scholarly journals The early loading of different surface-modified implants: a randomized clinical trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kinga Körmöczi ◽  
György Komlós ◽  
Petra Papócsi ◽  
Ferenc Horváth ◽  
Árpád Joób-Fancsaly

Abstract Background Various surface treatment options have been adopted with the aim to improve osseointegration, reducing the overall treatment time. Implant stability of early loaded implants with different modified surfaces was compared in the present study. Methods Patients were selected from the Department of Oro-Maxillofacial Surgery and Stomatology at Semmelweis University. Patients randomly received SA (alumina sandblasted and acid-etched), NH (bioabsorbable apatite nanocoating) or SLA (large-grit sandblasted and acid-etched) surface implants. Outcome measures were: implant success, implant stability, and periodontal parameters. The implant stability was measured at the time of implant placement (primary stability) and six weeks after (prothesis delivery, secondary stability). Osstell and Periotest were applied to take all the measurements. The primary and secondary stability were compared in the three study groups Finally the periimplant probing depth appearing after three months of loading was checked on 6 points around to the implant-supported prostheses. Shapiro–Wilk and Mann–Whitney tests were used for the comparison between the study groups. Results A total of 75 implants with different length and diameter were inserted into various positions. One implant failed spontaneously at the fourth week after implant placement. The survival rate was 98,7%. Comparing the primary and secondary stability values, the data were significantly improved in every groups. The difference was the highest in the NH group, however, this difference was not significant compared to the two other groups. Good periodontal parameters were experienced in all the tested implants, independently by the groups. Conclusions With the limitation of the present study, all the implants showed improved stability six weeks after implant placement. A trend of higher result was found for the NH group. Further studies with longer follow-up are needed to confirm this preliminary results. Trial registration: Current Controlled Trials ISRCTN13181677; the date of registration: 04/03/2021. Retrospectively registered.

2021 ◽  
Vol 11 (7) ◽  
pp. 2958
Author(s):  
Maciej Krawiec ◽  
Jakub Hadzik ◽  
Marzena Dominiak ◽  
Wojciech Grzebieluch ◽  
Artur Błaszczyszyn ◽  
...  

(1) Background: implant surface topology and active hydrophilic ions could have some benefit on implant osteointegration and stability; (2) methods: 40 adult patients, suffering from a single missing tooth in the aesthetic zone, were enrolled in the study. Each patient had a single titanium implant (Thommen SPI®lement) inserted. The implant surface was obtained through conditioning using the Apliquiq system. Patients were divided into two equal groups depending on the implant’s diameter (3.5 and 4.0 mm). Each implant was loaded within four weeks. Stability levels, using the Ostell device, were checked immediately after implant placement and in four weeks; additionally, marginal bone loss (MBL) was calculated based on 12 months; (3) results: all implants survived the study. The average primary stability achieved for both groups was initially 71.59 ISQ (±4.04) and declined to 69.94 ISQ (±3.29) in four weeks. The average MBL was 0.2 mm (±0.88). There were no statistically important differences between groups. There was a positive correlation between the patient’s age and implant stability quotient (ISQ) values; (4) conclusions: hydrophilic surface implants can be used in a protocol for early functional occlusal loading. Higher values of primary stability positively influence the values of secondary stability, and the age of the patient affects the values of implant stability.


Author(s):  
João Paulo do Vale Souza ◽  
Clóvis Lamartine de Moraes Melo Neto ◽  
Lucas Tavares Piacenza ◽  
Emily Vivianne Freitas da Silva ◽  
André Luiz de Melo Moreno ◽  
...  

Abstract Objectives This study aimed to assess the relation between the insertion torque and implant stability quotient (ISQ recorded immediately and 6 months after implant placement). Materials and Methods Twenty-five patients over the age of 18 years were selected for this study. One implant was placed per patient after tooth extraction. The implant site needed 15 mm in height and 8 mm in width. All implants had the same size (11.5 × 3.75 mm) and brand (Hexagonal Morse cone, DSP Biomedical). The insertion torque (Ncm) and resonance frequency analysis (ISQ value) (Osstell Mentor) were used to assess the primary stability (on the day of surgery). After 6 months, ISQ value was used to assess the secondary stability of each implant. Statistical Analysis The insertion torque data were correlated with ISQ measurements by using Pearson’s correlation. The significance level was 5%. Results There was a positive correlation between insertion torque and initial ISQ (correlation: 0.457; p = 0.022); however, no correlation was found between insertion torque and final ISQ (p = 0.308). Conclusion The present study demonstrated that there is a positive correlation between the insertion torque and the initial ISQ. Therefore, the higher the insertion torque, the higher the initial ISQ (or vice versa).


