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Purpose: To compare clinical and esthetic outcomes between immediately loaded single implants placed with and without a fully guided surgical procedure.Materials and Methods: Patients with a missing maxillary tooth (second premolar to second premolar) were considered for inclusion in this 1-year prospective nonrandomized study. Exclusion criteria were general health contraindications for oral surgery besides the need for bone grafting or ridge augmentation. One group received digital implant planning, fully guided surgery, and immediate loading (DIL). The other group received freehand surgery and immediate loading (IL). Outcome measures were implant survival, marginal bone loss, soft tissue changes, papilla index, pink and white esthetic scores (PES and WES, respectively), and patient-reported outcome measures (PROMs).Results: Two of 21 implants failed in the DIL group soon after placement, resulting in a 1-year implant survival rate of 90.5%, while no implants failed in the IL group. Significantly higher papilla index scores and lower soft tissue changes were found for the DIL group compared to the IL group. No differences were found after 1 year regarding marginal bone loss, PES, WES, or PROMs.Conclusion: Within the limitations of this study, immediate loading in combination with fully guided surgery might negatively affect implant survival. Immediate loading, fully guided surgery, and a digital workflow appear to have a positive effect on early soft tissue adaptation. [ABSTRACT FROM AUTHOR]

The author discusses his scholarship pursuits, professional journeys, and published works related to Per-Ingvar Branemark's research on osseointegration, the history of prosthodontic therapy, and forecasts regarding osseointegration and prosthodontics. Topics include his participation in a randomized clinical trial using osseointegration as anchorage for a hip arthroplasty, and his encouragement of prosthodontists to study published papers to gain knowledge despite the possibility for papers to misinterpret results.

Purpose: To assess the influence of several factors on the prevalence of dental implant failure, with special consideration of the placement of implants by different dental surgeons.Materials and Methods: This retrospective study is based on 2,670 patients who received 10,096 implants at one specialist clinic. Only the data of patients and implants treated by surgeons who had inserted a minimum of 200 implants at the clinic were included. Kaplan-Meier curves were stratified with respect to the individual surgeon. A generalized estimating equation (GEE) method was used to account for the fact that repeated observations (several implants) were placed in a single patient. The factors bone quantity, bone quality, implant location, implant surface, and implant system were analyzed with descriptive statistics separately for each individual surgeon.Results: A total of 10 surgeons were eligible. The differences between the survival curves of each individual were statistically significant. The multivariate GEE model showed the following variables to be statistically significant: surgeon, bruxism, intake of antidepressants, location, implant length, and implant system. The surgeon with the highest absolute number of failures was also the one who inserted the most implants in sites of poor bone and used turned implants in most cases, whereas the surgeon with the lowest absolute number of failures used mainly modern implants. Separate survival analyses of turned and modern implants stratified for the individual surgeon showed statistically significant differences in cumulative survival.Conclusion: Different levels of failure incidence could be observed between the surgeons, occasionally reaching significant levels. Although a direct causal relationship could not be ascertained, the results of the present study suggest that the surgeons' technique, skills, and/or judgment may negatively influence implant survival rates. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to assess the evidence of a correlation between the expertise of surgeons and the survival rate of dental implants.Materials and Methods: An electronic search in four databases (MEDLINE, EMBASE, SCOPUS, and the Cochrane Library) was performed for publications from their inception to May 2016 and was supplemented by manual searches. Prospective and retrospective cohorts were included if they met the following criteria: (1) the presence of an exposed group (inexperienced surgeons); and (2) the presence of a control group (experienced surgeons). Meta-analyses were performed to evaluate the effect of expertise on implant failure.Results: Of 609 potentially eligible articles, 8 were included in the qualitative analysis and 6 in the quantitative synthesis. Two meta-analyses were performed for different definitions of experienced surgeons. In the first meta-analysis, which included four retrospective comparative studies that defined experienced professionals as specialists, the experience of the surgeon did not significantly affect the implant failure rate (P = .54), with an odds ratio (OR) of 1.24 (95% CI, 0.62-2.48). In the second meta-analysis, which included two retrospective studies that defined experienced surgeons as professionals that had placed more than 50 implants, the expertise of the surgeon did significantly affect the implant failure rates (P = .0005), with an OR of 2.18 (95% CI, 1.40-3.39).Conclusion: The data from the included publications suggest that surgical experience did not significantly affect implant failure when considering experience based on specialty but were significantly affected when considering experience based on the number of implants placed. Further standardized prospective studies with a control of confounding factors are needed to clarify the role of surgical expertise on implant survival rates. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to test the null hypothesis that there is no difference in implant failure rates, marginal bone loss, and postoperative infection for implants inserted in bone with different qualities and quantities according to the classification of Lekholm and Zarb.Materials and Methods: An electronic search was undertaken in January 2015 for randomized and nonrandomized human clinical studies.Results: A total of 94 publications were included. When bone sites of different qualities were considered, the results suggested the following comparative implant failure rates: 1 > 2, 1 > 3, 3 > 2, 4 > 1, 4 > 2, and 4 > 3. Sensitivity analyses suggested that when implants inserted in bone qualities 1 and 2 and 1 and 3 were compared, oxidized and sandblasted/acid-etched surfaces showed a decrease in significant difference in failures compared with turned implants. The same is not true for failure of implants inserted in bone quality 4 compared to failure of implants in all other bone qualities. When bone sites of different quantities were considered, the following comparative implant failure rates were observed: A > B, A > C, A < D, B < C, B < D, C < D, E > A, E > B, E > C, E > D. Due to insufficient information, meta-analyses for the outcomes postoperative infection and marginal bone loss were not performed.Conclusion: Sites with poorer bone quality and lack of bone volume may statistically affect implant failure rates. Implant surfaces may play a role in failure of implants in different bone qualities. [ABSTRACT FROM AUTHOR]

