Implant replacement of congenitally missing lateral incisors: a case report.

J Oral Implantol. 2008;34(2):115-8

Authors: Winkler S, Boberick KG, Braid S, Wood R, Cari MJ

Implants can readily be placed and restored in congenitally missing maxillary lateral incisor sites with predictable results if surgical, periodontal, and prosthodontic conditions are favorable. A case report using dental implants to replace bilateral congenitally absent maxillary lateral incisors for teenage female identical twins is presented.

PMID: 18478908 [PubMed - indexed for MEDLINE]

Prosthetic solution for unfavorably inclined maxillary implants: a case report.

J Oral Implantol. 2008;34(2):111-4

Authors: Uludag B, Celik G, Goktug G

Misaligned implants may affect the esthetic, phonetic, and functional results and challenge the restorative dentist. Proper attachment selection is important considering the patient-related circumstances. This article presents a case where a change in prosthetic attachments was required because implant inclination diminished overdenture retention and stability. The treatment involved an alternative implant and soft-tissue impression technique.

PMID: 18478907 [PubMed - indexed for MEDLINE]

Immediate placement of multiple mini dental implants into fresh extraction sites: a case report.

J Oral Implantol. 2008;34(2):107-10

Authors: Flanagan D

This case report discusses the immediate placement of 3 mini dental implants into 3 fresh extraction sockets. The implants were used to support a splinted fixed partial denture. Immediately placing implants of a very small diameter into fresh extraction sockets to support a fixed partial denture is possible. Some implant sites cannot accept standard-sized implants because of length or width deficiencies. Very small diameter implants may be able to support fixed prostheses in these sites.

PMID: 18478906 [PubMed - indexed for MEDLINE]

Implant placement in extraction sockets: a short review of the literature and presentation of a series of three cases.

J Oral Implantol. 2008;34(2):97-106

Authors: Ataullah K, Chee LF, Peng LL, Tho CY, Wei WC, Baig MR

Successful placement of dental implants in extraction sockets has been reported in the literature. There are numerous practical considerations in relation to immediate implant placement that make the procedure more complex as compared with placement in healed extraction sites. A short review of the literature is presented to understand the scientific principles and controversies related to immediate implants. This is followed by a presentation of 3 completed cases of immediate implants. Some of the important practical considerations in relation to immediate implant placement are also highlighted.

PMID: 18478905 [PubMed - indexed for MEDLINE]

Implant-supported rehabilitation of severe malocclusion due to unilateral condylar hypoplasia: case report.

J Oral Implantol. 2008;34(2):90-6

Authors: Jacobson N, Starr C

Unilateral condylar hypoplasia results in facial, skeletal, and dental deformity and is a condition that is often treated with surgery and orthodontics. This report describes implant-supported prosthodontic rehabilitation in a 70-year-old patient who chose not to undergo orthognathic surgery. The patient underwent full-mouth dental extraction and placement of 9 maxillary and 5 mandibular implants. She received implant-supported cantilevered fixed prostheses in both arches to improve and minimize her skeletal and dental crossbite.

PMID: 18478904 [PubMed - indexed for MEDLINE]

Effect of ovariectomy and alendronate on implant osseointegration in rat maxillary bone.