Author(s):  
Vasilena Ivanova ◽  
Ivan Chenchev ◽  
Stefan Zlatev ◽  
Eitan Mijiritsky

Background: This study aims to evaluate whether there is a correlation between implant stability, bone density, vital bone formation and implant diameter and length. Methods: Ninety patients were enrolled in this study. They underwent a socket preservation procedure with allograft or PRF and after 4 months, a total of 90 implants were placed. CBCT scans were assigned prior to implant placement in order to assess the bone density. During the surgical re-entry, a bone biopsy was harvested with a trephine drill. Immediately after implant insertion, the primary stability was measured. The secondary stability was measured 4 months after implant placement. Results: Primary stability showed a significant positive linear correlation with bone density (r = 0.471, p < 0.001) as well as with percentage of new bone formation (r = 0.567, p < 0.001). An average significant association of secondary stability with bone density (rs = 0.498, p < 0.001) and percentage of newly formed bone (r = 0.477, p < 0.001) was revealed. The mean values of primary stability in all three implant sizes, regarding the diameter of the implants, were similar (narrow 67.75; standard 66.78; wide 71.21) with no significant difference (p = 0.262). The same tendency was observed for secondary stability (narrow 73.83; standard 75.25; wide 74.93), with no significant difference (p = 0.277). Conclusions: The study revealed a high correlation between primary and secondary implant stability, and bone density, as well as with the percentage of vital bone formation. Implant length and diameter revealed no linear correlation with the implant stability.


2013 ◽  
Vol 70 (6) ◽  
pp. 586-594 ◽  
Author(s):  
Zoran Vlahovic ◽  
Branko Mihailovic ◽  
Zoran Lazic ◽  
Mileta Golubovic

Background/Aim. Flapless implant surgery has become very important issue during recent years, mostly thanks to computerization of dentistry and software planning of dental implants placements. The aim of this study was to compare flap and flapless surgical techniques for implant placement through radiographic and radiofrequency analyses. Methods. The experiment was made in five domestic pigs. Nine weeks following domestic pigs teeth extraction, implants were placed, on the right side using surgical technique flap, and flapless on the left side. Digital dental Xrays were applied to determine primary dental implant stability quality (ISQ). At certain intervals, not later than three months, the experimental animals were sacrificed, and just before it, control X-rays were applied to measure dental implants stability. Results. Radiographic analysis showed that peri-implant bone resorption in the first 4 weeks following placement implants with flap and flapless surgical techniques was negligible. After the 3 months, mean value of peri-implant bone resorption of the implants placed using flap technique was 1.86 mm, and of those placed using flapless technique was 1.13 mm. In relation to the primary dental implant stability in the first and second week there was an expected decrease in ISQ values, but it was less expressed in the dental implants placed using the flapless technique. In the third week the ISQ values were increased in the dental implants placed by using both techniques, but the increase in flapless implant placement was higher (7.4 ISQ) than in flap implant placement (1.5 ISQ). The upward trend continued in a 4- week period, and after 3 months the dental implant stability values in the implants placed using flap technique were higher than the primary stability for 7.1 ISQ, and in the implants placed using flapless technique were higher comparing to the primary stability for 10.1 ISQ units. Conclusion. Based on the results of radiographic and resonance frequency analyses it can be concluded that the flapless technique in surgical implants placemat, leads to better results.


2017 ◽  
Vol 43 (2) ◽  
pp. 131-138 ◽  
Author(s):  
Yen-Ting Lin ◽  
Adrienne Hong ◽  
Ying-Chin Peng ◽  
Hsiang-Hsi Hong

Clinical decisions regarding the stability and osseointegration of mandibular implants positioned using the bone expansion techniques are conflicting and limited. The objective was to evaluate the stability of implants placed using 2 surgical techniques, selected according to the initial width of the mandibular posterior edentulous ridge, with D3 bone density, during a 12-week period. Fifty-eight implants in 33 patients were evaluated. Thirty-two implants in 24 patients were positioned using the osteotome expansion technique, and 26 fixtures in 17 patients were installed using the conventional drilling technique. The implant stability quotient values were recorded at weeks 0, 1, 2, 3, 4, 6, 8, 10, and 12 postsurgery and evaluated using analysis of variance, independent, and paired t tests. Calibrated according to the stability reading of a 3.3-mm diameter implant, the osteotome expansion group was associated with a lower bone density than the conventional group (64.96 ± 6.25 vs 68.98 ± 5.06, P = .011). The osteotome expansion group achieved a comparable primary stability (ISQb-0, P = .124) and greater increases in secondary stability (ISQb-12, P = .07) than did the conventional technique. A D3 quality ridge with mild horizontal deficiency is expandable by using the osteotome expansion technique. Although the 2 groups presented similar implant stability quotient readings during the study period, the osteotome expansion technique showed significant improvement in secondary stability. The healing patterns for these techniques are therefore inconsistent.