Purpose: This study compared the speed and strength of osseointegration and osteoconductivity between an oxidized experimental magnesium (Mg) implant, an oxidized commercially available TiUnite implant, and a dual acid-etched surface Osseotite implant. The aim was to investigate which surface properties enhance bone response to implants, and thereby to test a biochemical bonding theory. Materials and Methods: A total of 60 screw implants (20 of each design) were inserted through 1 cortex into the tibiae of 10 rabbits. Surface chemistry, oxide thickness, morphology, crystal structure, and surface roughness were evaluated. After healing times of 3 and 6 weeks, all bone implants were unscrewed with removal torque (RTQ) devices, and the bone specimens were subjected to histomorphometry. Results: RTQ values for Mg, TiUnite, and Osseotite implants were 27.1, 21.3, and 15.4 Ncm, with new bone formation values of 29%, 18%, and 15%, respectively, at 3 weeks. At 6 weeks the RTQ values were 37.5, 36.4, and 21.5 Ncm, with new bone formation values of 39%, 31%, and 26%, respectively. Discussion: Mg implants demonstrated significantly greater RTQ values (P= .008 and P = .0001) and more new bone formation (P= .031 and P= .030) than Osseotite at 3 and 6 weeks, respectively. Mg implants also showed higher RTQ values at 3 weeks and new bone formation at 6 weeks than TiUnite, but neither were significant ( P> .05). TiUnite showed significantly higher RTQ values than Osseotite at 6 weeks (P = .001), but was not significant at 3 weeks (P >.05). Osseointegration rate (ΔRTQ/Δweeks) was significantly faster for Mg (P= .011) and TiUnite (P= .001) implants between 3 and 6 weeks of healing time, but was not significant for Osseotite. Conclusions: The results indicate that surface chemistry facilitated more rapid and stronger osseointegration of the Mg implants despite their minimal roughness compared to the moderately roughened TiUnite. This suggests potential advantages of Mg implants for reducing high implant failure rates in the early postimplantation stage and in compromised bone, making it possible to shorten bone healing time from surgery to functional loading, and enhancing the possibility of immediate/early loading. [ABSTRACT FROM AUTHOR]