J Oral Implantol. 2008;34(2):76-82

Authors: Viera-Negrón YE, Ruan WH, Winger JN, Hou X, Sharawy MM, Borke JL

Bisphosphonates such as alendronate (ALD), although controversial, are worthy of investigation for the enhancement of implant osseointegration in patients with low bone mass who are already taking bisphosphonates for osteoporosis. These patients may receive additional benefits and be acceptable candidates for dental implants without needing to change their medication regimen and possibly as a result of their medication regimen. The purpose of this study was to compare implant osseointegration in maxillary bone of normal rats with a rat model of postmenopausal estrogen deficiency (ovariectomized [OVX]), with and without ALD. An experimental group of 32 rats was divided in 4 groups: ALD-OVX (n=8 OVX with ALD), OVX (n=8 OVX without ALD), ALD (n=8 normal rats with ALD), and control (n=8 normal rats). All rats received one titanium microscrew implant in the left edentulous region of the maxillary arch. The ALD-OVX and ALD groups received subcutaneous injections of ALD 3 times a week. On the fourth week after ALD administration, an implant was placed in all 32 rats. The maxilla of each rat was radiographed 4 times: at 0, 7, 14, and 28 days. On day 28 after implant placement, all rats were killed, and the peri-implant tissue was embedded in plastic or paraffin for histological examination. The X rays were used for a chronologic calculation of the contact ratio between implant and bone surfaces. Radiographic bone density was determined at 3 points: mesial, apical, and distal. The results show that osseointegration of the implants was impaired in the estrogen-deficient OVX rats compared with the ALD-OVX rats. Fifty percent of the implants were lost at 2 weeks in the OVX group. Radiographic evidence suggested that none of the implants in the OVX group osseointegrated. In the histologic examination more bone was observed around implants from the ALD-OVX and ALD groups than around implants from the OVX group. The OVX group presented a dramatic reduction in implant bone contact at 2 weeks and a significant 13% reduction at 4 weeks vs day of implant (P = .006). The ALD-OVX group presented 50% more bone density than the OVX group (P = .0003). Both ALD groups (ALD and ALD-OVX) had significantly higher radiographic bone density than the other groups (P < .01 for each comparison). In conclusion, osseointegration of implants was enhanced by ALD. Radiographic bone density and contact ratio improved with ALD administration. Implant osseointegration was impaired by estrogen deficiency in the OVX group.

PMID: 18478902 [PubMed - indexed for MEDLINE]

Novel protocols for predictable implantology.

Pract Proced Aesthet Dent. 2008 Mar;20(2):123-8

Authors: Anitua E

Contemporary advancements in implant therapy have resulted in the increased application of predictable rehabilitation methods. While the advent of immediate implantation procedures have revolutionized the method by which implants are delivered in patients with healthy osseous structures, care must be taken to ensure that proper evaluation of the patient's bone structure is performed preoperatively to ensure selection of an appropriate method. This article describes the techniques and clinical protocols that have recently evolved to improve daily clinical practice. Improved understanding of these protocols may ensure increased bio-safety and predictability during implant placement, and may improve clinical decision-making and long-term implant success.

PMID: 18478900 [PubMed - indexed for MEDLINE]

Aesthetic correction of a root fracture using an implant-supported zirconia restoration.

Pract Proced Aesthet Dent. 2008 Mar;20(2):117-9

Authors: Aherne T, Aherne S

PMID: 18478899 [PubMed - indexed for MEDLINE]

Implanting a new restorative solution.

Pract Proced Aesthet Dent. 2008 Mar;20(2):100-2

Authors:

PMID: 18478897 [PubMed - indexed for MEDLINE]

Implementing socket seal surgery as a socket preservation technique for pontic site development: surgical steps revisited--a report of two cases.

J Periodontol. 2008 May;79(5):945-54

Authors: Landsberg CJ

BACKGROUND: Tooth removal is always followed by the loss of vital soft and hard tissues. When occurring in the anterior region of the maxilla, the resulting ridge deformation may cause severe functional and esthetic problems. Diverse soft and hard tissue regenerative procedures have been developed for correcting ridge defects with the aim of establishing functional and esthetically pleasing pontic or implant restoration sites. However, these technically demanding procedures may be regarded as non-predictable in the hands of most clinicians. To reduce the need for restoring challenging ridge defects, an alternative exists in the form of a simple, minimally invasive socket-preservation procedure immediately following tooth extraction known as socket seal surgery. This article describes the currently improved surgical steps to be implemented with the objective of achieving a functional and esthetically acceptable pontic site. METHODS: Immediately following tooth extraction, the socket bony walls are debrided and decorticated, and the soft tissue walls are de-epithelialized by a coarse round diamond bur. The socket is filled with particles of a slowly resorbing bone substitute material except for 2 to 3 mm coronally. A cylindrically shaped soft tissue graft that matches the socket orifice contours is harvested from the palatal mucosa and placed atop the bone graft. The soft tissue graft is usually stabilized with six to eight simple interrupted 6-0 monofilament polyamide or 7-0 polypropylene sutures or, when the case allows, by a broad-based pontic restoration that is placed at a minimal distance from the graft. RESULTS: Two cases, each representing a different technique for stabilizing the soft tissue graft, demonstrate successful graft survival. Clinically and radiographically, successful regeneration of the ridge's hard and soft tissues, including the ability to develop functional and esthetically acceptable pontic sites, was demonstrated. CONCLUSIONS: Socket seal surgery is an efficacious procedure for ridge preservation and is effective in providing the necessary conditions for the development of functional and esthetic pontic sites.

