-stage procedures was about 10.3 months, healing time of implants 9.2 months. In one-stage procedures healing time of implants was about 7.7 months. Membrane perforations during surgery occurred in 11% and were not related to the development of postoperative sinusitis as described in literature.

PMID: 16524217 [PubMed - indexed for MEDLINE]

Mechanical interactions of an implant/tooth-supported system under different periodontal supports and number of splinted teeth with rigid and non-rigid connections.

J Dent. 2006 Oct;34(9):682-91

Authors: Lin CL, Chang SH, Wang JC, Chang WJ

OBJECTIVES: This study investigated the mechanical interactions of implant-teeth splinting systems under different periodontal supports and number of splinted teeth with rigid and non-rigid connectors using non-linear finite element (FE) approach. METHODS: Two FE models with normal and compromised periodontal supports containing a Frialit-2 implant splinted to the first and second premolars were constructed. Non-linear contact elements were used to simulate a realistic interface fixation within the implant system and the sliding function of the non-rigid connector. ANOVA was used to test for relative importance of the investigated factors and main effects for each level of the three investigated factors (periodontal supports, teeth splinting and connector designs) in terms of the stress values were performed. RESULTS: The simulated results indicated that the cross-interaction of the periodontal support and the splinting situation was a major factor affecting the stress value in alveolar bone. An additional splinting decreased the stress values of bone significantly for a compromised periodontal support. The individual factor of periodontal support also influenced the stress found in the alveolar bone (28%) and implant (72%), and the stress values increased when the periodontal support was reduced. Using different connectors affected the stresses found in bone (15%), implant (21%) and prosthesis (99%). The stress values of the implant and prosthesis increased, but were decreased in bone when the splinting system used non-rigid connectors. The mobility of natural teeth and the implant system between non-rigid and rigid connections showed only small differences. CONCLUSIONS: A non-rigid connector should be used with caution since it breaks the stress transfer and increases the unfavorable stress values in the implant system and prosthesis. The tooth/implant-supported system with an additional splinting is more efficient in compromised periodontal supports.

PMID: 16439048 [PubMed - indexed for MEDLINE]

Numerical simulation on the biomechanical interactions of tooth/implant-supported system under various occlusal forces with rigid/non-rigid connections.

J Biomech. 2006;39(3):453-63

Authors: Lin CL, Wang JC, Kuo YC

The aim of this study was to analyze the biomechanics in an implant/tooth-supported system under different occlusal forces with rigid/non-rigid connectors by adopting a 3D non-linear finite element (FE) approach. A 3D FE model containing one Frialit-2 implant splinted to the mandibular second premolar was constructed. Contact elements (frictional surface) were used to simulate the realistic interface condition within the implant system and the sliding keyway stress-breaker function. The stress distributions in the splinting system and dissimilar mobility between natural tooth and implant with rigid and non-rigid connectors were observed for six loading types. The simulated results indicated that the lateral occlusal forces significantly increased the implant (sigma(I, max)), alveolar bone (sigma(AB, max)) and prosthesis (sigma(P, max)) stress values when compared with the axial occlusal forces. The sigma(I, max) and sigma(AB, max) values did not exhibit significant differences regardless of the connector type used. However, the sigma(P, max) values with a non-rigid connection increased more than two times those of the rigid connection. The sigma(I, max), sigma(AB, max) and sigma(P, max) stress values were significantly reduced in centric or lateral contact situations once the occlusal forces on the pontic were decreased. Moreover, the vertical-tooth-to-implant displacement ratios with a non-rigid connection were 23 and 9.9 times that for axial and lateral loads, respectively, applied on the premolar. However, the compensated non-rigid connector capabilities were not significant when occlusal forces acted on the complete prosthesis. The non-rigid connector (keyway device) only significantly exploited its function when the occlusal forces acted on a natural tooth. Minimizing the occlusal loading force on the pontic area through occlusal adjustment procedures to redistribute stress in the maximum intercuspation or lateral working position for an implant/tooth-supported prosthesis is recommended.

PMID: 16389085 [PubMed - indexed for MEDLINE]

Correlation between placement torque and survival of single-tooth implants.

Int J Oral Maxillofac Implants. 2005 Sep-Oct;20(5):769-76

Authors: Ottoni JM, Oliveira ZF, Mansini R, Cabral AM

PURPOSE: This study evaluated the survival parameters of single-tooth implants through clinical and radiographic analysis. MATERIALS AND METHODS: Implants were restored within a 24-hour period with a provisional crown designed to receive an occlusal masticatory load. This approach was compared to implants restored after a healing period (the control group). Forty-six implants were placed in 23 patients who were each treated with 2 Frialit-2 implants placed in sites between the second premolar in the maxilla or mandible. The manufacturer's recommended formal surgical procedure was followed, and primary stability was standardized with a minimum insertion torque of 20 Ncm. The sites were randomly selected, and the clinical and radiographic parameters were standardized with individual templates. RESULTS: Data were collected at 24 h, and at 1, 3, 6, 12, 18, and 24 months. The experimental group included 10 failed implants; 9 of the failed implants had been placed with an insertion torque of 20 Ncm. One implant from the control group failed during the 24-month follow-up period. The survival rate was independent of implant length, site position, and bone quality and quantity. Relative risk for implant failure was associated with insertion torque (relative risk 0.79 [CI: 0.66-0.930]; Cox regression) (P < or = .007), in the experimental group but was not significant for those in the control group (ie, implants placed after a healing period; relative risk 0.78 [CI: 0.34-1.78]; Cox regression) (P < or = .057). To achieve osseointegration, it was found that an insertion torque above 32 Ncm was necessary (chi2= 15.68; P < or = .004). DISCUSSION: A careful evaluation is necessary for a better understanding of the survival rates of immediately loaded implants. In this study, insertion torque was associated with the potential for risk, which can be decreased by 20% per 9.8 Ncm added. CONCLUSION: Given these results, and considering the number of patients treated, immediate provisional crowns should only be proposed with early loading if an appropriate initial insertion torque has been applied.

PMID: 16274152 [PubMed - indexed for MEDLINE]

Clinical and biologic factors related to oral implant failure: a 2-year follow-up study.