2014 ◽  
Vol 15 (2) ◽  
pp. 181-185 ◽  
Author(s):  
Lanka Mahesh ◽  
TV Narayan ◽  
Sagrika Shukla ◽  
Georgios Kostakis

ABSTRACT Aim To measure implant stability using periotest values of implants placed in sockets augmented with calcium phosphosilicate putty (CPS Putty) as compared with implant stability in naturally healed sockets. Materials and methods Twenty two sockets were implanted with CPS Putty immediately after extraction. The sockets were re-entered after a healing period at 5 to 6 months (average 5.3 months) for implant placement. Periotest values were recorded during implant insertion to assess primary stability. These were compared with the Periotest values of 26 implants placed in 22 patients, with naturally healed sockets. Result Periotest values were significantly lower in the grafted group, indicating better implant stability in sites grafted with CPS putty. Conclusion Implant stability seems to be significantly higher in sockets augmented using CPS putty when compared to nongrafted sites. This suggests that socket grafting with CPS putty may enhance the quality of available bone for implantation. How to cite this article Mahesh L, Narayan TV, Kostakis G, Shukla S. Periotest Values of Implants Placed in Sockets Augmented with Calcium Phosphosilicate Putty Graft: A Comparative Analysis against Implants Placed in Naturally Healed Sockets. J Contemp Dent Pract 2014;15(2):181-185.


2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Antonio Scarano ◽  
Bartolomeo Assenza ◽  
Francesco Inchingolo ◽  
Filiberto Mastrangelo ◽  
Felice Lorusso

Background. The immediate placement of a dental implant could represent an option treatment for the rehabilitation of a postextractive missing tooth socket to replace compromised or untreatable teeth, with the advantage of single-session surgery. In this way, the anatomy of the alveolar bone defect, the preservation of the buccal cortical bone, and the primary stability of the fixture represent the critical factors that consent a precise implant placement. Objective. This case report describes a novel fixture design for postextractive alveolar socket immediate implant. Methods. Two patients (25 and 31 years old) were treated for postextractive dental implant placement to replace both central upper incisor teeth with four implants. The residual bone implant gap was not filled with graft or bone substitute. The restoration was provided following a standard loading protocol by a cement-sealed prosthetic abutment. Results. Clinically, all implants positioned showed an excellent insertion torque. No postoperative complications were reported. At 6 months of healing, the buccal cortical bone and the implant stability were present and well maintained. Conclusion. The evidence of this study allows us to underline the possible advantages of this new fixture design for postextractive implant technique.


Materials ◽  
2019 ◽  
Vol 12 (15) ◽  
pp. 2398 ◽  
Author(s):  
Christian Makary ◽  
Abdallah Menhall ◽  
Carole Zammarie ◽  
Teresa Lombardi ◽  
Seung Yeup Lee ◽  
...  

Background: Macro- and micro-geometry are among the factors influencing implant stability and potentially determining loading protocol. The purpose of this study was to test a protocol for early loading by controlling implant stability with the selection of fixtures with different thread depth according to the bone density of the implant site. Materials and Methods: Patients needing implant therapy for fixed prosthetic rehabilitation were treated by inserting fixtures with four different thread diameters, selected based on clinical assessment of bone quality at placement (D1, D2, D3, and D4, according to Misch classification). Final insertion torque (IT) and implant stability quotient (ISQ) were recorded at baseline and ISQ measurements repeated after one, two, three, and four weeks. At the three-week measurement (four weeks after implant replacement), implants with ISQ > 70 Ncm were functionally loaded with provisional restorations. Marginal bone level was radiographically measured 12 months after implant insertion. Results: Fourteen patients were treated with the insertion of forty implants: Among them, 39 implants showing ISQ > 70 after 3 weeks of healing were loaded with provisional restoration. Mean IT value was 82.3 ± 33.2 Ncm and varied between the four different types of bone (107.2 ± 35.6 Ncm, 74.7 ± 14.0 Ncm, 76.5 ± 31.1 Ncm, and 55.2 ± 22.6 Ncm in D1, D2, D3, and D4 bone, respectively). Results showed significant differences except between D2 and D3 bone types. Mean ISQ at baseline was 79.3 ± 4.3 and values in D1, D2, D3, and D4 bone were 81.9 ± 2.0, 81.1 ± 1.0, 78.3 ± 3.7, and 73.2 ± 4.9, respectively. Results showed significant differences except between D1 and D2 bone types. IT and ISQ showed a significant positive correlation when analyzing the entire sample (p = 0.0002) and D4 bone type (p = 0.0008). The correlation between IT and ISQ was not significant when considering D1, D2, and D3 types (p = 0.28; p = 0.31; p = 0.16, respectively). ISQ values showed a slight drop at three weeks for D1, D2, and D3 bone while remaining almost unchanged in D4 bone. At 12-month follow-up, all implants (39 early loading, 1 conventional loading) had satisfactory function, showing an average marginal bone loss of 0.12 ± 0.12 mm, when compared to baseline levels. Conclusion: Matching implant macro-geometry to bone density can lead to adequate implant stability both in hard and soft bone. High primary stability and limited implant stability loss during the first month of healing could allow the application of early loading protocols with predictable clinical outcomes.


