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Background: This study aims to show the clinical outcomes of implants supporting mandibular overdentures in edentulous patients. Methods: Mandibular edentulous patients were diagnosed with an oral examination, panoramic radiograph, and diagnostic casts for intermaxillary relations and treated with overdentures over two implants. After two-stage surgery, implants were early loaded with an overdenture at 6 weeks. Results: Fifty-four patients (28 females and 24 males) were treated with 108 implants. Thirty-two patients (59.2%) had a previous history of periodontitis. Twenty-three patients (46%) were smokers. Forty patients (74.1%) suffered from systemic diseases (i.e., diabetes, cardiovascular diseases). The clinical follow-up of the study was 147.8 ± 10.4 months. The clinical outcomes showed a global success of 94.5% of implants. Fifty-four overdentures were placed in the patients over the implants. The mean marginal bone loss was 1.12 ± 0.34 mm. Nineteen patients (35.2%) showed some kind of mechanical prosthodontic complication. Sixteen implants (14.8%) were associated with peri-implantitis. Conclusions: Based on the clinical results obtained, we can determine that the treatment of elderly edentulous patients with mandibular overdentures through the early loading of two placed implants is a successful implant protocol.

(1) Background. The immediate functional loading of implants is a clinical procedure used for treating periodontal edentulous patients. This clinical study aimed to evaluate the clinical outcomes of the immediate functional loading of implants with fully fixed rehabilitations in compromised periodontal patients. (2) Methods. Three hundred and five implants IPX screw implants were placed in 27 periodontal patients using an immediate functional loading protocol with fixed rehabilitations. All patients had a previous history of periodontitis, four patients (14.8%) were smokers and seven patients (25.9%) suffered from chronic medical conditions. (3) Results. Implant and prosthetic clinical findings were evaluated during a mean period of 41.3 ± 19.6 months. No implants were lost during the clinical follow-up. The cumulative survival rate for all implants was 100%. Regarding the prostheses designed, a total of 54 fixed prostheses were placed in the 27 patients immediately after the surgery. Forty-four hybrid fixed prostheses (81.5%) and 10 fixed rehabilitations (18.5%) were placed in the patients. The mean marginal bone loss was 1.51 ± 1.16 mm, ranging from 0 to 3.5 mm during the follow-up evaluation. Thirty-one implants (10.2%) in 10 patients (37%) were associated with peri-implantitis. Five patients (18.5%) showed some kind of technical complications (loss/fracture of the prosthetic screw, acrylic resin fracture, ceramic chipping). (4) Conclusions. The clinical outcomes of this study demonstrate that fixed rehabilitation by immediate functional loading of implants is considered a predictable procedure.

The influence of the surface topography of dental implants has been studied to optimize titanium surfaces in order to improve osseointegration. Different techniques can be used to obtain rough titanium, however, their effect on wettability, surface energy, as well as bacterial and cell adhesion and differentiation has not been studied deeply. Two-hundred disks made of grade 4 titanium were subjected to different treatments: machined titanium (MACH), acid-attacked titanium (AE), titanium sprayed with abrasive alumina particles under pressure (GBLAST), and titanium that has been treated with GBLAST and then subjected to AE (GBLAST + AE). The roughness of the different treatments was determined by confocal microscopy, and the wettability was determined by the sessile drop technique; then, the surface energy of each treatment was calculated. Osteoblast-like cells (SaOs-2) were cultured, and alkaline phosphatase was determined using a colorimetric test. Likewise, bacterial strains S. gordonii, S. oralis, A. viscosus, and E. faecalis were cultured, and proliferation on the different surfaces was determined. It could be observed that the roughness of the GBLAST and GBLAS + AE was higher, at 1.99 and 2.13 μm of Ra, with respect to the AE and MACH samples, which were 0.35 and 0.20 μm, respectively. The abrasive treated surfaces showed lower hydrophilicity but lower surface energy. Significant differences could be seen at 21 days between SaOS-2 osteoblastic cell adhesion for the blasted ones and higher osteocalcin levels. However, no significant differences in terms of bacterial proliferation were observed between the four surfaces studied, demonstrating the insensitivity of bacteria to topography. These results may help in the search for the best topographies for osteoblast behavior and for the inhibition of bacterial colonization. info:eu-repo/semantics/publishedVersion