Implant Dent. 2005 Sep;14(3):281-8

Authors: Moheng P, Feryn JM

The purpose of this study is to evaluate urinary biomarkers of bone formation and resorption as predictive factors for oral implant failure, and to contribute to the knowledge of factors related to oral implant failure. A total of 93 patients between 18 and 85 years old, with an indication of oral implant, were eligible in this 2-year prospective, open, and nonrandomized study. Patients who had bone graft before implantation or presented with prosthetic difficulties (implant-to-crown ratio < 1, and/or unfavorable intermaxillary space) were excluded. All patients received either Frialit-2 (Friadent, Mannheim, Germany), cylinder, or screwed implants or IMZ Twin Plus (Friadent), cylinder implants, with FRIOS (Friadent) titanium coating. Serum osteocalcin, and urinary pyridinoline and deoxypyridinoline were measured, together with bone density at implant location. The primary endpoint (implant failure) was the implant removal (radiographic evidence of peri-implant bone loss and/or pockets). Factors related to implant failure were analyzed using multilevel logistic regression models to consider within-patient effects. Of the 93 patients included, 61% were female, and 16% were current smokers. A total of 266 oral implants were placed and analyzed, with a mean number of 3.1 implants by patient. Eleven and 15% of bone locations scored at D1 and D4, respectively, for the Misch bone density scoring. The majority of implants (72%) were placed more than 3 months after tooth extraction, using a Frialit-2 system in 73% of cases. The mean of osteocalcin was 17.3 (+/-9.4) ng/L; those of pyridinoline and deoxypyridinoline were 33.2 (+/-15.8) and 10.2 (+/-11.9) mmol per creatinine mmol, respectively. At one-year, 95.5% (95% confidence interval 92.5-97.5) of implants have not been removed. One year later, no further implant failed. In both univariate and multivariate analysis, osteocalcin, pyridinoline, and deoxypyridinoline were not significant predictive factors of oral implant failure. In multilevel logistic regression analysis, only tobacco consumption and single-tooth replacement or removable prosthesis were independent and significant predictive factors of oral implant failure. Serum osteocalcin, and urinary pyridinoline and deoxypyridinoline were not predictive of oral implant failure in this study. These results suggest that oral implants are more likely to fail for posterior single-tooth replacements and removable prostheses rather than for complete edentulous fixed bridgeworks or overdentures. Tobacco smoking has been identified as a major risk factor of oral implant failure.

PMID: 16160575 [PubMed - indexed for MEDLINE]

Tissue healing in implants immediately placed into postextraction sockets: a pilot study in a mini-pig model.

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005 Sep;100(3):e43-50

Authors: Rimondini L, Bruschi GB, Scipioni A, Carrassi A, Nicoli-Aldini N, Giavaresi G, Fini M, Mortellaro C, Giardino R

OBJECTIVE: A pilot in vivo study was conducted to evaluate (1) the rate of osseointegration at apical, middle, and coronal levels of oral implants immediately installed into fresh extraction sockets; (2) the maturation of the newly formed bone surrounding implants during 60 days of healing; and (3) the epithelium seal development. STUDY DESIGN: The premolars of 8 male adult mini-pigs were extracted at each mandibular site under general anesthesia. In the experimental side, Frialit-2 implants were immediately inserted. The gap between bone and implants ranged between 3 and 6 mm circumferencially. Bone specimens were obtained at 7, 15, 30, and 60 days after surgery for histologic and histomorphometric studies. Bone-to-implant contact (BIC), bone volume, trabecular thickness, number, and separation were recorded. Nonparametric exact tests were used to evaluate data. RESULTS: BIC at the coronal level was observed close to 0% at day 7 and increased up to 60% at day 60 after surgery on an average. BIC increased from 11.7% to 47.38% at middle level and from 53.4% to 67.38% at apical level from day 7 to day 60. With respect to bone maturation, in the earlier stages of healing, many thin trabeculae were observed, which, particularly at coronal level, became significantly fewer and thicker in more advanced stages. At day 60, the features of the bone were similar to those of baseline. The epithelium never migrated more than 1.8 mm apically to the top of the alveolar bone level. CONCLUSION: When implants are placed immediately into fresh extraction sockets, in minipig models osseointegration also occurs without initial bone contact.

PMID: 16122646 [PubMed - indexed for MEDLINE]

Laser-assisted three-dimensional surface modifications of titanium implants: preliminary data.

Lasers Med Sci. 2005;19(4):229-33

Authors: Deppe H, Warmuth S, Heinrich A, K&#xF6;rner T

BACKGROUND: Modern implant systems used in the cervical region do not allow for the ingrowth of peri-implant mucosa. The aim of the present study was to use a laser to modify titanium implants used in that region in order to promote mucosa ingrowth, thereby creating a biological barrier against bacterial infection. METHODS: A KrF-excimer laser (lambda=248 nm) was used (tau=30 ns, fmax=50 Hz, Emax=1.2 J). Craters were generated, under normal atmospheric conditions or in vacuum, in the polished regions of 18 Frialit 2 implants. Surface analysis was performed using a scanning electron microscope, an energy dispersive X-ray technique, and profile analysis. RESULTS: By adjusting the parameters used, it was possible to create canals with widths of up to 100 microm and depths of 450 microm. Canal morphology was influenced by the laser energy and the surrounding atmospheric conditions. Irradiation with 3,000 pulses (650 mJ per pulse) resulted in rough surfaces under normal atmospheric conditions, whereas these parameters resulted in smooth surfaces in vacuum. The surface chemistry was also influenced by the laser parameters used. CONCLUSION: Laser-assisted modification of titanium surfaces permits fabrication of 3-D surface modifications. The surface chemistry can also be influenced, depending upon the parameters chosen. Further studies are necessary to evaluate whether ingrowth of mucosa into the canals can be realized.

PMID: 15726297 [PubMed - indexed for MEDLINE]

Clinical performance and 5-year retrospective evaluation of Frialit-2 implants.

Int J Oral Maxillofac Implants. 2004 Nov-Dec;19(6):887-91

Authors: Perry J, Lenchewski E

PURPOSE: This retrospective study documents 5 years of clinical experience with Frialit-2 implants. MATERIALS AND METHODS: A total of 1,215 implants (338 immediately placed, 877 placed according to a delayed-placement protocol) were placed in 487 patients. After exclusion criteria were applied, 1,099 implants (322 immediate, 777 delayed) in 442 patients remained. The influence of delayed versus immediate placement on the survival of these 1,099 implants was analyzed. The influence of diameter and location (maxilla versus mandible) on survival of the implant were also examined. Implantation sites included anterior and posterior regions; the surgical protocol (ie, immediate or delayed placement) was selected according to the indications for each site. Immediate implants were placed at the time of extraction, while delayed implants were placed 8 to 12 weeks postextraction. A 2-phase surgical protocol was used for all implants. Follow-up time ranged from 5.8 to 67.4 months. RESULTS: According to the Kaplan-Meier method, the cumulative survival rate (CSR) was determined to be 90.05% at 5 years with 103 failures (32 immediate, for a CSR of 90.03%; 71 delayed, for a CSR of 90.04%). The lowest CSR (85%) was seen in the 3.4-mm-wide implants, while the 3.8-mm-wide implants had the highest CSR (93.16%). The CSR for implants in the maxilla was 91.08%; the CSR for implants in the mandible was 89.11%. DISCUSSION: The CSR was relatively low compared to studies by other authors, who reported on implant populations much smaller than that presented here. CONCLUSIONS: A relatively low overall CSR was found, and more than 70% of the failures occurred prior to uncovering (loading) or within 2.5 months of uncovering in this patient population.

PMID: 15623066 [PubMed - indexed for MEDLINE]

Oral implant surfaces: Part 2--review focusing on clinical knowledge of different surfaces.

Int J Prosthodont. 2004 Sep-Oct;17(5):544-64

Authors: Albrektsson T, Wennerberg A

PURPOSE: This article reviews clinical knowledge of selected oral implant surfaces. MATERIALS AND METHODS: The surfaces most commonly used in clinical practice, marketed by the five largest oral implant companies, are identified; their clinical documentation was scrutinized following a strict protocol. Experimental knowledge of the surfaces is briefly summarized. Retrospective, prospective, and comparative clinical studies were analyzed separately, as were studies of implants in conjunction with bone grafts. RESULTS: TiUnite anodized surfaces are clinically documented in 1- to 2-year follow-up studies at best, with failures at about 3%. Sandblasted and acid-etched SLA surfaces are documented with good clinical results for up to 3 years. Osseotite dual acid-etched implants are documented with good clinical results for up to 5 years. Frialit-2 sandblasted and etched implants are positively documented for about 3 years in one study only. The Tioblast implant is the only design documented for survival over 10 years of follow-up and success over 7 years of follow-up. CONCLUSION: Generally, oral implants are introduced clinically without adequate clinical documentation. Implant companies initiate clinical documentation after product launch. The standards of clinical reporting have improved over the years. Proper long-term reports have been published for only one surface, Tioblast.

