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We evaluate bone remodeling and prostheses survival of immediately provisionalized with occlusal loading and delayed loading (DL) single implants placed in the posterior region after 1-yr follow-up in dental practices. Included in the study are patients selected to receive one regular implant (4 × 10 mm) for single tooth replacement in healed ridge sockets in the mandible and maxilla. Implants are immediately loaded or delayed functionally loaded with metal ceramic crowns, depending on peak insertion torque value. All implants are clinically and radiographically evaluated at T1, immediately postoperatively; T2, 60 d; T3, 180 d; and T4, 360 d. Measurements between implant platform and top of alveolar bone crest at distal and mesial areas are performed using periapical radiographs. Data are statistically evaluated through two-way repeated measures of analysis of variance following post hoc comparisons using the Tukey test (p < 0.05). Ten specialists working in ten different practices treat 36 patients who receive one implant each with internal conical connection (hybrid implant system, 4 × 10 mm) (Emfils; Itu, Brazil). Results show that bone-level alterations in immediate (IM; 0.56 mm; confidence interval [CI]: ± 0.21 mm) and delayed (0.65 mm; CI: ± 0.19 mm) groups are not significantly different (p = 0.515) during the course of the 1-yr observation period. In both groups, statistically significant progressive bone-level remodeling occurs through the evaluated follow-up time points (p < 0.047). All prostheses are rated "alpha," presenting 100% success at 1-yr follow-up. The loading method does not influence bone-remodeling levels around IM or DL at the posterior region after 1-yr follow-up. No prostheses complications are reported.

We describe the retrieval of a dental implant device that had been successfully osseointegrated for more than 4 years. After obtaining an informed patient consent, the device was retrieved for retreatment purposes from its position in a β-tricalcium phosphate (β-TCP) grafted sinus floor. The sinus floor augmentation, using β-TCP, had been performed in conjunction with the original implant placement, which in turn enabled the histological evaluation of specific regions of interest that were comprised of either grafted or native bone. Radiographs documented the rehabilitated area before and after grafting. The osteogenic events that occurred during the 4-yr-period depict the interplay of implant, synthetic graft material, and native bone in a dynamic process of osteogenesis, ongoing bone maturation, and remodeling that led to the development of haversian-like bone morphology. Two distinct areas were observed histologically, wherein osteointegration occurred uneventfully in both native bone and areas of grafted bone. Of particular interest was the presence of multiple remodeling sites of lamellar bone that could be seen between the plateaus-healing chambers-in which bone eventually evolved into a haversian cortical-like configuration.

This study evaluates the influence of two surface physicochemical modifications on osseointegration parameters of a healing chamber implant design. We examine dental implants with internal and external trapezoidal threads that have the following surface modifications: dual acid etching (DAE) and nano-hydroxyapatite (HA) coating over DAE surface (Nano). We installed implants in the right ilium of sheep and conducted histologic/metric analyses after 3 and 12 wk in vivo. We quantified the percentage of bone-to-implant contact (%BIC) and bone area fraction occupancy (%BAFO) within implant threads. Histologic micrographs indicate early bone formation within the healing chambers of implants with Nano surface relative to DAE surface. Histomorphometric analysis demonstrates there to be no significant differences in %BIC between 3 and 12 wk (p = 0.298). Compared to DAE, Nano shows more bone formation in contact with implant, regardless of time (p < 0.025). We observe > %BAFO at 12 wk relative to 3 wk, which differs significantly for Nano (p < 0.038). Implant surface treatment affects the amounts of bone formation within healing chambers, with Nano significantly outperforming DAE at 12 wk (p < 0.025). Nano presents a synergistic effect with implant design, improving osseointegration parameters.