Early Loading of Titanium Dental Implants with Hydroxyl Ion Modified Surface: a 12-Month Prospective Clinical Trial

(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.

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Primary Stability Optimization by Using Fixtures with Different Thread Depth According To Bone Density: A Clinical Prospective Study on Early Loaded Implants

Materials ◽

10.3390/ma12152398 ◽

2019 ◽

Vol 12 (15) ◽

pp. 2398 ◽

Cited By ~ 8

Author(s):

Christian Makary ◽

Abdallah Menhall ◽

Carole Zammarie ◽

Teresa Lombardi ◽

Seung Yeup Lee ◽

...

Keyword(s):

Bone Density ◽

Primary Stability ◽

Stability Loss ◽

Insertion Torque ◽

Implant Stability ◽

Marginal Bone Loss ◽

Early Loading ◽

Bone Level ◽

Implant Therapy ◽

Provisional Restoration

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.

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

BMC Oral Health ◽

10.1186/s12903-021-01498-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kinga Körmöczi ◽

György Komlós ◽

Petra Papócsi ◽

Ferenc Horváth ◽

Árpád Joób-Fancsaly

Keyword(s):

Treatment Time ◽

Treatment Options ◽

Maxillofacial Surgery ◽

Primary Stability ◽

Study Groups ◽

Implant Stability ◽

Overall Treatment Time ◽

Implant Placement ◽

Early Loading ◽

Secondary Stability

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.

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Comparative radiographic and resonance frequency analyses of the peri-implant tissue after dental implants placement using flap and flapless techniques: An experimental study on domestic pigs

Vojnosanitetski pregled ◽

10.2298/vsp1306586v ◽

2013 ◽

Vol 70 (6) ◽

pp. 586-594 ◽

Cited By ~ 6

Author(s):

Zoran Vlahovic ◽

Branko Mihailovic ◽

Zoran Lazic ◽

Mileta Golubovic

Keyword(s):

Bone Resorption ◽

Resonance Frequency ◽

Dental Implants ◽

Dental Implant ◽

Surgical Techniques ◽

Primary Stability ◽

Implant Stability ◽

Domestic Pigs ◽

Flap Technique ◽

Implant Placement

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.

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Periotest Values of Implants Placed in Sockets Augmented with Calcium Phosphosilicate Putty Graft: A Comparative Analysis against Implants Placed in Naturally Healed Sockets

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1511 ◽

2014 ◽

Vol 15 (2) ◽

pp. 181-185 ◽

Cited By ~ 2

Author(s):

Lanka Mahesh ◽

TV Narayan ◽

Sagrika Shukla ◽

Georgios Kostakis

Keyword(s):

Comparative Analysis ◽

Primary Stability ◽

Implant Stability ◽

Implant Placement ◽

Healing Period ◽

Calcium Phosphosilicate

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.

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New Implant Design with Midcrestal and Apical Wing Thread for Increased Implant Stability in Single Postextraction Maxillary Implant

Case Reports in Dentistry ◽

10.1155/2019/9529248 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Antonio Scarano ◽

Bartolomeo Assenza ◽

Francesco Inchingolo ◽

Filiberto Mastrangelo ◽

Felice Lorusso

Keyword(s):

Cortical Bone ◽

Dental Implant ◽

Alveolar Bone ◽

Primary Stability ◽

Implant Design ◽

Insertion Torque ◽

Fixture Design ◽

Implant Stability ◽

Implant Placement ◽

Immediate Placement

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.

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Immediate and Early Loading of Hydrothermally Treated, Hydroxyapatite-Coated Dental Implants: 2-Year Results from a Prospective Clinical Study

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-14-00283 ◽

2016 ◽

Vol 42 (1) ◽

pp. 17-25 ◽

Cited By ~ 3

Author(s):

David E. Simmons ◽

Archontia Palaiologou ◽

Austin G. Teitelbaum ◽

Susan Billiot ◽

Lomesh J. Popat ◽

...

