Surface treatments of titanium dental implants for rapid osseointegration

OBJECTIVES: The objective of this systematic review was to assess the 5-year survival of implant-supported single crowns (SCs) and to describe the incidence of biological and technical complications. METHODS: An electronic MEDLINE search complemented by manual searching was conducted to identify prospective and retrospective cohort studies on SCs with a mean follow-up time of at least 5 years. Failure and complication rates were analyzed using random-effects Poisson's regression models to obtain summary estimates of 5-year proportions. RESULTS: Twenty-six studies from an initial yield of 3601 titles were finally selected and data were extracted. In a meta-analysis of these studies, survival of implants supporting SCs was 96.8% [95% confidence interval (CI): 95.9-97.6%] after 5 years. The survival rate of SCs supported by implants was 94.5% (95% CI: 92.5-95.9%) after 5 years of function. The survival rate of metal-ceramic crowns, 95.4% (95% CI: 93.6-96.7%), was significantly (P=0.005) higher than the survival rate, 91.2% (95% CI: 86.8-94.2%), of all-ceramic crowns. Peri-implantitis and soft tissue complications occurred adjacent to 9.7% of the SCs and 6.3% of the implants had bone loss exceeding 2 mm over the 5-year observation period. The cumulative incidence of implant fractures after 5 years was 0.14%. After 5 years, the cumulative incidence of screw or abutment loosening was 12.7% and 0.35% for screw or abutment fracture. For supra-structure-related complications, the cumulative incidence of ceramic or veneer fractures was 4.5%. CONCLUSION: It can be concluded that after an observation period of 5 years, high survival rates for implants and implant-supported SCs can be expected. However, biological and particularly technical complications are frequent.

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A systematic review of the 5-year survival and complication rates of implant-supported single crowns

Objective
To assess the 5-year survival of implant-supported single crowns (SCs) and to describe the incidence of biological, technical, and aesthetic complications. The focused question was: What is the survival rate of implants supporting single crowns and implant-supported crowns with a mean follow-up of 5 years and to which extent do biological, technical, and aesthetic complications occur?

Methods
A Medline search (2006–2011) was performed for clinical studies focusing on implant-supported SCs with a mean follow-up of at least 5 years. The search was complemented by an additional hand search and the inclusion of 24 studies from a previous systematic review (Jung et al. 2008a). Survival and complication rates were analyzed using random-effects Poisson's regression models to obtain summary estimates of 5- and 10-year proportions.

Results
Forty-six studies derived from an initial search count of 1083 titles and the complementary publications from the previous systematic review (Jung et al. 2008a) were selected and the data were extracted. Based on the meta-analysis, survival of implants supporting SCs at 5 years amounted to 97.2% (95% CI: 96.3–97.9%), and at 10 years amounted to 95.2% (95% CI: 91.8–97.2%). The survival of implant-supported SCs was 96.3% (95% CI: 94.2–97.6%) after 5 years and 89.4% (95% CI: 82.8–93.6%) after 10 years. For biological complications, a 5-year cumulative soft tissue complication rate of 7.1% (95% CI: 4.4–11.3%) and a cumulative complication rate for implants with bone loss >2 mm of 5.2% (95% CI: 3.1–8.6%) were calculated. Technical complications reached a cumulative incidence of 8.8% (95% CI: 5.1–15.0%) for screw-loosening, 4.1% (95% CI: 2.2–7.5%) for loss of retention, and 3.5% (95% CI: 2.4–5.2%) for fracture of the veneering material after 5 years. The cumulative 5-year aesthetic complication rate amounted to 7.1% (95% CI: 3.6–13.6%).

Conclusions
The outcomes of the meta-analysis demonstrated high implant survival rates for both the single tooth implants and the respective single crowns after 5 and 10 years. However, technical, biological, and aesthetic complications were frequent.

Systematic review of the survival rate and the incidence of biological, technical, and aesthetic complications of single crowns on implants reported in longitudinal studies with a mean follow-up of 5 years

3D printing has been hailed as a disruptive technology which will change manufacturing. Used in aerospace, defence, art and design, 3D printing is becoming a subject of great interest in surgery. The technology has a particular resonance with dentistry, and with advances in 3D imaging and modelling technologies such as cone beam computed tomography and intraoral scanning, and with the relatively long history of the use of CAD CAM technologies in dentistry, it will become of increasing importance. Uses of 3D printing include the production of drill guides for dental implants, the production of physical models for prosthodontics, orthodontics and surgery, the manufacture of dental, craniomaxillofacial and orthopaedic implants, and the fabrication of copings and frameworks for implant and dental restorations. This paper reviews the types of 3D printing technologies available and their various applications in dentistry and in maxillofacial surgery.

3D printing in dentistry.