PMID: 18454676 [PubMed - indexed for MEDLINE]

Partial-thickness cortical bone graft from the mandibular ramus: a non-invasive harvesting technique.

J Periodontol. 2008 May;79(5):941-4

Authors: Hwang KG, Shim KS, Yang SM, Park CJ

BACKGROUND: The conventional method of harvesting full cortical bone from the mandibular ramus was reported to have associated complications ranging from postoperative pain and swelling to impaired inferior alveolar nerve function. METHODS: A modified ramal bone harvesting technique is described in which partial cortical-type bone is harvested from the mandibular ramus and used for an autogenous bone graft. RESULTS: Partial-thickness cortical bone was harvested without paresthesia while reducing postoperative discomfort and complications. Sufficient bone was obtained for ridge augmentation and eventual implant placement. CONCLUSION: Non-invasive partial cortical ramal bone harvesting is a reproducible and predictable technique for preventing nerve damage while providing sufficient block bone needed for a dental implant.

PMID: 18454675 [PubMed - indexed for MEDLINE]

Thyroid hormones may influence cortical bone healing around titanium implants: a histometric study in rats.

J Periodontol. 2008 May;79(5):881-7

Authors: Feitosa Dda S, Bezerra Bde B, Ambrosano GM, Nociti FH, Casati MZ, Sallum EA, de Toledo S

BACKGROUND: The aim of the present study was to evaluate, by histometric analysis, the influence of the thyroid hormones, triiodothyronine (T(3)) and thyroxine (T(4)), on bone healing around titanium implants inserted in rat tibiae. METHODS: Forty-two male Wistar rats were randomly assigned to the experimental groups: G1 = healthy animals (control; N = 15); G2 = hypothyroidism (N = 13); and G3 = hyperthyroidism (N = 14). Once alterations were confirmed by total serum levels of T(3) and T(4), one screw-shaped titanium implant was placed in the rat tibiae. Sixty days later, the animals were sacrificed, and undecalcified sections were obtained. Bone-to-implant contact (BIC), bone area within the limits of the implant threads, and bone density in a 500-microm-wide zone lateral to the implant were obtained separately for the cortical (zone A) and cancellous (zone B) bone regions. RESULTS: Intergroup analysis demonstrated that thyroid hormones may significantly affect cortical bone healing around titanium implants. Hyperthyroidism significantly increased the area of newly formed bone in zone A (P <0.05), whereas hypothyroidism significantly decreased the area of newly formed bone and bone density around the implant in zone A (P <0.05) compared to the healthy group. In addition, hyperthyroidism significantly increased BIC extension in zone A compared to hypothyroidism (P <0.05). CONCLUSION: Thyroid hormones may influence the healing process in the cortical bone around titanium implants placed in rats, whereas cancellous bone seems to be less sensitive to changes in T(3) and T(4) serum levels.

PMID: 18454667 [PubMed - indexed for MEDLINE]

Simultaneous flapless implant placement and peri-implant defect correction: an experimental pilot study in dogs.