PMID: 15543911 [PubMed - indexed for MEDLINE]

Clinical analysis of wide-diameter frialit-2 implants.

Int J Oral Maxillofac Implants. 2004 Sep-Oct;19(5):710-5

Authors: Krennmair G, Waldenberger O

PURPOSE: To evaluate wide-diameter (ie, 5.5-mm-wide) Frialit-2 implants used for several forms of prosthetic rehabilitation. MATERIALS AND METHODS: In this retrospective study, 121 wide implants (74 maxillary, 47 mandibular) were placed in 114 patients (61 female, 53 male, mean age 37.2 +/- 14.9 years). Thirty-six single-tooth restorations, 63 fixed partial dentures (68 implants), 6 removable overdentures (7 implants), and 3 fixed complete dentures (8 implants) were placed. Eighty-seven were placed in the molar regions. The follow-up period for the implants was 12 to 114 months (mean 41.8 +/- 18.5 months). Peri-implant bone loss, pocket depth, Plaque Index values, Bleeding Index values, and Periotest values were evaluated. RESULTS: Overall, 2 maxillary implants were lost, for a cumulative survival rate of 98.3% (97.3% in the maxilla; 100% in the mandible). Mean peri-implant pocket depth (3.4 +/- 1.1 mm), bone resorption (1.4 +/- 1.2 mm), Periotest values (-4.3 +/- 3.1) as well as the Plaque Index and Bleeding Index (grades of 0 in 80% of cases) indicated acceptable results. DISCUSSION: The high survival rate may be attributed to avoidance of the use of short wide-diameter implants, and the primary intention to place wide-diameter implants. Preference of the molar region was a consequence of the peri-implant bone situation in the premolar region, which was frequently inadequate for a 5.5-mm implant. CONCLUSIONS: The use of wide-diameter implants can be a viable treatment option and may provide benefits in posterior regions for long-term maintenance of various implant-supported prosthetic rehabilitations. Some anatomic and prosthodontic limitations for the use of wide implants were

PMID: 15508987 [PubMed - indexed for MEDLINE]

Crestal bone resorption 5 years after implant loading: clinical and radiologic results with a 2-stage implant system.

Int J Oral Maxillofac Implants. 2004 Jul-Aug;19(4):597-602

Authors: Ricci G, Aimetti M, Stablum W, Guasti A

PURPOSE: The aim of the present study was to assess crestal bone resorption 5 years after loading by conducting a clinical and radiographic evaluation of 112 Frialit-2 implants consecutively placed in 51 patients from January 1994 through June 1994. MATERIALS AND METHODS: All implants were placed in the same private-practice clinic by the same surgeon. Clinical assessment included plaque score monitoring, bleeding on probing, probing depth, type of occlusion, and prosthetic adaptation. Intraoral radiographs were taken and compared using suitable software to accurately measure peri-implant bone resorption. RESULTS: The survival rate of the implants was 100%. Plaque was present on 47 (42%) implants. Bleeding on probing was detectable at 17 implants (15.5%). Probing depth was > 5 mm for 5 implants (4.5%). Crestal bone resorption was > 3 mm for 32 implants (28.6%); the average observed crestal bone resorption was 2.17+/-1.6 mm. DISCUSSION: The survival rate of the implants may be the result of the relatively short functional period as well as the strict and frequent clinical evaluations associated with oral hygiene procedures during the supportive periodontal therapy. CONCLUSION: The results suggest that with strict plaque control, and provided that the patient follows a regular program of supportive therapy, crestal bone resorption around a 2-stage implant system may be limited.

PMID: 15346759 [PubMed - indexed for MEDLINE]

Immediate loading of dental implants placed in distracted bone: a case report.

Int J Oral Maxillofac Implants. 2004 May-Jun;19(3):448-54

Authors: Degidi M, Pieri F, Marchetti C, Piattelli A

A 40-year-old female patient presented for rehabilitation of an edentulous mandible with endosseous implants. Radiologic examination showed evidence of moderate atrophy in the intraforaminal area and an even more pronounced level of bone resorption in the posterior mandible. The patient desired a fixed rehabilitation with re-establishment of the posterior occlusal plane. From an esthetic standpoint, it was necessary to provide a restoration with crowns the same height as the original teeth while avoiding an unfavorable biomechanical situation. Vertical distraction of the complete mandible was performed using a Martin distractor according to the Hoffmeister technique. At the end of the period of activation and consolidation, the distractor was removed and 8 Frialit-2 Synchro-type implants were placed in predetermined sites and immediately loaded with a cemented transitional prosthesis. Ten months later the definitive restoration was delivered. The absence of any pathologic symptoms or negative radiologic findings 12 months after the surgery suggests a satisfactory result in the short term.

PMID: 15214233 [PubMed - indexed for MEDLINE]

Retrospective evaluation of the success of oral rehabilitation using the Frialit-2 implant system. Part 1: Influence of topographic and surgical parameters.

Int J Prosthodont. 2004 Mar-Apr;17(2):187-94

Authors: Strietzel FP, Lange KP, Svegar M, Hartmann HJ, K&#xFC;chler I

PURPOSE: This retrospective longitudinal study evaluated the success of implant-prosthetic rehabilitation with the Frialit-2 implant system. MATERIALS AND METHODS: The study was performed with 504 patients, from two treatment centers, who had received a total of 1,554 implants between May 1990 and May 2001. The data of these patients, who received the implants in various regions and for various indications, were analyzed with respect to clinical, topographic, and radiographic parameters. The mean observation period was 6.2 years, with a maximum of 134 months. RESULTS: A survival rate of 94.8% was found for all implants. The implant survival rate of 92.6% in the maxilla remained constant after 68 months of observation. In the mandible, the implant survival rate of 96.7% showed no changes after 76 months. Kaplan-Meier analysis identified jaw, occurrence of postoperative complications, and region as statistically significant factors influencing implant survival. Multivariate Cox regression showed that gender, occurrence of postoperative complications, and jaw were factors that increased the risk of implant loss. Statistically significant correlations were found between the incidence of implant loss and vertical bone loss adjacent to the implant at the time of second-stage surgery. CONCLUSION: Implant survival rate is influenced by implant site, gender, and occurrence of complications. On the whole, the Frialit-2 system proved successful in all areas of indication after long-term observation.

PMID: 15119870 [PubMed - indexed for MEDLINE]

Influence of implant microstructure on the dynamics of bone healing around immediate implants placed into periodontally infected sites. A confocal laser scanning microscopic study.

