Comparison of flapped versus flapless dental implant insertion subjected to immediate functional loading protocol: A parallel group randomised control trial for radiographic bone density changes

When planning an implant supported restoration the dentist is faced with the surgical and prosthetic technical issues as well as the patient’s expectations. Many patients wish an immediate solution to an edentulous condition. This is especially may be true in the esthetic zone. The extent of the zone is determined by the patient. The dentist may consider when it is feasible to load the supporting implants with definitive or provisional prosthetics. For the work herein, consideration of many parameters were theoretically assessed for inclusion: bone density, cortical thickness, seating torque, parafunction, bite load capacity, number of implants under load, implant/crown ratio, implant diameter and length. After assessment, the most influential parameters were selected. An iteration, using patient age, implant diameter, bite load capacity and cortical thickness, is now presented to aid the implant dentist in determining the feasibility for immediate functional loading of a just placed dental implant in a healed site. Extensive testing is required to develop this concept. According to this iteration, most immediate functional loaded implants would fail. A future refined and definitive formula may enable the clinician to safely immediately functional load an implant with a definitive prosthesis.

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Relationship between Cortical Bone Thickness and Cancellous Bone Density at Dental Implant Sites in the Jawbone

Diagnostics ◽

10.3390/diagnostics10090710 ◽

2020 ◽

Vol 10 (9) ◽

pp. 710

Author(s):

Shiuan-Hui Wang ◽

Yen-Wen Shen ◽

Lih-Jyh Fuh ◽

Shin-Lei Peng ◽

Ming-Tzu Tsai ◽

...

Keyword(s):

Bone Density ◽

Cortical Bone ◽

Dental Implant ◽

Cancellous Bone ◽

Bone Thickness ◽

Anterior Maxilla ◽

Cortical Bone Thickness ◽

Posterior Maxilla ◽

Dental Implant Surgery ◽

Anterior Mandible

Dental implant surgery is a common treatment for missing teeth. Its survival rate is considerably affected by host bone quality and quantity, which is often assessed prior to surgery through dental cone-beam computed tomography (CBCT). Dental CBCT was used in this study to evaluate dental implant sites for (1) differences in and (2) correlations between cancellous bone density and cortical bone thickness among four regions of the jawbone. In total, 315 dental implant sites (39 in the anterior mandible, 42 in the anterior maxilla, 107 in the posterior mandible, and 127 in the posterior maxilla) were identified in dental CBCT images from 128 patients. All CBCT images were loaded into Mimics 15.0 to measure cancellous bone density (unit: grayscale value (GV) and cortical bone thickness (unit: mm)). Differences among the four regions of the jawbone were evaluated using one-way analysis of variance and Scheffe’s posttest. Pearson coefficients for correlations between cancellous bone density and cortical bone thickness were also calculated for the four jawbone regions. The results revealed that the mean cancellous bone density was highest in the anterior mandible (722 ± 227 GV), followed by the anterior maxilla (542 ± 208 GV), posterior mandible (535 ± 206 GV), and posterior maxilla (388 ± 206 GV). Cortical bone thickness was highest in the posterior mandible (1.15 ± 0.42 mm), followed by the anterior mandible (1.01 ± 0.32 mm), anterior maxilla (0.89 ± 0.26 mm), and posterior maxilla (0.72 ± 0.19 mm). In the whole jawbone, a weak correlation (r = 0.133, p = 0.041) was detected between cancellous bone density and cortical bone thickness. Furthermore, except for the anterior maxilla (r = 0.306, p = 0.048), no correlation between the two bone parameters was observed (all p > 0.05). Cancellous bone density and cortical bone thickness varies by implant site in the four regions of the jawbone. The cortical and cancellous bone of a jawbone dental implant site should be evaluated individually before surgery.

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Biomechanical effects of dental implant diameter, connection type, and bone density on microgap formation and fatigue failure: A finite element analysis

Computer Methods and Programs in Biomedicine ◽

10.1016/j.cmpb.2020.105863 ◽

2020 ◽

pp. 105863

Author(s):

Hyeonjong Lee ◽

Minhye Jo ◽

Gunwoo Noh

Keyword(s):

Finite Element Analysis ◽

Finite Element ◽

Bone Density ◽

Dental Implant ◽

Fatigue Failure ◽

Element Analysis ◽

Connection Type

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Changes of Radiographic Trabecular Bone Density and Peri-Implant Marginal Bone Vertical Dimensions Around Non-Submerged Dental Implants with a Laser-Microtextured Collar after 5 Years of Functional Loading.

