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Background Bone density examination ( BDE) using preoperative cone beam computed tomography ( CBCT) might be used to predict primary implant stability in implant patients. Purpose The aim of the study was to validate a novel CBCT scanner in vitro with regard to BDE in preoperative scans and to analyze the in vivo correlation of CBCT scan results with primary implant stability measurements. Materials and Methods A CBCT scanner was validated in vitro with regard to spatial uniformity and linearity of CT numbers ( Hounsfield units, HU) by using a series of phantoms and plastic and hydroxyapatite specimens of various densities. Forty-nine patients (27 female and 22 male, mean age 55.6 ± 9.8) were scanned prior to and 1 to 6 months after the placement of 155 dental implants of different lengths and diameters. Mean and peak insertion torque ( IT) in Ncm were registered during implant placement. Resonance frequency analysis ( RFA) measurements in ISQ units were performed after placement. The second scan was used to export and superimpose the exact positions of bone and implants into the first scan. Virtual probes with the same length as the actual implant were automatically placed at the implant sites, and mean HU values were measured in a 1 mm-wide circular corridor from the tip of the threads and out. Results The in vitro validation showed high uniformity and linearity of CT numbers ( HU). The clinical study showed significant correlations between bone density and ISQ, mean IT, and peak IT, respectively. Conclusions The White Fox CBCT scanner measures bone density with high accuracy. There is a correlation between bone density and primary implant stability as assessed with IT and RFA measurements. The findings suggest that BDE may be used as an additional feature in treatment-planning software to estimate primary stability at predetermined implant sites. [ABSTRACT FROM AUTHOR]

Background Full-arch clearances of compromised teeth and placement of implant-supported prostheses is one solution for the prosthetic rehabilitation of partially dentate patients. Purpose To retrospectively evaluate treatment outcomes after full clearance, immediate placement, and early loading of full-arch fixed bridges. Materials and Methods Fifty-five patients subjected to full clearance and placement of 284 Neoss implants ( Bimodal™ and Proactive™, Neoss Ltd, Harrogate, UK) in 29 edentulous maxillae and 26 mandibles for early loading (1 to 3 days) of a provisional full-arch bridge were retrospectively evaluated after 1 to 6 years of loading. Osstell™ measurements ( Osstell AB, Göteborg, Sweden) were taken at placement and after 3 to 9 months when the provisional bridge was replaced with a permanent one. Marginal bone levels were measured in intraoral radiographs. Results All patients (100%) wore a fixed bridge at the time of finalizing the study. A total of 18 failures (6.3%) were encountered during the follow-up, giving an overall cumulative survival rate of 93.7%. All failures occurred in the maxilla (10.6%), and no implants were lost in the mandible. More Bimodal™ (9.0%) than Proactive™ (4.1%) implants failed. Failing implants showed a significantly lower mean primary stability than successful ones ( p = .015). Failed cases showed a significantly lower average ISQ for all implants ( p = .015) and a marked decrease to the second registration, while successful cases showed and maintained high ISQs. The average bone loss after 1 year was 0.8 ± 0.5 mm. Conclusions Full-arch clearance of severely diseased teeth followed by immediate placement of Neoss implants, early loading with provisional full-arch bridges, and subsequent permanent bridges is a possible treatment modality for partially dentate patients. Caution with this approach is recommended for the maxilla, as opposed to the mandible. [ABSTRACT FROM AUTHOR]

Background New implant designs are continuously introduced to the market. It is important to evaluate and report on their clinical performance when used in everyday practice. Purpose The aim of the present study was to evaluate the clinical performance of a novel hydrophilic dental implant for 1 year. Materials and Methods A total of 49 patients previously treated with 102 hydrophilic dental implants ( Neoss Proactive, Neoss Ltd, Harrogate, UK) were retrospectively evaluated with regard to survival rate and marginal bone loss. Fifty-four implants were installed in maxillae and 48 in mandibles to replace single teeth ( n = 21), to support partial bridges ( n = 26), total maxillary bridges ( n = 2), or mandibular overdentures ( n = 2). The majority of patients ( n = 37) had implants placed in healed sites without any adjunctive procedures. In 12 patients, implants were immediately placed in extraction sockets or in conjunction with maxillary sinus floor augmentation. All implant sites had been classified according to the Lekholm and Zarb index. Baseline and 1-year intraoral radiographs were used to calculate marginal bone levels and bone loss. Implant stability quotient ( ISQ) measurements had been taken at placement and after 3 to 4 months of healing Results The implants became rapidly covered with blood at the first contact. One implant was lost, giving a cumulative survival rate ( CSR) of 99.0% after 1 year. The marginal bone loss amounted to 0.7 ± 0.6 mm with 3.5% of the implants showing more than 2 mm of bone loss and no implant more than 3 mm bone loss after 1 year. The primary stability was found to be 72.7 ± 7.5 ISQ, which slightly increased to 73.6 ± 7.2 ISQ ( NS) after 3 to 4 months of healing. The stability was significantly higher in the mandible than in the maxilla at placement and after healing. Conclusion In this limited clinical study, the use of a novel hydrophilic dental implant results in favorable short-term outcomes. [ABSTRACT FROM AUTHOR]