Clin Oral Implants Res. 2004 Feb;15(1):44-53

Authors: Papalexiou V, Novaes AB, Grisi MF, Souza SS, Taba M, Kajiwara JK

This study evaluated by fluorescence analysis the influence of implant microstructure on the placement of immediate implants in periodontally infected sockets. Periodontal disease was induced during 12 weeks bilaterally from P1 to P4 in six dogs. The teeth were extracted and immediate implants were placed. Each dog received six implants: three with Friadent experimental surface (grit blasted/acid etched - FES group) and three covered with titanium plasma spray (TPS group), for a total of 36 Frialit-2 stepped cylinder implants. During the healing period, fluorescent bone markers were injected to study the bone remodeling around the implants. The dyes were injected in the following sequence: oxytetracyclin hydrochloride 3 days and 8 weeks, calcein green 4 weeks after the implantation and alizarin red S 3 days before killing. The animals were anesthetized and killed 12 weeks after implant placement. The mandibles were removed, dissected and processed for analyses of the percentage of newly formed bone surrounding the implant using a confocal laser scanning microscope. There were no significant statistical differences in bone formation (Mann-Whitney) between groups (FES group: 5.28% formation at 3 days, 10.3% at 4 weeks, 21.14% at 8 weeks and 6.98% at 12 weeks; TPS group: 3.36% at 3 days, 9.58% at 4 weeks, 14.57% at 8 weeks and 7.08% at 12 weeks). However, covariance analysis showed that the percent of marked bone was statistically greater for the FES group when compared to the TPS group, between the 3-day and 8-week periods of evaluation.

PMID: 14731176 [PubMed - indexed for MEDLINE]

Immediate placement of implants into periodontally infected sites in dogs. Part 2: A fluorescence microscopy study.

Int J Oral Maxillofac Implants. 2003 Nov-Dec;18(6):812-9

Authors: Marcaccini AM, Novaes AB, Souza SL, Taba M, Grisi MF

PURPOSE: Polychromatic sequence labeling of bone was used to study the effect of periodontal infection on the immediate placement of Frialit-2 implants. MATERIALS AND METHODS: In the surgical first phase, periodontitis was induced with ligatures involving the mandibular premolars of 5 mongrel dogs, and the contralateral teeth were used as controls (received only prophylaxis). After 3 months, the second phase was initiated and 40 implants were placed in the alveoli of both experimental and control teeth. During the healing period, fluorescent bone markers were injected to study bone formation around the implants. The dyes were injected in the following sequence: oxytetracycline hydrochloride at 3 days after implant placement, calcein green 4 weeks after implant placement, oxytetracycline 8 weeks after implant placement, and alizarin red S 3 days before sacrifice. Following a healing period of 12 weeks, the animals were euthanized and the hemimandibles were removed, dissected, fixed, and prepared for histomorphometic analysis of the percentage of each bone marker present. RESULTS: Fluorescence microscopy showed a similar sequence of bone remodeling (Mann-Whitney test) for both groups: experimental group, 9% bone formation at 3 days, 29% at 4 weeks, 21.6% at 8 weeks, and 52% at 12 weeks; control group, 14% at 3 days, 35.2% at 4 weeks, 32.3% at 8 weeks, and 45.8% at 12 weeks. DISCUSSION: Remodeling in both groups had similar characteristics in the degree of bone formation. CONCLUSIONS: It was concluded that periodontal disease does not affect bone remodeling around immediate implants. Although the healing in periodontally infected sites was slower initially, it reached the levels of the non-diseased sites after 12 weeks.

PMID: 14696656 [PubMed - indexed for MEDLINE]

[Single-tooth replacement in the aesthetic zone with immediate provisionalization]

Shanghai Kou Qiang Yi Xue. 2003 Jun;12(3):174-7

Authors: Huang JS, Zhou L, Song GB

OBJECTIVE: To investigate the clinical results of immediate loading of a single anterior implant. METHODS: 8 Frialit-2 implants were placed into anterior sites. Provisional prosthesis were placed at the time of fixture placement. RESULTS: No fixture has been lost since the immediate restoration was delivered, the minimum being 7 months and the maximum 14 months. CONCLUSION: Clinical studies on the placement of immediate restoration in anterior implant have revealed predictable results.

PMID: 14661323 [PubMed - indexed for MEDLINE]

Use of the Frialit-2 Implant System in private practice: a clinical report.

Int J Oral Maxillofac Implants. 2003 Jul-Aug;18(4):552-5

Authors: Wheeler S

This retrospective study presents the results of the use of the Frialit-2 System in a private practice setting. A total of 802 implants, both threaded and press-fit, were placed between February 2, 1996, and March 6, 2002. The overall success rate was 97%, and the cumulative survival rate using life table analysis was 96.1%. The statistical breakdown and an analysis of the results of the treatment of this patient population are presented.

PMID: 12939007 [PubMed - indexed for MEDLINE]

[Maxillary sinus lifting and simultaneously placement of implants from the top of alveoli]

Zhonghua Kou Qiang Yi Xue Za Zhi. 2003 Jul;38(4):251-3

Authors: Zhao BD, Li NY, Xu JS, Bu LX, Wang YH

OBJECTIVE: To study the effect of maxillary sinus floor elevation by the Frialit-2 Bone Condenser for implantation. METHODS: 11 patients underwent sinus floor lift by The Frialit-2 Bone Condenser and were inserted 14 implants. The time of following up was 10 - 21 months. RESULTS: There were no implant loose or lost, no clinical complaint of maxillary sinus area, and X-ray exam showed well osseointegration. CONCLUSIONS: The Frialit-2 bone condenser can be used for lifting sinus floor, and the sinus elevation without lateral access allows the insertion of implants with no additional surgical stress for the patients.

PMID: 12930649 [PubMed - indexed for MEDLINE]

A new adhesive technology for all-ceramics.

Dent Mater. 2003 Sep;19(6):567-73

Authors: Janda R, Roulet JF, Wulf M, Tiller HJ

OBJECTIVES: Evaluation of a new surface treatment method to obtain a good bond strength between a luting composite and several ceramics. METHODS: Specimen preparation and test procedure were done according to ISO 10477 Amendment 1. The surfaces of Empress II, InCeram-Alumina, InCeram-Zirconia and Frialit (ZrO2) were ground under water-cooling with 400 grit grinding paper, afterwards polished with 800 grit and air-dried. Each ceramic material investigated was divided into three groups of 10 specimens each. Group 1 was flame-treated with the PyrosilPen for 2.5 s, group 2 for 5 s and group 3 for 10 s/cm(2). After the flame treatment, a methacryl silane was applied followed by a luting composite. Prior to measuring shear bond strength, the specimens were thermocycled 5,000 times in a water-bath between +5 and +55 degrees C. Furthermore, SEM- and Fourier-transform infrared spectrophotometer (FT-IR)-investigations were done. As a control, Empress II etched and silaned was used. RESULTS: Shear bond strength measurements indicated that the optimal treatment time was 5 s/cm(2). Regarding this time the following bond strength values between the luting composite and the various ceramics were obtained: Empress II 23 (5)MPa, InCeram-Alumina 23 (5)MPa, InCeram-Zirconia 13 (8)MPa, and Frialit 16 (6)MPa. The control achieved 27 (6)MPa. On all surfaces of the flamed specimens Si could be detected by FT-IR.Significance. The PyrosilPen-Technology is an easy and effective method for surface-treating silicate, aluminum oxide and zirconium oxide ceramics to obtain good bonding to luting composites.

PMID: 12837406 [PubMed - indexed for MEDLINE]

Nonlinear finite element analysis of a splinted implant with various connectors and occlusal forces.