The prescription of preventive antibiotics in dental implant treatments reduces the incidence of early failures. This study has focused mainly on the influence of amoxicillin, which is contraindicated in penicillin-allergic patients. The present systematic review aimed to determine whether penicillin-allergic patients have a higher risk of implant failure compared to non-allergic patients. An electronic search was performed on Medline and Web of Science using the following MeSH terms: (penicillin allergy OR clindamycin OR erythromycin OR azithromycin OR metronidazole) AND (dental implant OR dental implant failure OR dental implant complications). The criteria employed were those described in the PRISMA® Declaration. Only five articles were included that analyzed the failure rates of implants placed in penicillin-allergic patients who were prescribed clindamycin compared to non-allergic patients who were prescribed amoxicillin. With the limitations of this study, it is not possible to state that penicillin allergy per se constitutes a risk factor for early dental implant failure as most of the studies included self-reported allergic patients. Clindamycin has been associated with a significantly elevated risk of failure and an up to six times increased risk of infection. Immediate implants also have a 5.7 to 10 times higher risk of failure.

Introduction. The aim of this study was to show the long-term clinical outcomes of implants placed in maxillary sinus floor augmentation (MFSA) using beta-tricalcium phosphate (β-TCP). Patients and methods. Maxillary patients were diagnosed for MFSA and used beta- β-TCP. After the lateral sinus surgery, implants were loaded at 6 months with restorations. The clinical follow-up was at 10 years. Results. One hundred and one patients (58 females and 43 males) were treated with MFSA. Twenty-nine patients (28.7%) had a history of periodontitis. Thirty-three patients (32.7%) were smokers. One hundred and twenty-one MFSA, 81 unilateral and 20 bilateral sites, with 234 implants were performed. The average vertical bone height available was 4.92 ± 1.83 mm. The average vertical bone gain obtained was 6.95 ± 2.19 mm following MFSA. The implant cumulative survival rate was 97.2%. Three implants (1.3%) were lost during the healing period. Six implants (2.6%) were lost by peri-implantitis. One hundred and fifteen restorations were placed in the patients. Mean marginal bone loss was 1.93 mm ± 1.03 mm. Six patients (27.3%) showed technical complications. Thirty-six implants (15.3%) in 14 patients (13.9%) were associated with peri-implantitis. Conclusions. This study indicates that treatment with implant-supported restoration by MFSA using β-TCP constitutes a successful implant approach.

Titanium surface is an important factor in achieving osseointegration during the early wound healing of dental implants in alveolar bone. The purpose of this study was to evaluate sandblasted-etched surface implants to investigate the osseointegration. In the present study, we used two different types of sandblasted-etched surface implants, an SLA™ surface and a Nanoblast Plus™ surface. Roughness and chemical composition were evaluated by a white light interferometer microscope and X-ray photoelectron spectroscopy, respectively. The SLA™ surface exhibited the higher values (Ra 3.05 μm) of rugosity compared to the Nanoblast Plus™ surface (Ra 1.78 μm). Both types of implants were inserted in the femoral condyles of ten New Zealand white rabbits. After 12 weeks, histological and histomorphometric analysis was performed. All the implants were osseointegrated and no signs of infection were observed. Histomorphometric analysis revealed that the bone–implant contact % (BIC) ratio was similar around the SLA™ implants (63.74 ± 13.61) than around the Nanoblast Plus™ implants (62.83 ± 9.91). Both implant surfaces demonstrated a favorable bone response, confirming the relevance of the sandblasted-etched surface on implant osseointegration. info:eu-repo/semantics/publishedVersion

The surface modification by the formation of apatitic compounds, such as hydroxyapatite, improves biological fixation implants at an early stage after implantation. The structure, which is identical to mineral content of human bone, has the potential to be osteoinductive and/or osteoconductive materials. These calcium phosphates provoke the action of the cell signals that interact with the surface after implantation in order to quickly regenerate bone in contact with dental implants with mineral coating. A new generation of calcium phosphate coatings applied on the titanium surfaces of dental implants using laser, plasma-sprayed, laser-ablation, or electrochemical deposition processes produces that response. However, these modifications produce failures and bad responses in long-term behavior. Calcium phosphates films result in heterogeneous degradation due to the lack of crystallinity of the phosphates with a fast dissolution; conversely, the film presents cracks, which produce fractures in the coating. New thermochemical treatments have been developed to obtain biomimetic surfaces with calcium phosphate compounds that overcome the aforementioned problems. Among them, the chemical modification using biomineralization treatments has been extended to other materials, including composites, bioceramics, biopolymers, peptides, organic molecules, and other metallic materials, showing the potential for growing a calcium phosphate layer under biomimetic conditions. Ramón y Cajal Beca a C.M.-M. RYC-2015-18566 Cofinanciados por la UE a través de la Unión Europea Fondos de Desarrollo Regional