Keyword(s):

Tactile Feedback ◽

Prospective Clinical Study ◽

Insertion Torque ◽

Implant Stability ◽

Implant Placement ◽

Early Loading ◽

Group A ◽

Bone Level ◽

Group B ◽

Plasma Sprayed

This investigation was undertaken to determine if multithreaded implants partially coated with plasma-sprayed hydroxyapatite (HA) could be effectively loaded earlier than 3–6 months after placement. Forty-eight patients (22 men, 26 women) were enrolled in the study and received 48 implants. The population was divided into 2 groups: A implants (n = 23) were loaded immediately on the day of surgery and group B implants (n = 19) were loaded 3 weeks after surgery. Cone beam computerized tomography (CBCT) scans were taken preoperatively to aid in treatment planning. Bone density was evaluated by tactile feedback during surgery. Insertion torque was recorded at time of implant placement. Resonance frequency analysis, performed on the day of surgery, at the time of loading, and at 6, 12, and 24 months, was used to record implant stability according to the unit's implant stability quotient (Osstell ISQ). Standardized radiographs were taken at time of implant placement and at 6, 12, and 24 months to measure crestal bone stability. Bone level changes were measured by software (Image J). Bone quality was judged as either type 1 (n = 1), 2 (n = 31), 3 (n = 15), or 4 (n = 1). There were no failures in the group A (survival = 100%, n = 23/23) and 1 failure in group B (survival = 94.7%, n = 18/19). After 2 years in function, cumulative mean radiographic bone loss was 0.75 ± 0.50mm (maxillae: 0.92 ± 0.49 mm, n = 14; mandibles: 0.67 ± 0.49 mm, n = 28). No differences in bone levels were noted between implants placed in previously augmented and nonaugmented sites, and there were no periodontal or soft tissue complications. After 2 years in function, implants partially coated with plasma-sprayed and hydrothermally treated HA were clinically predictable when restored in occlusion immediately after or within 3 weeks of implant placement.

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Stability Development of Immediately Loaded Hybrid Self-Tapping Implants Inserted in the Posterior Maxilla: 1-Year Results of a Randomized Controlled Trial

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-16-00143 ◽

2017 ◽

Vol 43 (1) ◽

pp. 33-38 ◽

Cited By ~ 2

Author(s):

Vladimir S. Todorovic ◽

Miroslav Vasovic ◽

Mia-Michaela Beetge ◽

Andre W. van Zyl ◽

Vladimir Kokovic

Keyword(s):

Controlled Trial ◽

Primary Stability ◽

Implant Stability ◽

Chemically Modified ◽

Implant Placement ◽

Early Results ◽

Posterior Maxilla ◽

Initial Drop ◽

Modified Surface ◽

Type 3

The objective of the present study was to elucidate stability development of immediately loaded hybrid self-tapping implants inserted in the posterior maxilla. Forty-eight hybrid self-tapping implants with a chemically modified surface (∅︀4.1; length: 8 mm) were inserted bilaterally in the maxillary first and second premolar and first molar sites of 8 patients. In each patient, both sides of the maxilla were assigned randomly to either immediate (IL) or early (EL) loading group. Implant stability was evaluated by means of resonance frequency analysis immediately after implant placement and after 1, 2, 3, 4, 5, 6, 12, 26, and 52 weeks. High values of primary stability were found in both groups (71.91 ± 6.52 implant stability quotient [ISQ] in IL group; 73.87 ± 6.5 ISQ in EL group), with significant differences between the groups at the different time points. Initial decrease in stability was observed between the first and fifth weeks in the IL group and between the first and third weeks for the EL group. In the IL group 1 implant was removed after 3 weeks due to lack of stability. Early results of this study showed the ability of hybrid self-tapping dental implants with a chemically modified surface to achieve sufficient primary stability and to maintain high values of secondary implant stability in bone type 3 and 4, even when loaded immediately. Minimal alterations in stability were observed for both investigated groups, but the EL group showed faster recovery after an initial drop in stability.

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Comparison between Osseo densification burs and osteotome technique for closed sinus lift in partially edentulous maxilla (clinical and radiological study)

Journal of University of Shanghai for Science and Technology ◽

10.51201/jusst/21/05164 ◽

2021 ◽

Vol 23 (05) ◽

pp. 392-411

Author(s):

Dr. Ali Nahi Hamdi ◽

◽

Dr. Shehab Ahmed Hemd ◽

Keyword(s):