ABSTRACT Background: The presence of localized defects and/or small amounts of bone below the maxillary sinus is a common finding, which may compromise implant placement. There is therefore a need for predictable techniques for bone augmentation in such situations. Purpose: The study aims to clinically and histologically evaluate a porcine bone (PB) substitute used for augmentation of the alveolar crest or the maxillary sinus floor prior to or in conjunction with implant placement. Materials and Methods: Nineteen patients were treated with a porcine bone substitute and barrier membranes (OsteoBiol, Tecnoss Dental, Turin, Italy) for lateral bone augmentation (Group 1a) and healing of bone defects (Group 1b) or for augmentation of the maxillary sinus floor using either a replaceable (Group 2a) or an infractured bone window (Group 2b). A total of 34 implants (Neoss Ltd., Harrogate, UK) were placed in conjunction or 5 to 7 months after the procedure. Implants were followed with implant stability measurements at placement and abutment connection, and with intraoral radiographs at abutment connection and after at least 1 year of loading. A biopsy for histology and morphometry was taken at the first reentry operation. Results: All but one of the procedures was successful (94.7%) as one maxillary sinus procedure (Group 2a) resulted in insufficient bone for implant placement. One of the 34 implants failed, giving an implant survival rate of 97.1% after 1 year. Implant stability measurements showed a mean stability of 71.9 ± 7.7 implant stability quotient (ISQ) at placement, which significantly increased to 75.3 ± 6.8 ISQ at abutment connection ( p = .03). The average bone loss was 0.5 ± 0.7 mm during 1 year. Histology revealed new bone formation at the PB surface, which formed bridges between particles and between particles and preexisting bone. The presence of scalloped resorption lacunae and new osteons inside the particles indicated ongoing resorption/remodeling of the particles. The histomorphometric analyses showed that the total specimen area consisted of, in average, 56.5 ± 15.7% mineralized tissue of which 24.8 ± 13.9% of the total area was PB particles. Conclusion: This study showed good clinical results when using a PB substitute and barrier membranes for augmentation of the alveolar crest and maxillary sinus. Histology revealed bone condensation properties and indicated that the material can be resorbed with time. [ABSTRACT FROM AUTHOR]

ABSTRACT Background: The Neoss implant system has been available since 2004. Few studies documenting the clinical performance of this implant are available. Purpose: To study the stability and clinical/radiographic outcomes of Neoss implants 1 year of loading when using a two-stage protocol. Materials and Methods: Ninety (90) consecutive patients scheduled for implant treatment using a two-stage procedure were enrolled in a prospective follow-up study. A total of 218 implants (Neoss System, Bimodal surface, Neoss Ltd, Harrogate, UK) in diameters of 3.5, 4.0, and 4.5 mm and in lengths from 7 to 15 mm were placed to support 29 single tooth replacements, 53 partial bridges, 5 full bridges, and 10 overdentures in both jaws. Abutment connection was made after a healing period of 3-4 months. The patients were followed during 1 year of loading with clinical, radiographic, and resonance frequency analysis (Osstell Mentor™, Osstell AB, Gothenburg, Sweden) examinations. Prostheses were removed at the annual check-up for individual testing of implant stability. Results: Three implant failures were experienced, giving a survival rate of 98.6% after 1 year. A mean bone loss of 0.6 mm (SD 0.8) was observed after 1 year. There was a significant inverse correlation between implant diameter and marginal bone loss ( p < .003). The mean implant stability quotient levels were 73.7 (SD 7.6), 74.4 (SD 6.4), and 76.7 (SD 5.2) at placement, abutment connection, and first annual check-up, respectively. The stability had increased significantly from placement to 1 year ( p < .001) and from abutment to 1 year ( p < .0001). Implant stability was higher in the mandible than in the maxilla at all time points. There was a significant correlation between bone quality and stability at placement ( p < .0001) and abutment connection ( p < .001) but not after 1 year. Conclusions: The use of Neoss implants for prosthetic rehabilitation of consecutive edentate patients with different needs resulted in predictable clinical and radiographic outcomes after 1 year of loading. Implant stability measurements revealed a favorable bone tissue reaction to the implants. [ABSTRACT FROM AUTHOR]