The aim of this study was to show the clinical outcomes of the immediate loading of implants inserted by guided surgery in edentulous mandible patients. Edentulous mandible patients were diagnosed with oral examination, cone beam computerized tomography and diagnostic casts for intermaxillary relations and treated with 8–10 implants for rehabilitation with guided surgery and immediate loading. After flapless surgery, implants were loaded with an immediate acrylic temporary prosthesis. After a period of six months, a ceramic definitive full-arch prosthesis was placed. A total of 22 patients (12 females and 10 males) were treated with 198 implants. Eleven patients (50%) had a previous history of periodontitis. Six patients (27.3%) were smokers. The follow-up was 84.2 ± 4.9 months. Clinical outcomes showed a global success rate of 97.5% of implants. Five implants were lost during the healing phase with provisional prosthesis. Twenty-two fixed full-arch rehabilitations were placed in the patients over the 193 remaining implants. Mean marginal bone loss was 1.44 mm ± 0.45 mm. Six patients (27.3%) showed some kind of mechanical prosthodontic complication. Eighteen (9.3%) of the 193 remaining implants were associated with peri-implantitis. The antecedents of peri-implantitis are critical elements for the survival of the implants. The loss of implants was significant in patients who smoked up to 10 cigarettes, compared to non-smokers. Peri-implantitis is one of the key elements in the long-term follow-up of implants and it was more manifest in smoking patients, and in those with a history of peri-implantitis. Marginal bone loss was more significant in smokers. Full-arch rehabilitation is presented as a predictable alternative with minor fatigue problems that are easily solvable.

Sandblasting is a standard procedure used for treating the implant surface to enhance the osseointegration with known clinical success. This retrospective cohort study aimed to evaluate the long-term clinical outcomes of sandblasted implants. Two hundred fifty-five MG Osseous screw implants were placed in 81 patients using a two-stage surgical technique and conventional loading protocol (three-months). Implant and prosthetic clinical findings were evaluated during a 15-years follow-up. Four implants were lost during the healing period, and 103 fixed prostheses were placed over the 251 implants left: 58 single-crowns, 31 partially fixed bridges, and 14 full-arch fixed restorations. Fourteen implants were lost during the follow-up period. Clinical results indicated an implant survival rate of 92.9%. 11.8% of implants showed peri-implantitis as the primary biological complication. The mean marginal bone loss was 1.76 ± 0.38 mm, ranging from 0.9 to 2.8 mm. The most frequent complication was mechanical prosthodontic complications (20.9%). Sandblasted surface implants inserted in both maxillary and mandibular areas produce favorable outcomes and stable tissue conditions when a delayed loading protocol is followed.

The prescription of preventive antibiotics (PA) in oral implantology is a controversial issue. The study aimed to determine the prescribing habits of PA in professionals dedicated to oral implantology in various treatments in healthy and at-risk patients. This is a cross-sectional observational study based on the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. An electronic survey consisting of 4 blocks of questions was sent to members of the Spanish Society of Implants. The data were analyzed using descriptive analysis. A total of 303 participants (20.8%) responded to the questionnaire. One percent never prescribed PA, 55.4% prescribed them always, and 43.6% prescribed them sometimes. Ninety-six percent administered them preoperatively, while 92.4% administered them postoperatively. The most commonly used antibiotic is amoxicillin followed by amoxicillin with clavulanic acid (875/125 mg). Clindamycin is the most commonly administered antibiotic in patients with allergies. Professionals dedicated to oral implantology frequently prescribe PA in both healthy and at-risk patients, especially perioperatively. Immediate implant placement, sinus lifts, bone regeneration, and multiple implant placement are the treatments in which PA are most commonly prescribed, as well as in patients with heart valve prostheses or a history of bacterial endocarditis and immunodeficiency. Sociedad Española de Implantes

