| 1. |
- Browaeys, Hilde, et al.
(author)
-
The histological evaluation of osseointegration of surface enhanced microimplants immediately loaded in conjunction with sinuslifting in humans.
- 2013
-
In: Clinical oral implants research. - : Wiley. - 1600-0501 .- 0905-7161. ; 24:1, s. 36-44
-
Journal article (peer-reviewed)abstract
- OBJECTIVE: The aim was to investigate histomorphometrically whether or not implant surface nanotopography improves the bone response under immediate loading simultaneous to sinus grafting. MATERIALS AND METHODS: Dual acid-etched titanium microimplants with/without crystalline surface deposition of calcium phosphate particles were placed in bilateral sinuslift areas grafted with a mixture of iliac crest bone and BioOss. Surface topography of microimplants was characterized using interferometry. Loaded microimplants (MsL) were immobilized in a provisional bridge supported by four normal size implants. Some patients had unloaded microimplants as controls (MsU). Biopsies were trephined after 2 or 4months and histomorphometric analysis of bone area (BA) and bone-to-implant contact (BC) was performed. Nonparametric methods for dependent data were used to compare effect of surface modification, and healing time (2 vs. 4months). RESULTS: A total of 53 biopsies were available from 13 patients. A total of 4/28 and 1/11 MsL failed after resp. 2 and 4months vs. 0/6 and 1/5 MsU. Many loaded biopsies were damaged at the apical portion and showed no bone adhesion. MsL decreased in BA from coronal to apical from 2 to 4months; Coronal>Middle (P=0.047), Coronal>Apical (P<0.001) and Middle>Apical (P<0.001). This gradual decrease was not observed for BC; CoronalApical (P<0.001). Only the middle part showed significant bone contact after 2months. For MsL there was no statistically significant difference between surface or time indicating that improvement of osseointegration over time due to maturation of the graft was poor. The MsU did not show any difference between Osseotite and Nanotite for BIC and BA (P>0.05) but doubled both their BA and BIC (P<0.05) between 2 and 4months. CONCLUSIONS: Osseointegration in sinus-grafted bone mixed with BioOss was poor irrespective of healing time or nanotopographical surface modification. The apex of MsL showed minimal bone contact suggesting that the graft does not add to the loading capacity. Surface enhancement was not beneficial despite the enlarged surface area. Overloading, most critical coronally of an implant, increases risks for implant failure and jeopardizes bone healing especially under immediate loading conditions with high load.
|
|
| 2. |
- Vervaeke, Stijn, et al.
(author)
-
A Multifactorial Analysis to Identify Predictors of Implant Failure and Peri-Implant Bone Loss
- 2013
-
In: Clinical Implant Dentistry and Related Research. - : John Wiley & Sons. - 1523-0899 .- 1708-8208. ; 17:S1, s. e298-e307
-
Journal article (peer-reviewed)abstract
- OBJECTIVE: To identify risk factors for failure and bone loss of implants in a large study sample on the basis of multivariate analyses. MATERIALS AND METHODS: Patient files of all patients referred for implant treatment from November 2004 to December 2007 were scrutinized, and information on implant- and patient-related factors was collected. The study sample in this retrospective cohort study consisted of both partially dentate and fully edentulous patients referred for various indications. The only inclusion criterion was a follow-up of at least 2 years. Implant survival and bone loss were assessed by an external investigator (SV) comparing digital periapical radiographs taken during recall visits with the postoperative ones. Univariate and multivariate tests were adopted to identify possible risk indicators for implant failure and peri-implant bone loss. RESULTS: Twenty-one of 1,320 (1.6%) implants were lost in 19 of 376 (5.1%) patients (210 female, 166 male; mean age 56, range 17-82) after a mean follow-up of 32 months (range 24-62). Based on multivariate analysis, only smoking (p = .001) and recall compliance (p = .010) had a significant influence on implant failure, with smokers more prone to failure. The overall mean bone loss was 0.36 mm (SD 0.68, range 0.00-7.10). Smoking (p = .001) and jaw of treatment (p = .001) affected peri-implant bone loss. More peri-implant bone loss was observed in smokers and in the maxilla. A clear discrepancy was found between univariate and multivariate analysis with regard to identification of risk factors. CONCLUSION: Multivariate analysis demonstrated that implant-related factors did not affect the clinical outcome, but smoking was identified as a predictor for implant failure. Predictors for peri-implant bone loss were smoking and jaw of treatment.
|
|
| 3. |
- Vervaeke, Stijn, et al.
(author)
-
The effect of smoking on survival and bone loss of implants with a fluoride-modified surface : a 2-year retrospective analysis of 1106 implants placed in daily practice
- 2012
-
In: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 23:6, s. 758-766
-
Journal article (peer-reviewed)abstract
- Aim: To compare the survival and peri-implant bone loss of implants with a fluoride-modified surface in smokers and nonsmokers. Materials and methods: Patient files of all patients referred for implant treatment from November 2004 to 2007 were scrutinized. All implants were placed by the same experienced surgeon (B. C.). The only inclusion criterion was a follow-up time of at least 2 years. Implant survival and bone loss were assessed by an external calibrated examiner (S. V.) comparing digital peri-apical radiographs taken during recall visits with the post-operative ones. Implant success was determined according to the international success criteria (Albrektsson et al. 1986). Survival of implants installed in smokers and nonsmokers was compared using the log-rank test. Both nonparametric tests and fixed model analysis were adopted to evaluate bone loss in smokers and nonsmokers. Results: One-thousand one-hundred and six implants in 300 patients (186 females; 114 males) with a mean follow-up of 31 months (SD 7.15; range 24–58) were included. Nineteen implants in 17 patients failed, resulting in an overall survival rate of 98.3% at the implant level and 94.6% at the patient level. After a follow-up period of 2 years, the cumulative survival rates was 96.7% and 99.1% with the patient and implant as the statistical unit, respectively. Implant survival was significantly higher for nonsmokers compared with smokers (implant level P=0.025; patient level P=0.017). The overall mean bone loss was 0.34 mm (n=1076; SD 0.65; range 0–7.1). Smokers lost significantly more bone compared with nonsmokers in the maxilla (0.74 mm; SD 1.07 vs. 0.33 mm; SD 0.65; P<0.001), but not in the mandible (0.25 mm; SD 0.65 vs. 0.22 mm; SD 0.5; P=0.298). Conclusion: The present study is the first to compare peri-implant bone loss in smokers and nonsmokers from the time of implant insertion (baseline) to at least 2 years of follow-up. Implants with a fluoride-modified surface demonstrated a high survival rate and limited bone loss. However, smokers are at a higher risk of experiencing implant failure and more prone to show peri-implant bone loss in the maxilla. Whether this bone loss is predicting future biological complications remains to be evaluated.
|
|