Objectives: The objective of this systematic review was to assess and compare the 5- and 10-year survival of different types of tooth-supported and implant-supported fixed dental prosthesis (FDPs) and single crowns (SCs) and to describe the incidence of biological and technical complications. Methods: Three electronic searches complemented by manual searching were conducted to identify prospective and retrospective cohort studies on FDPs and SCs with a mean follow-up time of at least 5 years. Patients had to have been examined clinically at the follow-up visit. Failure and complication rates were analyzed using random-effects Poisson’s regression models to obtain summary estimates of 5- and 10-year survival proportions. Results: Meta-analysis of the included studies indicated an estimated 5-year survival of conventional tooth-supported FDPs of 93.8%, cantilever FDPs of 91.4%, solely implantsupported FDPs of 95.2%, combined tooth-implant-supported FDPs of 95.5% and implantsupported SCs of 94.5%. Moreover, after 10 years of function the estimated survival decreased to 89.2% for conventional FDPs, to 80.3% for cantilever FDPs, to 86.7% for implant-supported FDPs, to 77.8% for combined tooth-implant-supported FDPs and to 89.4% for implant-supported SCs. Despite high survival rates, 38.7% the patients with implant-supported FDPs had some complications after the 5-year observation period. This is compared with 15.7% for conventional FDPs and 20.6% for cantilever FDPs, respectively. For conventional tooth-supported FDPs, the most frequent complications were biological complications like caries and loss of pulp vitality. Compared with tooth-supported FDPs, the incidence of technical complications was significantly higher for the implant-supported reconstructions.The most frequent technical complications were fractures of the veneer material (ceramic fractures or chipping), abutment or screw loosening and loss of retention. Conclusion: On the basis of the results of the present systematic review, planning of prosthetic rehabilitations should preferentially include conventional end abutment tooth-supported FDPs, solely implant-supported FDPs or implant-supported SCs. Only for reasons of anatomical structures or patient-centered preferences and as a second option should cantilever toothsupported FDPs or FDPs supported by combination of implants and teeth be chosen.

http://coimplante.odo.br/Biblioteca/Biomecanica/complication%20rates%20of%20tooth-supported%20and%20implant-supported%20FDPs%20-%20Pjetursson%20et%20al.pdf

Comparison of survival and complication rates of tooth-supported fixed dental prostheses (FDPs) and implant-supported FDPs and single crowns (SCs)

Implant screw mechanics.

Clinical Accuracy of 3 Different Types of Computed Tomography-Derived Stereolithographic Surgical Guides in Implant Placement

The aim of the present clinical study was to determine the local bone density in dental implant recipient sites using computerized tomography (CT) and to investigate the influence of local bone density on implant stability parameters and implant success A total of 300 implants were placed in 111 patients between 2003 and 2005 The bone density in each implant recipient site was determined using CT Insertion torque and resonance frequency analysis were used as implant stability parameters The peak insertion torque values were recorded with OsseoCare machine The resonance frequency analysis measurements were performed with Osstell instrument immediately after implant placement, 6, and 12 months later Of 300 implants placed, 20 were lost, meaning a survival rate of % 933 after three years (average 37 ± 07 years) The mean bone density, insertion torque and RFA recordings of all 300 implants were 620 ± 251 HU, 361 ± 8 Ncm, and 657 ± 9 ISQ at implant placement respectively; which indicated statistically significant correlations between bone density and insertion torque values (p < 0001), bone density and ISQ values (p < 0001), and insertion torque and ISQ values (p < 0001) The mean bone density, insertion torque and RFA values were 645 ± 240 HU, 372 ± 7 Ncm, and 671 ± 7 ISQ for 280 successful implants at implant placement, while corresponding values were 267 ± 47 HU, 218 ± 4 Ncm, and 465 ± 4 ISQ for 20 failed implants; which indicated statistically significant differences for each parameter (p < 0001) CT is a useful tool to determine the bone density in the implant recipient sites, and the local bone density has a prevailing influence on primary implant stability, which is an important determinant for implant success

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Influence of bone density on implant stability parameters and implant success: a retrospective clinical study

Background: Dental implant placement requires precise planning with regard to anatomic limitations and restorative goals. The aim of this study was to evaluate the match between the positions and axes of the planned and placed implants using stereolithographic (SLA) surgical guides.Methods: Ninety-four implants were placed using SLA surgical guides generated from computed tomography (CT) between 2005 and 2006. Radiographic templates were used for all subjects during CT imaging. After obtaining three-dimensional CT images, each implant was virtually placed on the CT images. SLA surgical guides, fabricated using an SLA machine with a laser beam to polymerize the liquid photo-polymerized resin, were used during implant placement. A new CT scan was taken for each subject following implant placement. Special software was used to fuse the images of the planned and placed implants, and the locations and axes were compared.Results: Compared to the planned implants, the placed implants showed angular deviation of ...

Reliability of Implant Placement With Stereolithographic Surgical Guides Generated From Computed Tomography: Clinical Data From 94 Implants

Conventional complete denture prosthetics require several appointments to register the maxillomandibular relationship and evaluate the esthetics The fabrication of milled complete dental prostheses with digital scanning technology may decrease the number of appointments The step-by-step method necessary to obtain impressions, maxillomandibular relation records, and anterior tooth position with an anatomic measuring device is described The technique allows the generation of a virtual denture, which is milled to exact specifications without the use of conventional stone casts, flasking, or processing techniques

Edwin A. McGlumphy

Papers

Implant screw mechanics.

Clinical Accuracy of 3 Different Types of Computed Tomography-Derived Stereolithographic Surgical Guides in Implant Placement

Influence of bone density on implant stability parameters and implant success: a retrospective clinical study

Reliability of Implant Placement With Stereolithographic Surgical Guides Generated From Computed Tomography: Clinical Data From 94 Implants

Fabricating complete dentures with CAD/CAM technology