PURPOSE: The purpose of this systematic review was to evaluate crestal bone loss (CBL) around zirconia dental implants and clinical periimplant inflammatory parameters.
MATERIAL AND METHODS: The focus question addressed was, "Do zirconia implants maintain crestal bone levels and periimplant soft tissue health?" Databases were searched for articles from 1977 through September 2014 with different combinations of the following MeSH terms: "dental implants," "zirconium," "alveolar bone loss," "periodontal attachment loss," "periodontal pocket," "periodontal index." Letters to the editor, case reports, commentaries, review articles, and articles published in languages other than English were excluded.
RESULTS: Thirteen clinical studies were included. In 8 of the studies, the CBL around zirconia implants was comparable between baseline and follow-up. In the other 5 studies, the CBL around zirconia implants was significantly higher at follow-up. Among the studies that used titanium implants as controls, 2 studies showed significantly higher CBL around zirconia implants, and in 1 study, the CBL around zirconia and titanium implants was comparable. The reported implant survival rates for zirconia implants ranged between 67.6% and 100%. Eleven studies selectively reported the periimplant inflammatory parameters.
CONCLUSIONS: Because of the variations in study design and methodology, it was difficult to reach a consensus regarding the efficacy of zirconia implants in maintaining crestal bone levels and periimplant soft tissue health.
PURPOSE: The purpose of this prospective randomized controlled clinical study was to evaluate crest bone-level changes and patient satisfaction with mandibular overdentures retained by 1 or 2 titanium-zirconium (Ti-Zr) implants with immediate loading protocols after 1 year.
MATERIAL AND METHODS: Thirty-six Ti-Zr implants were placed in 24 participants (single central implant in 12 participants and 2 interforaminal implants in 11 participants) by a single operator. LOCATOR attachments were used to retain the mandibular overdentures with an immediate loading protocol, and observations were made at 1 month and 1 year. Changes to the crestal bone level were evaluated with digital periapical radiographs. A 100-mm visual analog scale (VAS) was used to evaluate patient satisfaction. The Mann-Whitney U test was used to analyze the data.
RESULTS: At 1 month, the mean crestal bone loss was 0.23 mm in the 2-implant group (n=22) and 0.39 mm (P=.181) in the single-implant group (n=11). At 1 year, the bone loss was 0.67 mm in the 2-implant group and 0.88 mm (P=.248) in the single-implant group. The mean VAS score for patient satisfaction level increased from 38.3% to 49.7% for single-implant participants and from 40.5% to 54.8% for 2-implant participants 1 month after implant placement (P=.250) and from 38.3% to 54.5% for single-implant participants and from 40.5% to 58.9% for 2-implant participants after 1 year (P=.341).
CONCLUSIONS: Single-implant-retained mandibular overdentures with an immediate loading protocol may represent a viable treatment option considering crestal bone-level changes and patient satisfaction compared with 2-implant-retained mandibular overdentures after 1 year of follow-up.
METHODS: Forty direct impressions of a mandibular reference model fitted with six dental implants and multibase abutments were made using VPES and PE, and implant casts were poured (N = 20). The VPES and PE groups were split into four subgroups of five each, based on splinting type: (a) no splinting; (b) bite registration polyether; (c) bite registration addition silicone; and (d) autopolymerizing acrylic resin. The accuracy of implant-abutment replica positions was calculated on the experimental casts, in terms of interimplant distances in the x, y, and z-axes, using a coordinate measuring machine; values were compared with those measured on the reference model. Data were analyzed using non-parametrical Kruskal-Wallis and Mann-Whitney tests at α = .05.
RESULTS: The differences between the two impression materials, VPES and PE, regardless of splinting type, were not statistically significant (P>.05). Non-splinting and splinting groups were also not significantly different for both PE and VPES (P>.05).
CONCLUSIONS: The accuracy of VPES impression material seemed comparable with PE for multi-implant abutment-level impressions. Splinting had no effect on the accuracy of implant impressions.
PURPOSE: The purpose of this in vitro study was to evaluate the crestal strain around 2 implants to support mandibular overdentures when placed at different positions.
MATERIAL AND METHODS: Edentulous mandibles were 3-dimensionally (3D) designed separately with 2 holes for implant placement at similar distances of 5, 10, 15, and 20 mm from the midline, resulting in 4 study conditions. The complete denture models were 3D designed and printed from digital imaging and communications in medicine (DICOM) images after scanning the patient's denture. Two 4.3×12-mm dummy implants were placed in the preplanned holes. Two linear strain gauges were attached on the crest of the mesial and distal side of each implant (CH1, CH2, CH3, and CH4) and connected to a computer to record the electrical signals. Male LOCATOR attachments were attached, the mucosal layer simulated, and the denture picked up with pink female nylon caps. A unilateral and bilateral force of 100 N was maintained for 10 seconds for each model in a universal testing machine while recording the maximum strains in the DCS-100A KYOWA computer software program. Data were analyzed by using 1-way analysis of variance, the Tukey post hoc test, and the paired t test (α=.05).