Primary Stability ◽

Controlled Clinical Trial ◽

Height Loss ◽

Implant Stability ◽

Implant Placement ◽

First Choice ◽

Posterior Maxilla ◽

Atrophic Maxilla ◽

Sinus Floor ◽

Bone Height

Dental implants are considered the first choice to replace lost or non-restorable teeth. However, the posterior maxilla remains a challenge in its management because of the quality of bone in the posterior maxilla. Osseo densification (OD) concept has been proposed in the literature to improve primary implant stability, which is an important aspect of osseointegration. Densah bur is novel drills specially designed to enhance a bone density by Osseo densification, which in turn increases primary stability. This present study was conducted to assess crestal sinus floor elevation by osteotome in comparison to Densah bur in the posterior atrophic maxilla. This was a randomized controlled clinical trial conducted on 20 patients to evaluate available crestal bone height loss, implant stability after implant placement in healed posterior maxillary alveolar ridge, whole bone height, Schneiderian membrane trauma, and post-operative complication.

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Improvement in the Initial Implant Stability Quotient Through Use of a Modified Surgical Technique

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-16-00159 ◽

2017 ◽

Vol 43 (3) ◽

pp. 186-193 ◽

Cited By ~ 4

Author(s):

Rosa-María Díaz-Sánchez ◽

José-María Delgado-Muñoz ◽

Pilar Hita-Iglesias ◽

Kyle T. Pullen ◽

María-Ángeles Serrera-Figallo ◽

...

Keyword(s):

Primary Stability ◽

Titanium Implants ◽

Implant Design ◽

Prospective Clinical Study ◽

Implant Stability ◽

Implant Stability Quotient ◽

Implant Placement ◽

Cone Beam Computerized Tomography ◽

Surrounding Bone ◽

Type Classification

To ensure similar primary implant stability measured by resonance frequency analysis (RFA) could be obtained in different jawbone densities by using a specific surgical drilling protocol and, to correlate those RFA measurements with factors related to the implant design, width, and length, we are performed a 1-year prospective clinical study was carried out using 27 subjects. A total of 67 hydrophilic titanium implants were placed using a standard 2-stage implant placement protocol. The bone type at each implant site was determined by evaluation of a preoperative, high-resolution cone beam computerized tomography (CBCT) scan. A modified drilling protocol was used in softer bone (types 2, 3, and 4) that allowed for greater implant thread contact with the surrounding bone. The implant stability quotient (ISQ) was measured at 4 different times during the study: initially it was determined immediately after implant placement, then again at stage 2 uncovering surgery, then at 6 months' postplacement and, and finally at 1 year postplacement. Data collected immediately after implant surgery demonstrated a high correlation (R2 = .99) between the ISQ and bone type classification. An overall trend toward a higher ISQ was found over the 1-year study period for all types of bone. Implants remained clinically and radiographically stable during the 1-year study period. Our data allow conclude that the primary stability of 2-staged loaded implants placed in different bone types can be optimized by applying this surgical drilling protocol during the implant placement. The ISQ method was found to be a reliable predictor of implant stability.

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Influence of smoking upon dental implant osseointegration: a radiofrequency analysis of 194 implants

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-19-00223 ◽

2020 ◽

Cited By ~ 1

Author(s):

Javier Badenes ◽

Antonio Pallarés

Keyword(s):

Dental Implant ◽

Marked Decrease ◽

Primary Stability ◽

Insertion Torque ◽

Implant Stability ◽

Marginal Bone Loss ◽

Age And Gender ◽

Potential Impact ◽

And Gender ◽

Secondary Stability

While many studies have related smoking to periimplantitis and marginal bone loss, little is known of its potential impact upon dental implant osseointegration. The present clinical study explores the influence of smoking upon secondary stabilization based on radiofrequency analysis. A total of 194 implants in 114 patients were included. Implant stability was evaluated on the day of surgery and a minimum of 90 days after implantation, when osseointegration is considered to have been completed. The evolution of implant stability was compared between two groups: smokers versus non-smokers. The following variables were also analyzed: implant brand, model, length and diameter, insertion torque, bone density according to the Misch classification, location of the implant, and patient age and gender. The results showed that smoking does not affect primary stability of the implant, though it was associated to a marked decrease in secondary stability. The non-smokers showed a gain of 2.69 points (95%CI: 1.529 to 3.865) in the osseointegration process with respect to the smokers (p<0.001). Among the latter, implant stability was seen to decrease 0.91 points (95%CI: -3.424 to 1.600) (p<0.004), generating a difference of 3.61 points between smokers and non-smokers. Smoking is thus concluded to be an important factor that must be taken into account when seeking good implant osseointegration outcomes.

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