Introduction: This study aimed to show the clinical outcomes of implants inserted by guided surgery supporting mandibular overdentures in edentulous patients. Patients and methods: Mandibular edentulous patients were diagnosed with an oral examination, cone-beam computerized tomography, and diagnostic casts for intermaxillary relations and treated with overdentures over two implants by guided surgery. After flapless surgery, implants were early loaded with an overdenture at 6 weeks. Results and discussion: Fourteen patients (nine females and five males) were treated with 28 implants. Four patients (28.6%) had a previous history of periodontitis. Five patients (35.7%) were smokers. Nine patients (64.3%) suffered from systemic diseases (i.e., diabetes, cardiovascular diseases). The clinical follow-up of the study was 44.7 ± 31.4 months. Clinical outcomes showed a global success of 100% of implants. Fourteen overdentures were placed in the patients over the implants. Mean marginal bone loss was 1.25 mm ± 0.95 mm. Four patients (28.6%) showed some kind of mechanical prosthodontic complications. Six implants (21.4%) were associated with peri-implantitis. Conclusions: This study indicates that treatment of mandibular edentulous patients with overdentures by guided surgery and early loading of implants placed appears to be a successful implant protocol.

Implant dentistry constitutes a therapeutic modality in the prosthodontic treatment of partially and totally edentulous patients. This study reports a long-term evaluation of treatment by the early loading of acid-etched surface implants. Forty-eight partially and totally edentulous patients were treated with 169 TSA Defcon&reg, acid-etched surface implants for prosthodontic rehabilitation. Implants were loaded after a healing free-loading period of 6&ndash, 8 weeks in mandible and maxilla, respectively. Implant and prosthodontic clinical findings were followed during at least 17 years. Clinical results indicate a survival and success rate of implants of 92.9%, demonstrating that acid-etched surface achieves and maintains successful osseointegration. Five implants in three patients were lost during the healing period. Sixty-five prostheses were placed in 45 patients over the remaining 164 implants, 30 single crowns, 21 partially fixed bridges, 9 overdentures, and 5 full-arch fixed rehabilitations. A total of 12 implants were lost during the follow-up period. Mean marginal bone loss was 1.91 &plusmn, 1.24 mm, ranging from 1.1 to 3.6 mm. The most frequent complication was prosthetic technical complications (14.2%), followed by peri-implantitis (10.6%). The mean follow-up was of 214.4 months (208&ndash, 228 months). Prosthodontic rehabilitation with an early-loading protocol over acid-etched surface implants is a successful implant treatment.

The implant surface features affect the osseointegration process. Different surface treatment methods have been applied to improve the surface topography and properties. Trace of different elements may appear on the implant surface, which can modify surface properties and may affect the body&rsquo, s response. The aim was to evaluate the roughness based on the surface treatment received and the amount and type of trace elements found. Ninety implants (nine different surface treatment) were evaluated. Roughness parameters were measured using white-light-interferometry (WLI). The arithmetical mean for Ra, Rq, Rt, and Rz of each implant system was calculated, and Fisher&rsquo, s exact test was applied, obtaining Ra values between 0.79 and 2.89 &micro, m. Surface chemical composition was evaluated using X-ray photoelectron spectroscopy (XPS) at two times: as received by the manufacturer (AR) and after sputter-cleaning (SC). Traces of several elements were found in all groups, decreasing in favor of the Ti concentration after the sputter-cleaning. Within the limitations of this study, we can conclude that the surface treatment influences the roughness and the average percentage of the trace elements on the implant surface. The cleaning process at the implant surface should be improved by the manufacturer before assembling the implant.

Two-pieces dental implants must provide stability of the implant-abutment-interface. The connection type and platform diameter could influence the biomechanical resistance and stress distribution. This study aims to evaluate the fatigue for different types of connections, external and internal, and different platform diameters. Three implant designs with the same length were used: (a) external hexagon/narrow platform, (b) internal double hexagon/narrow platform, (c) internal octagon/regular platform. A fatigue test was developed to establish the number of cycles needed before fracture. A 30&ordm, oblique load with a sinusoidal function of fatigue at a frequency of 15 Hz and 10% stress variation was applied to each system. The fatigue load limit (FLL) for design (a) was 190N, being the nominal-curvature-moment (NCM) = 1.045, FLL = 150 N, with a NCM = 0.825 for (b), and FLL = 325 N, with a NCM = 1.788 for (c). The platform diameter affects the FLL, obtaining lower FLL on a narrow platform. The connection type interferes with the implant walls&rsquo, width, especially in narrow implants, making internal connections more unstable at this level. Long-term clinical studies to assess the restoration&rsquo, s success rate and survival are mandatory.