Purpose: This article reviews clinical knowledge of selected oral implant surfaces. Materials and Methods: The surfaces most commonly used in clinical practice, marketed by the five largest oral implant companies, are identified; their clinical documentation was scrutinized following a strict protocol. Experimental knowledge of the surfaces is briefly summarized. Retrospective, prospective, and comparative clinical studies were analyzed separately, as were studies of implants in conjunction with bone grafts. Results: TiUnite anodized surfaces are clinically documented in 1- to 2-year follow-up studies at best, with failures at about 3%. Sandblasted and acid-etched SLA surfaces are documented with good clinical results for up to 3 years. Osseotite dual acid-etched implants are documented with good clinical results for up to 5 years. Frialit-2 sandblasted and etched implants are positively documented for about 3 years in one study only. The Tioblast implant is the only design documented for survival over 10 years of follow-up and success over 7 years of follow-up. Conclusion: Generally, oral implants are introduced clinically without adequate clinical documentation. Implant companies initiate clinical documentation after product launch. The standards of clinical reporting have improved over the years. Proper long-term reports have been published for only one surface, Tioblast. [ABSTRACT FROM AUTHOR]

Purpose: This article reviews the topographic and chemical properties of different oral implant surfaces and in vivo responses to them. Materials and Methods: The article considers detailed mechanical, topographic, and physical characteristics of implant surfaces. Anchorage mechanisms such as biomechanical and biochemical bonding are examined. Osteoattraction and doped surfaces are discussed. Results: Surface quality of an oral implant may be subdivided into mechanical, topographic, and physicochemical properties. Topographic properties are evaluated at the micrometer level of resolution. Moderately rough surfaces (Sa between 1.0 and 2.0 µm) show stronger bone responses than smoother or rougher surfaces. The majority of currently marketed implants are moderately rough. Oral implants permit bone in growth into minor surface irregularities--biomechanical bonding or osseointegration. Additional biochemical bonding seems possible with certain surfaces. Osteoattraction is a commercial term without precise biologic correspondence. Surfaces doped with biochemical agents such as bone growth factors have been developed. Conclusion: Moderately roughened surfaces seem to have some clinical advantages over smoother or rougher surfaces, but the differences are small and often not statistically significant. Bioactive implants may offer some promise. [ABSTRACT FROM AUTHOR]

The article examines the checkpoints used when obtaining clinical data. Scheduled recalls, along with data on whether patients were present at recalls, are required in a controlled clinical study. If possible, new dental implants or particular clinical treatment measures should be examined against a control in the same patient. A common measure for presenting the results of oral implants is the utilization of life tables, which refer to a statistical method used for prognosis. Time-dependent prosthodontic outcomes are considered the ultimate checkpoint of overall success when prescribing dental implants.

The so-called concept of osseointegration demands both histomorphometric as well as clinical descriptions and definitions. The understanding of both of these aspects is still evolving and impacts significantly on the ongoing clinical determinants of success. This paper reviews some of the current clinical concerns regarding the clinical evaluation of osseointegrated implants. [ABSTRACT FROM AUTHOR]

The term osseointegration is analyzed in relation to its theoretical and clinical definitions, and comparisons are made to other implant modalities. The term osseointegration has a clear clinical meaning, but there is doubt about its precise usage in an experimental setting. Clinically, an implant can be described as osseointegrated if there is no discernable movement when force is applied to the fixture. This is in contrast to implants surrounded by fibrous connective tissue, which move within soft tissue. Newly developed laboratory techniques may be used in the future to precisely characterize osseointegration in the laboratory. [ABSTRACT FROM AUTHOR]

The article gives information about an international study group's meeting to review research literature on peri-implant gingivitis and marginal bone loss around dental implants, the maintenance of osseointegration in denture patients, and the progressive deterioration of the mouth's hard and soft tissue in the mouth. It is noted that the symposium was funded by five implant manufacturers.

The article expresses the author's opinions regarding a debate that has occurred involving the impact that placement efficacy can have on the success rate of dental implants. Debates regarding the bone loss that can occur surrounding a dental implant are discussed. The author's opinions regarding the impact of the strain of the bone surrounding an implant can have on the implant are mentioned.