J Periodontol. 2008 May;79(5):876-80

Authors: Jeong SM, Choi BH, Li J, Xuan F

BACKGROUND: Minimally invasive implant surgery allows clinicians to place implants in less time, without extensive flaps, and with less bleeding and postoperative discomfort. The purpose of this study was to evaluate a new surgical technique by which implants are inserted in a deficient alveolar ridge using a flapless technique simultaneously with a peri-implant defect correction that is performed using a subperiosteal tunneling procedure. METHODS: Bilateral, horizontal defects of the alveolar ridge were created in the mandibles of five mongrel dogs. After 3 months of healing, one implant was placed on each side of the mandible by a flapless procedure. The exposed threads of the implant on one side of the mandible were covered with a 1:1 autogenous bone/xenograft mixture using a subperiosteal tunneling technique. Four months later, biopsies of the implant sites were taken and prepared for ground sectioning and analysis. RESULTS: All implants were well osseointegrated with the host bone. All of the peri-implant defects at the test sites were covered with tissue that resembled bone. In all specimens, a mixture of bone, connective tissue, and residual bone particles was observed in the graft area. In the control sites, where no graft was used, none of the exposed threads on any implants were covered with new bone. CONCLUSION: This preliminary report indicates the potential use of a minimally invasive flapless technique as a substitute for a more invasive implant placement and ridge augmentation procedure.

PMID: 18454666 [PubMed - indexed for MEDLINE]

Mechanical and repeated antimicrobial therapy using a local drug delivery system in the treatment of peri-implantitis: a randomized clinical trial.

J Periodontol. 2008 May;79(5):836-44

Authors: Renvert S, Lessem J, Dahl&#xE9;n G, Renvert H, Lindahl C

BACKGROUND: Peri-implantitis is an inflammatory process caused by microorganisms affecting the tissues around an osseointegrated implant in function, resulting in a loss of supporting bone. Limited data exist regarding the treatment of peri-implantitis. The aim of this study was to assess the clinical and microbiologic outcome of repeated local administration of minocycline microspheres, 1 mg, in cases of peri-implantitis. METHODS: Thirty-two subjects with at least one implant with a probing depth > or =4 mm combined with bleeding and/or exudate on probing and the presence of putative pathogenic bacteria were included in the study. At baseline, subjects were randomly assigned to receive local minocycline microspheres (17 subjects and 57 implants) or chlorhexidine gel (15 subjects and 38 implants) following debridement. Treatments were performed on three occasions: baseline and days 30 and 90. Follow-up examinations were conducted at 10 days and at 1, 3, 6, 9, and 12 months. RESULTS: The use of minocycline resulted in significant improvements in probing depths compared to chlorhexidine at days 30, 90, and 180 (P = 0.5, P = 0.01, and P = 0.04, respectively). For the deepest sites of the minocycline-treated implants, the mean probing depth reduction was 0.6 mm at 12 months. Regarding bleeding on probing, significant differences between groups, based on all four sites at the implants, were found at days 30, 90, 180, 270, and 360. Both treatments resulted in a marked reduction in the indicator bacteria. CONCLUSIONS: The use of a repeated local antibiotic as an adjunct to the mechanical treatment of peri-implantitis lesions demonstrated improvements in probing depths that were significantly different from controls and were sustained for 6 months. The adjunctive use of minocycline microspheres is beneficial in the treatment of peri-implant lesions, but the treatment may have to be repeated.

PMID: 18454662 [PubMed - indexed for MEDLINE]

One-stage operation of large oroantral fistula closure, sinus lifting, and autogenous bone grafting for dental implant installation.

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Jun;105(6):707-13

Authors: Lee BK

Bone grafts to the maxillary sinus are often required after closure of an oroantral fistula (OAF) to allow for subsequent implant installation. This report describes a single procedure that closes a large OAF using bone grafting to the involved sinus. This technique involves sinus mucosal lifting via elevating the sinus membrane, which is recovered as a continuous layer by combining the residual sinus membranes with a rotated part of oral mucosa around the OAF. Autogenous bone from the ilium was grafted into the prepared sinus space, and the oral side of the graft was covered by a rotated palatal flap. This technique was used to treat 3 patients who had large OAFs in the atrophied posterior maxillary region owing to previous multiple implant failures after sinus lifting. The treatment was successful in all cases. This technique appears to be suitable for large OAFs where implants are subsequently desired.

PMID: 18299230 [PubMed - indexed for MEDLINE]