The Open Dentistry Journal ◽

10.2174/1874210602014010226 ◽

2020 ◽

Vol 14 (1) ◽

pp. 226-234

Author(s):

Renzo Guarnieri ◽

Gabriele Miccoli ◽

Marco Seracchiani ◽

Maurilio D’Angelo ◽

Dario Di Nardo ◽

...

Keyword(s):

Bone Density ◽

Trabecular Bone ◽

Trabecular Bone Density ◽

Dimensional Changes ◽

Implant Placement ◽

Texture Parameters ◽

Mixed Regression ◽

Bone Level ◽

Occurrence Matrix ◽

Functional Loading

Objectives: The progressive peri-implant bone remodeling caused by dynamic cycles of microdamage may change peri-implant bone characteristics and volume after the functional loading. This prospective study was designed to evaluate the radiographic trabecular bone density and peri-implant vertical dimensional changes around the non submerged dental implant with a laser-microtextured collar (NSLI)s after 5 years of functional loading. Methods: Digital periapical radiographs of 58 NSLIs supported fixed single crowns and fixed partial dentures in 26 patients (14 men, mean age of 52 ± 3.8 years) were used for comparative evaluation between the implant placement [Baseline (BSL)], the definitive Crowns Delivery (CD) and the 5 years post-functional loading examination (T5). Regions of interest (ROI) were taken into consideration for the measurement of mean gray levels, standard deviation, and variation coefficient. The texture parameters, such as contrast, correlation, angular second moment and entropy, were investigated by using the software ImageJ (v.1.50i), by means of the Gray-level Co-occurrence Matrix (GLCM) Texture Tool plugin. Vertical Peri-implant Marginal Bone Level (VPMBL) was assessed at the mesial and the distal sides of each implant by subtracting the measure at BSL from the measure at T5 by means of dedicate software (VixWin Platinum Imaging Software). Mixed regression models were adopted to analyze data. The possible effects of some variables, such as the use of provisional denture, location, crown/implant ratio, type of prosthetic design (single or splinted), on radiographic dimensional vertical changes, gray levels and texture analysis variables were also evaluated. Results: From BSL to T5, mesial and distal VPMBL showed a statistically significant gain of 0.9 ±0.5, and 0.10 mm ±0.6, respectively (P<0.05). From CD to T5, mean gray levels increased from 94.4±26.8) to 111.8±27.1 (P<0.05), while the coefficient of variation decreased from 0.08±0,03 to 0.05±0.04) (P<0.05). Variables showed no statistically significant correlation with texture parameters (P > 0.05). Conclusion: NSLIs showed an increase in radiographic vertical peri-implant marginal bone levels and bone density up to 5 years of loading.

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The Effect of Recipient Jaw and Implant Dimensions on Pre- and Post- Loading Dental Implant Stability: A Prospective Clinical Study

Journal of Baghdad College of Dentistry ◽

10.26477/jbcd.v33i4.3017 ◽

2021 ◽

Vol 33 (4) ◽

pp. 31-37

Author(s):

Dhuha A Al-Assaf ◽

Salwan Y Bede

Keyword(s):