An editorial is presented in which the author discusses the differences between dental implants and natural dentition. He comments on factors which can result in peri-implantitis such as the presence of dental cement remnants in surrounding soft tissue. He talks about the formation of dental plaque around oral implant parts which are not anchored to bone and talks about factors leading to successful implant osseointegration. He considers the role bacteria play in bone resorption.

The article looks at the biological factors involved in direct bone-to-metal implantation in the practice of prosthodontics. The author discusses osseointegration, in which metallic implants are directly anchored to bone. The tissue reaction found in osseointegration occurs with various metals and ceramic biomaterials.

An obituary for physician and dental innovator Per-Ingvar Brånemark who researched the osseointegration process is presented.

The article discusses various reports published within the issue, including one on the symposium titled "Towards Optimized Treatment Outcomes for Dental Implants," and another on the determinants of correct clinical reporting.

Purpose: To compare clinical and esthetic outcomes between immediately loaded single implants placed with and without a fully guided surgical procedure., Materials and Methods: Patients with a missing maxillary tooth (second premolar to second premolar) were considered for inclusion in this 1-year prospective nonrandomized study. Exclusion criteria were general health contraindications for oral surgery besides the need for bone grafting or ridge augmentation. One group received digital implant planning, fully guided surgery, and immediate loading (DIL). The other group received freehand surgery and immediate loading (IL). Outcome measures were implant survival, marginal bone loss, soft tissue changes, papilla index, pink and white esthetic scores (PES and WES, respectively), and patient-reported outcome measures (PROMs)., Results: Two of 21 implants failed in the DIL group soon after placement, resulting in a 1-year implant survival rate of 90.5%, while no implants failed in the IL group. Significantly higher papilla index scores and lower soft tissue changes were found for the DIL group compared to the IL group. No differences were found after 1 year regarding marginal bone loss, PES, WES, or PROMs., Conclusion: Within the limitations of this study, immediate loading in combination with fully guided surgery might negatively affect implant survival. Immediate loading, fully guided surgery, and a digital workflow appear to have a positive effect on early soft tissue adaptation.

No abstract available.

Purpose: This study compared the speed and strength of osseointegration and osteoconductivity between an oxidized experimental magnesium (Mg) implant, an oxidized commercially available TiUnite implant, and a dual acid-etched surface Osseotite implant. The aim was to investigate which surface properties enhance bone response to implants, and thereby to test a biochemical bonding theory., Materials and Methods: A total of 60 screw implants (20 of each design) were inserted through 1 cortex into the tibiae of 10 rabbits. Surface chemistry, oxide thickness, morphology, crystal structure, and surface roughness were evaluated. After healing times of 3 and 6 weeks, all bone implants were unscrewed with removal torque (RTQ) devices, and the bone specimens were subjected to histomorphometry., Results: RTQ values for Mg, TiUnite, and Osseotite implants were 27.1, 21.3, and 15.4 Ncm, with new bone formation values of 29%, 18%, and 15%, respectively, at 3 weeks. At 6 weeks the RTQ values were 37.5, 36.4, and 21.5 Ncm, with new bone formation values of 39%, 31%, and 26%, respectively., Discussion: Mg implants demonstrated significantly greater RTQ values (P = .008 and P = .0001) and more new bone formation (P = .031 and P = .030) than Osseotite at 3 and 6 weeks, respectively. Mg implants also showed higher RTQ values at 3 weeks and new bone formation at 6 weeks than TiUnite, but neither were significant (P > .05). TiUnite showed significantly higher RTQ values than Osseotite at 6 weeks (P = .001), but was not significant at 3 weeks (P > .05). Osseointegration rate (deltaRTQ/deltaweeks) was significantly faster for Mg (P = .011) and TiUnite (P = .001) implants between 3 and 6 weeks of healing time, but was not significant for Osseotite., Conclusions: The results indicate that surface chemistry facilitated more rapid and stronger osseointegration of the Mg implants despite their minimal roughness compared to the moderately roughened TiUnite. This suggests potential advantages of Mg implants for reducing high implant failure rates in the early postimplantation stage and in compromised bone, making it possible to shorten bone healing time from surgery to functional loading, and enhancing the possibility of immediate/early loading.