The surface modifications of titanium dental implants play important roles in the enhancement of osseointegration. The objective of the present study was to test two different implant surface treatments on a rabbit model to investigate the osseointegration. The tested surfaces were: a) acid-etched surface with sandblasting treatment (SA) and b) an oxidized implant surface (OS). The roughness was measured by an interferometeric microscope with white light and the residual stress of the surfaces was measured with X-ray residual stress Bragg–Bentano diffraction. Six New Zealand white rabbits were used for the in vivo study. Implants with the two different surfaces (SA and OS) were inserted in the femoral bone. After 12 weeks of implantation, histological and histomorphometric analyses of the blocks containing the implants and the surrounding bone were performed. All the implants were correctly implanted and no signs of infection were observed. SA and OS surfaces were both surrounded by newly formed trabeculae. Histomorphometric analysis revealed that the bone–implant contact % (BIC) was higher around the SA implants (53.49 ± 8.46) than around the OS implants (50.94 ± 16.42), although there were no significant statistical differences among them. Both implant surfaces (SA and OS) demonstrated a good bone response with significant amounts of newly formed bone along the implant surface after 12 weeks of implantation. These results confirmed the importance of the topography and physico–chemical properties of dental implants in the osseointegration. The authors are grateful to the Spanish Government and European Union FEDER by the concession of the project RTI2018-098075-B-C22 SI

Background The aim of this prospective study was to report the outcome of treatment with implants inserted after tooth extraction and immediately loaded. Material and Methods Fifty-six patients with single tooth loss were treated with 116 IPX Galimplant® implants with internal connections and a sandblasted, acid-etched surface. All implants were placed after tooth extraction using a flapless approach without bone regeneration, and they were then immediately loaded with cemented acrylic prostheses. After a period of three months, definitive cemented ceramic prostheses were placed. Patients were examined throughout a total of 4 years of follow-up. Marginal bone loss and survival rates were evaluated using digital periapical radiographs, taking into account clinical variables such as age, gender, smoking, history of periodontitis, etiology of extraction, placement site, diameter, and implant length. The Mann-Whitney U and Kruskal-Wallis non-parametric tests were used to compare differences between subgroups created based on the different clinical variables identified. Results Clinical results indicate an implant survival and success rate of 97.4%. Three implants were lost. Of the 116 immediate acrylic single crowns initially placed, 113 were replaced with definitive ceramic crowns after 3 months. A total of 77.8% of implants were inserted in the maxilla, while 22.2% were inserted in the mandible. No further complications were reported after the follow-up period (4 years). The mean marginal bone loss was 0.67 mm ± 0.40 mm. No differences were found among the subgroups of study patients. Conclusions This study indicates that dental implants that are inserted after tooth extraction and immediately loaded may constitute a successful and predictable alternative implant treatment. Key words:Dental implants, post-extraction implants, fresh sockets, immediate loading, immediate prostheses, implant dentistry.

Background The aim of this study was to assess the dental status (DMFT) in patients with schizophrenia compared with a control group. Material In this case–control study, 50 patients with schizophrenia attended in the Psychiatric Unit at the Virgen Macarena University Hospital of Seville were compared with 50 people (without systemic diseases and not taking psychotropic drugs) in a control group attended in the School of Dentistry of Seville. Decayed, missing and filled teeth (DMFT) were assessed according to the World Health Organization WHO criteria. Results Patients with schizophrenia showed a decayed teeth (DT) score of 7.26 ± 5.69 compared with 6.50 ± 4.37 for patients the control group. These differences were significant and suggest that dental caries are most prevalent in patients with schizophrenia. People who smoked showed significantly higher DT scores in both groups. Among patients with schizophrenia, smokers scored 9.34 ± 5.42 compared with 4.38 ± 4.82 for non-smokers. Among the healthy controls, smokers scored 6.88 ± 4.85 compared with 6.12 ± 3.85 for non-smokers (p