Dental Implant ◽

Primary Stability ◽

Prospective Clinical Study ◽

Implant Stability ◽

Significant Difference ◽

Rest Time ◽

Age Range ◽

Implant Length ◽

Functional Loading

Background: Implant stability is a mandatory factor for dental implant (DI) osseointegration and long-term success. The aim of this study was to evaluate the effect of implant length, diameter, and recipient jaw on the pre- and post-functional loading stability. Materials and methods: This study included 17 healthy patients with an age range of 24-61 years. Twenty-two DI were inserted into healed extraction sockets to replace missing tooth/ teeth in premolar and molar regions in upper and lower jaws. Implant stability was measured for each implant and was recorded as implant stability quotient (ISQ) immediately (ISQ0), and at 8 (ISQ8) and 12 (ISQ12) weeks postoperatively, as well as post-functional loading (ISQPFL). The pattern of implant stability changes throughout the study period and its correlation with the recipient jaw and the DI dimensions were evaluated. Results: There was a significant difference in ISQ values throughout the study. DI stability in the maxilla was significantly higher than that in mandible for the ISQ0, with no significant effect for the rest time points. The effect of implant diameter was significant with DI of 4.1mm diameter being more stable. While for the length, there was no significant difference regarding its effect on ISQ values through-out the study period. Conclusions: DI inserted in the maxilla demonstrated better primary stability with no effect of recipient jaw on secondary stability and after functional loading, also DI with wider diameter had better stability throughout the study whereas DI length showed no significant effect on stability

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Beyond osseointegration: dealing with late dental implant complications

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-20-00101 ◽

2020 ◽

Author(s):

Goo Chui Ling ◽

Victor Goh

Keyword(s):

Dental Implants ◽

Dental Implant ◽

Late Complications ◽

Treatment Modalities ◽

Restorative Dentistry ◽

Missing Teeth ◽

Implant Complications ◽

Osseointegrated Implants ◽

Case Presentations ◽

Functional Loading

The advent of dental implants has been a boon in the field of restorative dentistry. With dental implants, the treatment modalities to replace missing teeth has widened considerably. While the advantages of implants are undeniable, it is not without its own complications. In this series of case presentations, the authors will highlight late complications associated with osseointegrated implants after functional loading and how such problems were managed.

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Success or Failure of a Dental Implant: It's Relationship to Bone Density: A Case Report of a Failed Implant

The Journal of Contemporary Dental Practice ◽

10.5005/jcdp-11-6-65 ◽

2010 ◽

Vol 11 (6) ◽

pp. 65-72 ◽

Cited By ~ 3

Author(s):

Rajvir Malik ◽

Rachna Garg ◽

D.K. Suresh ◽

Shalu Chandna

Keyword(s):

Case Report ◽

Bone Density ◽

Dental Implant ◽

Treatment Modalities ◽

Success Rates ◽

Mucoperiosteal Flap ◽

Immediate Implant ◽

Implant Therapy ◽

Relationship Of

Abstract Aim The purpose of this article is to illustrate the relationship of bone quality and the prognosis of dental implant. Background Reported success rates for dental implants are high. Thus, an implant-supported restoration offers a predictable treatment for tooth replacement. Nevertheless, failures that mandate immediate implant removal do occur. Case Description A case involving a 40-yearold male patient who had a missing mandibular left first molar is reported. A mucoperiosteal flap was made using interdental and crevicular incisions. The osteotomy was performed starting with the pilot drill, then the depth of the osteotomy was assessed using the shoulder depth gauge. The site was gradually enlarged using reamers with progressively increasing diameters. The implant (Bicon's Nano Tite™) was then placed. However, three months later at the second stage surgery, the implant was found to be clinically mobile. The surgical site selected in this case had fine trabeculated bone with thin cortical plates (D4 bone) that apparently contributed to the failure of dental implant. Summary Implant therapy has become common practice and will continue to increase in popularity. This also implies that dental professionals will have to learn more how to deal with implant failure and related complications. Why an implant does not integrate could have a multifactorial etiology. Clinical Significance The type and quality of bone available to support a dental implant are very important, so attention should be directed to all the factors responsible for the success or failure of a dental implant. In cases involving D4 bone, one must consider other treatment modalities for replacement of a missing tooth or use caution in the placement of the implants, especially in the high-load-bearing molar areas. Citation Malik R, Garg R, Suresh DK, Chandna S. Success or Failure of a Dental Implant: It's Relationship to Bone Density: A Case Report of a Failed Implant. J Contemp Dent Pract [Internet]. 2010 December; 11(6):065-072. Available from: http://www.thejcdp.com/journal/view/volume11- issue6-malik

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Immediate Dental Implant Placements Using Osteotome Technique: A Case Report and Literature Review

The Open Dentistry Journal ◽

10.2174/1874210616021001367 ◽

2016 ◽

Vol 10 (1) ◽

pp. 367-374 ◽

Cited By ~ 1

Author(s):