RESULTS: Under bilateral loading, the strain values indicated a trend with increasing distance between the implants with both right and left distal strain gauges (CH4 and CH1). The negative (-ve) values indicated the compressive force, and the positive (+ve) values indicated the tensile force being applied on the strain gauges. The strain values for CH4 ranged between -166.08 for the 5-mm and -251.58 for the 20-mm position; and for CH1 between -168.08 for the 5-mm and -297.83 for the 20-mm position. The remaining 2 mesial strain gauges for all 4 implant positions remained lower than for CH4 and CH1. Under unilateral-right loading, only the right-side distal strain gauge CH4 indicated the increasing trend in the strain values with -147.5 for the 5-mm, -157.17 for the 10-mm, -209.33 for the 15-mm, and -234.75 for the 20 mm position. The remaining 3 strain gauges CH3, CH2, and CH1 ranged between -28.33 and -107.17. For each position for both implants, significantly higher (P
OBJECTIVES: The aim of the study was to evaluate the deviation of implant placement performed with a surgical guide fabricated by means of the rapid prototyping technique (the PolyJet™ technology).
MATERIAL AND METHODS: Twenty sheep mandibles were used in the study. Pre-surgical cone-beam computed tomography (CBCT) scans were acquired for the mandibles by using the Kodak 9000 3D cone-beam system. Two implants with dimensions of 4 mm in diameter and 10 mm in length were virtually planned on the 3D models of each mandible by using the Mimics software, v. 16.0. Twenty surgical guides were designed and printed using the PolyJet technology. A total of 40 implants were placed using the surgical guides, 1 on each side of the mandible (2 implants per mandible). The post-surgical CBCT scans of the mandibles were performed and superimposed on the pre-surgical CBCT scans. The amount of deviation between the virtually planned placement and the actual implant placement was measured, and a descriptive analysis was done.
RESULTS: The results showed that the mean deviation at the implant coronal position was 1.82 ±0.74 mm, the mean deviation at the implant apex was 1.54 ±0.88 mm, the mean depth deviation was 0.44 ±0.32 mm, and the mean angular deviation was 3.01 ±1.98°.
CONCLUSIONS: The deviation of dental implant placement performed with a 3D-printed surgical guide (the PolyJet technology) is within the acceptable 2-millimeter limit reported in the literature.
MATERIAL AND METHODS: Sandblasted and cleansed planar titanium specimens with a size of 5 × 5 × 1 mm were coated on one side with 0.25 vol% eicosapentaenoic acid (EPA). The other side of the specimens was kept highly polished (the control side). These specimens were inserted in rabbit mandibles. Twelve rabbits were randomly assigned into three study groups (n = 4). The rabbits were sacrificed at 4, 8, and 12 weeks. The harvested specimens with the implants were assessed for new bone formation on both sides of the implant using CBCT, conventional radiographs, and the biaxial pullout test. The results were statistically analyzed by a nonparametric Kruskal-Wallis test and Friedman's test as multiple comparisons and by Brunner-Langer nonparametric mixed model approach (R Software).
RESULTS: A significant osteoconductive bone formation was found on the EPA-coated Ti implant surface (P < 0.05) at 8 weeks when compared to the polished surface (control). Biaxial pullout test results showed a significant difference (P < 0.05) after 8 and 12 weeks with a maximum force of 243.8 N, compared to 143.25 N after 4 week.
CONCLUSION: EPA implant coating promoted osteoconduction on the Ti implant surfaces, enhancing the anchorage of the implant to the surrounding bone in white New Zealand rabbits.
METHODS: Twenty patients with two adjacent missing posterior teeth were recruited. Patients were assigned equally and randomly into two groups; Bicon(®) (6 or 8 mm) and Ankylos(®) (8 mm) implants. A two-stage surgical approach and single crowns were used for implant placement and loading. Outcomes included peri-implant clinical parameters, implant stability (Periotest values; PTVs) and peri-implant bone changes, which were assessed at baseline, 2, 6 and 12 months post-loading.
RESULTS: No implant loss was encountered up to 12 months post-loading. No significant difference in the clinical or radiographic parameters was observed except for PTVs (p < 0.05) that was lower in Ankylos(®) implants.
CONCLUSIONS: The use of short dental implants was associated with excellent 12 months clinical and radiographic outcomes. Ankylos(®) and Bicon(®) implants demonstrated similar peri-implant soft tissue and alveolar bone changes. However, Ankylos(®) implants demonstrated better implant stability at all evaluation intervals.