Author(s):  
José Vicente Ríos-Santos ◽  
Gregorio Tello-González ◽  
Pedro Lázaro-Calvo ◽  
Francisco Javier Gil Mur ◽  
Blanca Ríos-Carrasco ◽  
...  

Aim: (PRIMARY) Assess the changes in bone level (6 and 12 months after implant placement) between the test (definitive abutment (DEF)) and control (healing abutment (HEA)) groups. (SECONDARY) Assess the changes in bone level (6 and 12 months after implant placement) between the 1 mm high abutment group and 2 mm abutment group. Evaluate changes in implant stability recorded with analysis of the resonance frequency (RFA) Osstell system, at 6 and 12 months after implant placement, between the control group (HEA) and test (DEF). For the DEF group, the abutment was placed at the time of the surgery and was never removed. For the HEA group, the abutment was removed three times during the manufacture of the crowns. The abutments used were 1 mm high (Subgroup A) and 2 mm high (Subgroup B). Materials and methods: A total of 147 patients were selected between 54.82 ± 11.92 years old. After implant placement, patients were randomly distributed in the DEF and HEA group. After the implant placement, a periapical radiograph was taken to assess the peri-implant bone level; the same procedure was carried out 6 and 12 months post-placement. To compare the qualitative variables between the groups (HEA/DEF), the Chi-square test was used; for quantitative (MANOVA). Results: After a year, the accumulated bone loss was 0.48 ± 0.71 mm for the HEA group and 0.36 ± 0.79 mm for the DEF group, without statistical significance. Differences were only found due to timing (time) between 0 and 6 months (=0.001) and 0 and 12 months (0.001), with no differences attributable to the study groups (DEF and HEA). The accumulated bone loss (1 year) was 0.45 ± 0.78 mm for the 1 mm abutment group and 0.41 ± 0.70 mm for the 2 mm abutment group (p = 0.02). No differences were observed in implant stability between groups. Conclusions: The “One Abutment—One Time” concept does not reduce peri-implant bone loss compared to the connection–disconnection technique. The height of the abutment does influence bone loss: the higher the abutment, the lower the bone loss.


2018 ◽  
Vol 36 (6_suppl) ◽  
pp. TPS153-TPS153 ◽  
Author(s):  
Kirsty Morrison ◽  
Alison Tree ◽  
Vincent Khoo ◽  
Nicholas John Van As ◽  

TPS153 Background: The development of Stereotactic Body Radiotherapy (SBRT) has provided a further treatment option for early stage prostate cancer. In addition to the benefits of an overall treatment time reduction, profound hypofractionation could result in therapeutic gain given the radiobiology of prostate cancer. Evidence suggests SBRT to be safe and effective; however randomised data is lacking comparing outcomes with standard treatment options. Aim: To assess whether SBRT offers therapeutic benefit in comparison to prostatectomy or standard radiotherapy. Methods: The PACE trial is an international multicentre phase III trial, comprising two parallel randomisation processes. Within PACE A, potential surgical candidates are randomised between radical prostatectomy and SBRT (36.25 Gy in 5 fractions). In PACE B, randomisation is between standard radiotherapy (78Gy in 39 fractions or 62Gy in 20 fractions) and SBRT (36.35Gy in 5 fractions). SBRT can be delivered using Cyberknife or gantry based techniques. Patients with low or intermediate risk prostate cancer are eligible for the trial, and are treated without the use androgen deprivation therapy. Follow up is for a period of 10 years. The aim is to recruit 234 patients to PACE A (117 in each arm) and 858 patients to PACE B (429 patients in each arm). Primary Objectives: PACE A: To determine whether there is improved quality of life after SBRT compared with surgery at 2 years post treatment, using EPIC score to measure urinary incontinence and bowel bother. PACE B: to determine whether SBRT is non-inferior to surgery in terms of freedom from biochemical/clinical failure at 5 years from randomisation. Progress: PACE A has been slower to recruit than anticipated due to the difficulties of a surgery versus radiotherapy randomisation. However, it is expected to reach target accrual, having recruited 57 patients from 3 centres. In contrast, PACE B is recruiting exceptionally well, open in 40 centres, and as of October 2017 recruited 762 patients. Accrual target is expected to be reached by the end of 2017. Clinical trial information: NCT01584258.


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