Saad Al-Almaie

Keyword(s):

Dental Implant ◽

Treatment Time ◽

Wound Dehiscence ◽

Surgical Trauma ◽

Implant Placement ◽

Bone Expansion ◽

Immediate Implant ◽

One Year ◽

Functional Loading

This clinical case describes the effect of the osteotome technique on the osseointegration of a mandibular dental implant in a 42-year-old female patient with dento-alveolar bony defects and to review the literature regarding immediate implant placement using osteotome technique. The amount of bone expansion at the alveolar ridge and the marginal bone resorption from the time of implant placement to one year after the implant’s functional loading were recorded clinically. The esthetic outcome for the restored implant (the gingival margin) was achieved one years after the implant’s functional loading. The surgical and prosthetic sites for the implant showed no postoperative complications, and no infection or wound dehiscence was recorded during the follow-up period. The osteotome technique is good for the purpose for which it was introduced, and its advantages with immediate implant placement include reduced surgical trauma and a shorter treatment time.

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Evaluation of The Bio-Stimulatory Effect of Platelet Rich Fibrin Augmented by Diode LASER Compared to Platelet Rich Fibrin Alone on Dental Implant Replacing Posterior Mandibular Teeth. Randomised Clinical Trial: Split Mouth Study

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.183 ◽

2019 ◽

Vol 7 (5) ◽

pp. 869-875

Author(s):

Sherif Shafik Mohamed El Bahnasy ◽

Mohamed Khalifa Zayet ◽

Tarek Ibrahim El-Ghareeb ◽

Hoda Abd Kader Saleh

Keyword(s):

Bone Density ◽

Dental Implant ◽

Randomised Clinical Trial ◽

Control Group ◽

P Value ◽

Platelet Rich Fibrin ◽

Post Operative Pain ◽

Significant Difference ◽

And Control

BACKGROUND: Restoring masticatory function and replacing missing teeth with minimal pain and discomfort are the most important issues for the patient and clinician. Nowadays dental implants became the most popular line of treatment to replace missing teeth; offering a comfortable long lasting prosthesis. Osseo-integration reflects the long term success of a dental implant. Many bio-modulators are used aiming to improve the osseointegration and healing around dental implants such as Low-Level Laser treatment (LLLT) and Platelet Rich Fibrin (PRF). PRF has been proven to improve bone repair process around the dental implant. LLLT is considered a noninvasive, safe technique that stimulates osteogenesis and alleviates post-operative pain. AIM: Evaluation of the bio-stimulatory effect of LLLT on a dental implant with PRF compared to PRF alone clinically and radiographically. METHODS: A randomised clinical trial with the split-mouth design was conducted on nine patients with bilaterally missing lower posterior tooth. All patients received one dental implant on each side with PRF. LASER application was performed to one side twice weekly for one month starting on the day of insertion. Post-operative pain was assessed daily through the first week using numerical rating pain scale (NRS) as the primary outcome. Relative peri-implant bone density was measured using direct digital intraoral radiography immediately after insertion, one, four and nine months postoperatively. Implants stability were measured using radio frequency assessment immediately after insertion, four and nine months post-operative as secondary outcomes. RESULTS: The NRS for pain was significantly decreased by the end of the first-week postoperatively in the intervention and control group with a mean of (2.22 ± 1.56) (2.11 ± 1.83) respectively. However, there was no statistically significant difference between the test groups at P-Value (0.892). The relative bone density values were decreased by the end of the ninth month of follow-up in the intervention and control group with a mean of (134.42 ± 16.13) (128.77 ± 33.54) respectively. No statistically significant difference was observed between the two test groups at P-value (0.863). The radiofrequency values for implant stability showed no statically significant difference after nine months of follow up when compared to the initial stability values at the day of insertion in the intervention and control group. The mean radiofrequency values were (67.24 ± 1.79) and (66.9 ± 2.57) respectively, and no statistically significant difference was observed between the two test groups at P-value (0.793) CONCLUSION: There are no statistically significant differences in post-operative pain values, implant stability and bone density between the implant sites treated with PRF augmented by Diode laser compared to implant sites treated by PRF alone.

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