Int J Oral Maxillofac Implants. 2003 May-Jun;18(3):331-40

Authors: Lin CL, Wang JC

PURPOSE: The aim of this study was to analyze the biomechanics in an implant/tooth-supported system under different occlusal forces with rigid and nonrigid connectors by adopting a nonlinear finite element (FE) approach. MATERIALS AND METHODS: A model containing 1 Frialit-2 implant (placed in the second molar position) splinted to the mandibular second premolar was constructed. Nonlinear contact elements were used to simulate a realistic interface fixation between the implant body and abutment screw and the sliding keyway stress-breaker function. Stress distributions in the splinting system with rigid and nonrigid connectors were observed when vertical forces were applied to the tooth, pontic, implant abutment, or complete prosthesis in 10 simulated models. RESULTS: The displacement obtained from the natural tooth increased 11 times than that of the implant, and the peak stress values within the implant system (sigmaI, max) increased significantly when vertical forces acted only on the premolar of a fixed prosthesis with a rigid connector. The sigmaI, max values seen in the splinting prosthesis were not significantly different when vertical forces (50 N) were applied to the pontic, molar (implant) only, or the entire prosthesis, respectively, regardless of whether rigid or nonrigid connectors were used. Moreover, the peak stress values in the implant system and prosthesis were significantly reduced in single- or multiple-contact situations once vertical forces on the pontic were decreased. DISCUSSION: The compensatory mechanism between the implant components and keyway sliding function of the implant/tooth-supported prosthesis could be realistically simulated using nonlinear contact FE analysis. The nonrigid connector (keyway device) significantly exploited its function only when the splinting system received light occlusal forces. CONCLUSION: Minimization of the occlusal loading force on the pontic area through occlusal adjustment procedures to redistribute stress within the implant system in the maximum intercuspation position for an implant/tooth-supported prosthesis is recommended.

PMID: 12814307 [PubMed - indexed for MEDLINE]

In-patient comparison of immediately loaded and non-loaded implants within 6 months.

Clin Oral Implants Res. 2003 Jun;14(3):273-9

Authors: Lorenzoni M, Pertl C, Zhang K, Wegscheider WA

According to the Br&#xE5;nemark protocol, a stress-free healing period is one of the most emphasised requirements for implant integration. Recent studies have encouraged a progressive shortening of the healing period and immediate loading has been proposed for the edentulous mandible. This prospective study evaluated the clinical outcomes of 14 immediately loaded FRIALIT-2(R) implants compared with 28 non-loaded controls in an in-patient study. The results were based on clinical stability and on changes of bone level from implant placement to abutment connection 6 months after insertion. In the course of our investigation, seven patients with edentulous mandibles have been treated with 43 implants following an immediate-loading protocol. Six FRIALIT-2(R) implants were placed in the interforaminal region located at positions 34, 33, 32, 42, 43, 44. Bone level in relation to implant margin was measured and recorded. In order to obtain an in-patient comparison of immediately loaded and non-loaded implants, the ones at 33 and 43 were chosen to be immediately loaded by a Dolder-bar retained overdenture. The implants in position 32, 34, 42 and 44 were covered and left to heal. After a healing period of 6 months, second stage surgery was carried out. The clinical criteria to be checked at this point were survival, Periotest values and marginal bone level at the loaded and non-loaded implants. The mean Periotest value was -2.7 for the loaded and -5.6 for the non-loaded implants. The Mann-Whitney U-test showed that the difference was highly significant (P < 0.001). The mean bone level changes at prosthetic delivery were 0.9 mm resorption for the loaded implants and 0.33 mm for non-loaded implants. The difference was highly significant (P < 0.001). No implant failures were observed up to the prosthetic restoration 6 months post insertion. The results of this investigation allowed for direct comparison of implant survival and clinical results between immediately loaded implants and standard implants. Clinical bone changes at the 6-month evaluation demonstrated significantly higher crestal resorption around loaded implants. This fact was confirmed by higher median Periotest values (-3 vs. -6) of immediately loaded implants. According to the outcome of this study, immediate loading of two interforaminal implants with a Dolder-bar resulted in an intimate bone apposition comparable with implants with submerged healing. Nevertheless, the coronal bone level as well as clinical stability (PTV) were significantly lower in the case of the immediately loaded implants. Future studies will be necessary to evaluate marginal bone resorption, Periotest values and clinical success rates of mandibular immediately loaded implants in the long-term.

PMID: 12755777 [PubMed - indexed for MEDLINE]

Immediate loading of single-tooth implants in the anterior maxilla. Preliminary results after one year.

Clin Oral Implants Res. 2003 Apr;14(2):180-7

Authors: Lorenzoni M, Pertl C, Zhang K, Wimmer G, Wegscheider WA

According to the standard protocol, a load-free healing period is one of the most emphasized requirements for implant integration. Recent studies have encouraged a progressive shortening of the healing period for single-tooth implants and immediate loading has been proposed for the aesthetic zone in the maxilla. The present study evaluated clinical outcomes of immediately loaded FRIALIT-2 Synchro implants 12 months after placement in the maxillary incisal region. In the course of our investigation, nine patients have been treated following an immediate loading protocol. The stepped-screw type implants were inserted with an increasing torque up to 45 Ncm, thus measuring the primary stability of the implants. All implants were immediately restored with unsplinted acrylic resin provisional crowns and the patients provided with occlusal splints. Regular controls were performed at monthly intervals, intraoral radiographs were taken directly after implant placement, 6 and 12 months post insertion. The survival rate, clinical stability (Periotest) and radiographic coronal bone defects (CBD) were evaluated at delivery of the definitive superstructures (CBD 6) and 6 months later (CBD 12). Twelve FRIALIT-2 Synchro stepped screws of 3.8, 4.5 and 5.5 mm diameter and 13 and 15 mm length were placed in the incisal maxillary region. The median Periotest value 6 months post insertion was -2 with a minimum of -5 and a maximum of +2. The mean coronal bone level changes (CBD) at 6 and 12 months were 0.45 and 0.75 mm. No implant failed up to 12 months after insertion, resulting in a 100% survival rate. The presented results showed promising data for immediately loaded single-tooth implants in the anterior maxilla. Periotest values were within the range published for submerged implants. The radiographic coronal bone resorption after 6 and 12 months was even less than evaluated for implants placed in a standard two-stage procedure. It is evident that successful immediate loading protocols require a careful and strict patient selection aimed at achieving the best primary stability and avoiding any excessive functional or non-functional loading. Additional research needs to be done to provide data in situations where problems of poor bone quality, multiple implants or augmentation procedures must be overcome.

PMID: 12656877 [PubMed - indexed for MEDLINE]

Histologic findings in sinus augmentation with autogenous bone chips versus a bovine bone substitute.

Int J Oral Maxillofac Implants. 2003 Jan-Feb;18(1):53-8

Authors: Schlegel KA, Fichtner G, Schultze-Mosgau S, Wiltfang J

PURPOSE: The aim of this study was to compare a bovine bone substitute (Bio-Oss) to autogenous bone with respect to its value as a material for sinus augmentation. MATERIALS AND METHODS: In 10 beagle dogs 12 months of age, the 3 maxillary premolars were extracted on both sides. Six weeks later, 2 cavities of predefined size were produced in the region of the nasal cavity. The antral window was 25 mm long and had a vertical extension of 7 mm. Two Frialit-2 implants (3 x 8 mm) were placed in each bone defect (n = 20). Every implant was primarily stable because of fixation in native bone. In each maxilla, 1 bone defect was filled with autogenous bone harvested from the mandible and 1 was filled with Bio-Oss (material selected at random). The animals were sacrificed at 90 and 180 days, and histologic specimens were examined and the results subjected to statistical analysis by the Wilcoxon test for paired observations. RESULTS: No healing problems were observed. Histologically, after 90 days the volume of the augmentation showed a reduction of 14.6 +/- 4.4% within the Bio-Oss group and 3.8 +/- 2.5% in the group with autogenous bone. Bone-implant contact of 52.16 +/- 13.15% in the Bio-Oss group and 60.21 +/- 11.46% in the autogenous bone group was observed. At 180 days, the Bio-Oss group showed bony ingrowth of the substitute, whereas in the autogenous group a differentiation from original bone could no longer be made. The volume reduction was 16.5 +/- 8.67% in the Bio-Oss group and 39.8 +/- 16.14% in the autogenous group. Bone-implant contact of 63.43 +/- 19.56% in the Bio-Oss group and 42.22 +/- 12.80% in the autogenous bone group was measured. DISCUSSION AND CONCLUSION: The results indicated that because of the nonresorptive properties of the bone substitute Bio-Oss, regeneration of the defects is achievable. It was demonstrated that the bone substitute seemed to behave as a permanent implant. The volume of the area augmented by autogenous bone decreased over the observation period.

PMID: 12608669 [PubMed - indexed for MEDLINE]

The microflora recovered from the outer-surfaces of the Frialit-2 implanto-prosthetic connector.

Clin Oral Implants Res. 2003 Feb;14(1):28-34

Authors: Buchmann R, Khoury F, Pingel D, Lange DE

The aim of the present investigation was to examine the outer-surface microbiota of the prosthetic connector of Frialit-2 implants, and to compare the microbial findings with the peri-implant parameters 2 years after functional loading. In 16 implant-treated patients (55.8 +/- 9.5 years) the outer-surface micro-organisms of the prosthetic connectors were determined in 32 Frialit-2 implants. The functional loading time of the prosthetic suprastructures was 24.1 +/- 13.8 months on average. After removal of the implant-supported restoration, microbial samples were obtained from the outer-surfaces of the Frialit-2 prosthetic connector. The microbial plaque samples were specified on CDC-blood agar as percentages of the total cultivable flora. Actinobacillus actinomycetemcomitans was semiquantitively determined on TSBV-agar in CFU/ml. The microbial plaque samples were dominated by Actinomyces israelii (68.8%), Eubacterium lentum (56.3%) and Veillonella parvula (43.8%) with proportions ranking between 3.9% (V. parvula) and 11.1% (A. israelii). The most frequently detected gram-negative microorganisms were Fusobacterium nucleatum (87.5%), Porphyromonas gingivalis (81.3%), and Peptostreptococcus micros (68.8%) with enhanced proportions for P. gingivalis (11.4%) and P. micros (11.4%). No statistical significant correlation could be established between the microbiota present on the outer-surfaces of the F2-connector and the peri-implant parameters examined. The outer-surface microflora recovered from the implanto-prosthetic-connector of Frialit-2 implants reveals a colonization with gram-positive bacteria and potentially harmful gram-negative micro-organisms that were frequently detected, but present at low levels. After 2 years of restorative loading, the outer-surface microbial colonization is compatible with peri-implant soft tissue health.

PMID: 12562362 [PubMed - indexed for MEDLINE]

[Criteria of success in implantology]

Mund Kiefer Gesichtschir. 2003 Jan;7(1):42-6

Authors: Buch RS, Weibrich G, Wagner W

BACKGROUND: So far there is no generally accepted definition of success in the case of dental implants, although criteria differing from country to country have been proposed, which evaluate the success of implants with reference to clinical and X-ray control parameters. The aim of the study was to examine the five most frequently used sets of criteria suggested for determination of the success or otherwise of implants ( Albrektsson, Jahn, Buser, NIH conference, Naert) and ascertain their relative values. METHODS: In a clinical review, 508 implants (Astra, Frialit-2, IMZ TwinPlus and ITI) were examined and a subjective evaluation of them was made by the patients. Subsequently a statistical analysis was executed (in situ rate, Kaplan-Meier, success criteria). RESULTS: The average observation time of all implants included in the study was 3.5 years, and the in situ survival rate was 95%; Kaplan-Meier survival analysis revealed that the probability of survival after 6 years was 93%. Application of different criteria for success gave very different results (Albrektsson 88%, Naert 89%, NIH 85%, Buser 88%, Jahn and dacute;Hoedt 75%). DISCUSSION: The increasing importance of quality assurance in medicine makes it necessary to establish standards that will permit reliable comparative analysis of how successful implants are in the future.

PMID: 12556985 [PubMed - indexed for MEDLINE]

Histomorphometric and fluorescence microscopic analysis of bone remodelling after installation of implants using an osteotome technique.

Clin Oral Implants Res. 2002 Dec;13(6):595-602

Authors: Nkenke E, Kloss F, Wiltfang J, Schultze-Mosgau S, Radespiel-Tr&#xF6;ger M, Loos K, Neukam FW

The influence of the osteotome technique on the osseointegration of rough-surfaced stepped cylinder implants (Frialit)-2) was compared to conventional preparation of the implant site in an animal model. A total of 104 implants were placed into the distal femoral condyle of 52 New Zealand white rabbits. This region contains sufficient trabecular bone for implant placement. The implant site was prepared either by the osteotome technique or by conventional technique with drills as a control group. During the healing period polychromatic fluorescence labelling was performed with four different fluorescent dyes. After 2, 4 and 8 weeks, the implants were removed with the surrounding bone. The sample preparation was done using the 'sawing and grinding' technique. Ground sections 100 microm thick were used for fluorescence microscopic analysis; 30- microm-thick ground sections were examined histomorphometrically. After 2 weeks the bone-to-implant contact ratio was 55.0 +/- 7.1% for the osteotome technique and 29.2 +/- 4.8% for the control group (P < 0.0005). After 4 weeks, the bone-to-implant contact ratio was still significantly better for the osteotome technique (bone-to-implant contact ratio osteotome technique 71.1 +/- 7.2%, bone-to-implant contact ratio control 59.0 +/- 6.3%, P = 0.003). Eight weeks after implant placement the bone-to-implant contact ratio was still better for the osteotome technique compared to the conventional implant placement. However it was no longer statistically significant. The qualitative fluorescence microscopic examination showed an earlier and stronger signal for the osteotome technique than the control group. With the latter, the zone of mineralization moved slowly towards the implant surface. Implant sites prepared by the osteotome technique showed a pronounced signal in the whole compressed area already by the second day. In conclusion, the osteotome technique increases new bone formation and leads to an enhanced osseointegration of dental implants in trabecular bone. However, more experimental trials have to be carried out on higher mammals that show a metabolic rate of bone that is more comparable to humans.

PMID: 12519333 [PubMed - indexed for MEDLINE]

Immediate implant in extraction socket with acellular dermal matrix graft and bioactive glass: a case report.

Implant Dent. 2002;11(4):343-8

Authors: Novaes Júnior AB, Papalexiou V, Luczyszyn SM, Muglia VA, Souza SL, Taba Júnior M

A buccal plate destroyed as a result of a longitudinal root fracture was completely restored by the use of a Frialit-2 implant placed in the alveolus of the fractured maxillary left first bicuspid. An acellular dermal matrix material was used as a membrane barrier to cover the implant, and a bioactive glass was used as grafting material. After 6 months, the defect around the implant was completely filled by mineralized tissue.

PMID: 12518701 [PubMed - indexed for MEDLINE]

[Patient satisfaction with dental implants]

Mund Kiefer Gesichtschir. 2002 Nov;6(6):433-6

Authors: Buch RS, Weibrich G, Wegener J, Wagner W

BACKGROUND: Almost all implant systems available today achieve success rates of over 90%. The subjective satisfaction of patients with dental implants is only rarely considered in the definition of implant success and there are only limited data on the satisfaction of patients with dental implants in the literature. Therefore, a satisfaction analysis was carried out in a retrospective study. DESIGN OF STUDY: In addition to a clinical investigation, 330 patients with 1,273 implants (Astra, Frialit-2, IMZ TwinPlus and ITI) were asked to answer a standardized questionnaire to rate their personal opinion on the implant success. A total of 199 questionnaires (803 implants, 63%) were returned and could be analyzed. RESULTS: Of the patients, 67% participated in regular follow-up after implantation and 15% indicated postoperative discomfort. Patient satisfaction with the implants (rated on a scale of 1-6) was good or excellent (2 and 1, respectively) in 88% of cases. Satisfaction with the prosthetic treatment was 80%. The whole treatment was considered good or very comfortable by 86% of patients. If necessary, 91% of patients who underwent the procedure would do so again, and 94% would recommend the procedure to someone else. The Spearman correlation analysis did not reveal any statistically significant correlations between the clinical parameters and patient satisfaction scores. DISCUSSION: Despite the high number of patients involved ( n=330), the expected influence of objective clinical parameters on patient satisfaction could not be statistically evaluated. Nevertheless, in addition to the clinical parameters, subjective patient satisfaction should be included in the evaluation of implant success.

PMID: 12447657 [PubMed - indexed for MEDLINE]

Maxillary and mandibular bone reconstruction with hip grafts and implants using Frialit-2 implants.

Int J Periodontics Restorative Dent. 2002 Jun;22(3):221-9

Authors: Maiorana C, Santoro F

Many types of osseointegrated implants that are very reliable and supported by scientific medium- and long-term studies are presently available. Often, unfavorable anatomic situations require bone augmentation procedures either prior to or at the same time as implant placement. Some of these procedures present limits. Using versatile implant systems is desirable in cases such as advanced osseointe-. gration, intraoral bone grafts or guided bone regeneration techniques, or major surgical reconstruction with bone grafts from the hip. The aim of this study was to evaluate the efficacy of the Frialit-2 implant in 29 clinical cases of maxillary and mandibular reconstruction using different bone augmentation techniques, and to consider its success ratio through a 1- to 5-year follow-up.

PMID: 12186344 [PubMed - indexed for MEDLINE]

R-curve behavior of dental ceramic materials.

J Dent Res. 2002 Aug;81(8):547-51

Authors: Fischer H, Rentzsch W, Marx R

Some technical ceramics exhibit the R-curve effect, i.e., an increasing fracture resistance with crack extension which is a desirable material property because more energy is necessary to propagate a microscopic crack. The objective of this study was to prove whether dental ceramic materials exhibit R-curve behavior. Nine dental ceramics were examined by the indentation-strength method. It was found that all of the tested ceramic materials exhibit a rising R-curve with crack extension. The R-curve behavior was more pronounced for the high-strength materials In-Ceram Alumina, monolithic alumina, and especially Empress 2. We conclude from our results that the mechanical behavior of a dental ceramic material can be judged more comprehensively, if the R-curve of the respective material is known.

PMID: 12147745 [PubMed - indexed for MEDLINE]

Effect of low-power laser irradiation on bony implant sites.

Clin Oral Implants Res. 2002 Jun;13(3):288-92

Authors: D&#xF6;rtbudak O, Haas R, Mailath-Pokorny G

This study was designed to examine the effects of low-energy laser irradiation on osteocytes and bone resorption at bony implant sites. Five male baboons with a mean age of 6.5 years were used in the study. Four holes for accommodating implants were drilled in each iliac crest. Sites on the left side were irradiated with a 100 mW low-energy laser (690 nm) for 1 min (6 Joule) immediately after drilling and insertion of four sandblasted and etched (Frialit-2 Synchro) implants. Five days later, the bone was removed en bloc and was evaluated histomorphometrically. The mean osteocyte count per unit area was 109.8 cells in the irradiated group vs. 94.8 cells in the control group. As intra-individual cell counts varied substantially, osteocyte viability was used for evaluation. In the irradiated group, viable osteocytes were found in 41.7% of the lacuna vs. 34.4% in the non-irradiated group. This difference was statistically significant at P < 0.027. The total resorption area, eroded surface, was found to be 24.9% in the control group vs. 24.6% in the irradiated group. This difference was not statistically significant. This study showed that osteocyte viability was significantly higher in the samples that were subjected to laser irradiation immediately after implant site drilling and implant insertion, in comparison to control sites. This may have positive effects on the integration of implants. The bone resorption rate, in contrast, was not affected by laser irradiation.

PMID: 12010159 [PubMed - indexed for MEDLINE]

Effect of simulated CO2 and GaAlAs laser surface decontamination on temperature changes in Ti-plasma sprayed dental implants.

Lasers Surg Med. 2002;30(3):233-9

Authors: Kreisler M, Al Haj H, Götz H, Duschner H, d'Hoedt B

BACKGROUND AND OBJECTIVE: To investigate and compare temperature elevations at the implant-bone interface during simulated implant surface decontamination with a CO2 and a GaAlAs laser. STUDY DESIGN/MATERIALS AND METHODS: Stepped cylinder implants (Frialit 2) Friadent GmbH, Mannheim, Germany) with a Titanium plasma sprayed surface were inserted into bone blocks cut from pig femurs. An artificial periimplant bone defect provided access for laser irradiation in the coronal third. Both lasers were operated at 1.0-2.5 W in the cw-mode. The bone block was placed into a 37 degrees C water bath in order to simulate in vivo thermal conductivity and diffusitivity of heat. K-type thermocouples connected to a digital meter were used to register temperature changes at the periimplant bone. RESULTS: In mean, the critical threshold of 47 degrees C was exceeded after 8 seconds at a power output of 2.5 W, 13 seconds at 2.0 W, 18 seconds at 1.5 W, and 42 seconds at 1.0 W with the GaAlAs laser and 15 seconds (2.5 W), 23 seconds (2.0 W), 35 seconds (1.5 W), and 56 seconds (1.0 W) with the CO2 laser. At equal energy fluence, GaAlAs laser irradiation induced significantly higher temperature elevations than CO2 laser irradiation. CONCLUSIONS: In an energy dependent manner implant surface decontamination with both laser types must be limited in time to allow the implant and bone to cool down. Clinical guidelines are presented to avoid tissue damage.

PMID: 11891744 [PubMed - indexed for MEDLINE]

Single-tooth replacement with the Frialit-2 system: a retrospective clinical analysis of 146 implants.

Int J Oral Maxillofac Implants. 2002 Jan-Feb;17(1):78-85

Authors: Krennmair G, Schmidinger S, Waldenberger O

PURPOSE: This study was intended to provide a report of experience and results with Frialit-2 implants used for single-tooth replacement. MATERIALS AND METHODS: Over a 7-year period (1994-2000), 146 single-tooth implants (84 maxilla, 62 mandible) were placed in 112 patients (67 females, 45 males; 31.2 +/- 16.4 years). The sites included maxillary anterior teeth (n = 38) as well as the mandibular premolars and molars (n = 57). Ninety-three crowns were cemented and 53 crowns were screw mounted (22 with vertical, 31 with horizontal screws) on standard abutments. The follow-up time varied between 3 and 80 months (35.8 +/- 16.5 months). RESULTS: Two implants (1.4%) were lost, 1 during early loading and the other after 6 years. The most frequent prosthetic complication was isolated crown loosening of cemented crowns requiring recementation of 9 crowns (9.9%). Crowns with vertical screws showed no crown and/or screw loosening. Four crowns (2.8%) were replaced because of ceramic fracture. DISCUSSION: Peri-implant soft tissue condition, bone resorption, and Periotest values indicated satisfactory results. The cumulative implant survival rate during the follow-up period was 97.3%, and that of the crowns 96.4% (total cumulative survival rate 93.7%). CONCLUSIONS: With the low number of abutment screw loosenings (3.5%), the deep internal hexagonal retention compared favorably to external retention methods. The predominant use of long implants (98.4% > or = 13 mm) allowed a favorable implant/crown ratio with the potential for problem-free, long-term results.

PMID: 11858577 [PubMed - indexed for MEDLINE]

Single tooth-by-tooth crowns over Frialit-2 implants.

J Oral Implantol. 2000;26(1):20-7; discussion 28

Authors: Kosinski T

Optimizing aesthetics in the anterior maxilla can be a challenge because of tissue contouring problems. Dental implants allow for restoration of edentulous areas, thus improving function. Some compromises may result as a result of the necessity of predicting the stability of the replacement restorations. The Frialit-2 dental implant system with the internal hex design provides excellent stability for single-tooth restorations. Aesthetics are maximized using Procera Allceram crowns. This case study describes in detail the following: diagnosing and treatment planning for a challenging trauma case; surgical preparation and placement of two Frialit-2 dental implants in the maxillary left central and lateral incisor areas; primary impression techniques and fabrication of a temporary prosthesis over ProTect abutments; second-phase opening; final impressions; and fabrication of two single crowns.

PMID: 11831298 [PubMed - indexed for MEDLINE]

Influence of the implant abutment on the Periotest value: an in vivo study.

Quintessence Int. 2001 Nov-Dec;32(10):797-9

Authors: Gomez-Roman G, Lukas D

OBJECTIVE: Periotest values for dental implants depend on the type of prosthetic abutment utilized for the restoration. If Periotest value cannot be measured at the single crown, the Periotest values used for comparison must be derived from the same type of superstructure. METHOD AND MATERIALS: Fifty-nine patients were selected from a regular follow-up program. At the end of the healing period, the Periotest values of Frialit-2 implants were measured at the gingiva former and abutment. The values were then compared with the Periotest measurements obtained at the placement of the final single crown and during the first follow-up examination. RESULTS: Compared to values measured at single crowns, the Periotest value measured at gingiva formers decreased on average by 3.5. The measurement of the abutment revealed a decrease of 1.7. Until the first recall and under functional loading of implants, the Periotest value increased on average by 1.8. These differences significantly differed from 0. CONCLUSION: If measurements at different abutments such as crown abutments or single crowns are necessary, comparison of the Periotest values in accordance with the given mean values will lead to more precise results. It is recommended that Periotest measurements be performed for the first and subsequent prostheses, during all prosthetic stages, to allow comparison if some parts of the prosthetic abutment have to be replaced.

PMID: 11820048 [PubMed - indexed for MEDLINE]

[Clinical and radiographic evaluation of 108 dental implants after 1-year loading]

Zhonghua Kou Qiang Yi Xue Za Zhi. 2001 Jan;36(1):17-9

Authors: Tang Z, Sha Y, Lin Y

OBJECTIVE: To evaluate the clinical outcomes and a possible correlation between peri-implant mucosal inflammation and marginal bone loss in a group of Chinese patients who received IMZ and Frialit-2 implants one year after restoration. METHODS: The clinical and radiography parameters of 108 IMZ and Frialit-2 dental implants in 70 patients were measured. RESULTS: There were no signs of mobility and peri-implant radiolucencies in any of the implants. The average bone loss adjacent to implants was (0.63 +/- 0.78) mm. The prevalence of peri-implant mucosal inflammation, as indicated by suclus bleeding index (SBI) of 1.0 or more, was 32.9%. Significant correlation was found between mucosal inflammation and bone loss. The severely inflamed sites experienced greater bone loss than that of healthy or slightly inflamed sites (P < 0.05). In 92% of sites, plaque index (PLI) of more than 1 was measured on implant surfaces. The periodontal status of the remaining natural teeth in each subject was evaluated using the community periodontal index of treatment need (CPITN). Of the 70 examined patients, 15 patients needed oral hygiene instruction, 44 needed scaling and root planing, 8 patients needed periodontal surgical therapy, and only 3 did not need any periodontal treatment. CONCLUSIONS: The 1-year outcomes from this patient series indicated that IMZ and Frialit-2 implant provide satisfactory clinical results. One of the etiologic factors of alveolar bone loss around implants seems to be plaque-associated marginal inflammation. Improvement of oral hygiene, elimination of marginal tissue inflammation, and proper treatment of periodontal disease of natural teeth are needed for maintaining the implants in these observed subjects.

PMID: 11812295 [PubMed - indexed for MEDLINE]

Per-implant care of ailing implants with the carbon dioxide laser.

Int J Oral Maxillofac Implants. 2001 Sep-Oct;16(5):659-67

Authors: Deppe H, Horch HH, Henke J, Donath K

One of the many applications for which lasers have been proposed in implant dentistry is for the decontamination process. The purposes of this study were to assess possible alterations in titanium implants in vitro and in vivo by use of the carbon dioxide (CO2) laser and to determine whether new bone formation can occur on previously contaminated implants. In vitro, temperature changes at the bone-titanium implant interface were recorded during use of a CO2 laser-scanning system (Swiftlase). Additionally, the effects of laser irradiation on titanium implants at various power settings were examined. In 6 beagle dogs, a total of 60 implants and bony defects resulting from plaque accumulation were treated by air-powder abrasive (the conventional treatment), laser irradiation, or both. Depending on the parameters chosen, melting and other surface alterations were seen in vitro, especially in the superpulse mode. Otherwise, no alterations were found, even at high power settings in the continuous mode. In vivo, corresponding histologic examination of 4-month sections showed evidence of new direct bone-to-implant contact after laser-assisted therapy, especially when the implants had been treated concomitantly with submerged membranes. These results support the hypothesis that peri-implant defects can be treated successfully by laser decontamination without damaging the surrounding tissues in the dog model. Nevertheless, further investigations will be required to determine the clinical efficacy of the treatment.

PMID: 11669248 [PubMed - indexed for MEDLINE]