Dental implants inserted in native bone: Cases series analyses

BACKGROUND: The concept of osseointegration, i.e., the direct anchorage of endosseous implants made of commercially pure or titanium alloy to the bone caused a breakthrough in oral rehabilitation. The identification of factors for long-term survival and success rate are the main goal of the recent literature. Several variables can influence the final result, and in general they are grouped in surgery-, host-, implant-, and occlusion-related factors. MATERIALS AND METHODS: A retrospective analysis on a large series of dental implants was performed to detect those variables influencing the clinical outcome. In the period between January 2007 and December 2009, 157 patients were operated. A total of 429 implants were inserted. Dental implants are reliable devices to be used in oral rehabilitation. RESULTS: Globally, very few implants were lost at the end of the follow-up period. Slight but significant differences existed among different implants types with regard to peri-implant bone resorption. CONCLUSION: A better clinical outcome was revealed for Sweden and Martina global implant

Overdentures on implants placed in bone augmented with fresh frozen bone

In the last decade several studies have been performed to evaluate the clinical outcome of one or two stage loaded implants supporting overdentures. Since fresh frozen bone (FFB) has an ever-increasing number of clinical applications and few reports are available on implants inserted into FFB, we performed a retrospective study on fixtures inserted in FFB and bearing overdentures.In the period between December 2003 and December 2006, 17 patients (14 females and 3 males with a median age of about 56 years) were grafted and 60 implants inserted thereafter. A total of 17 overdentures were delivered: 8 in the mandible and 9 in the maxilla. Multiple implant systems were used: 22 Double etched, 7 SLA, 9 Anodic oxidized, and 22 CaPo4 ceramic-blasted. Implant diameter ranged from 3.25 to 4.3 mm and length from 11.5 to 16.0 mm. Implants were inserted to replace 23 incisors, 9 cuspids, 20 premolars and 8 molars.No implants were lost (i.e., survival rate=100\%) and no differences were detected among the studied variables. Kaplan Meier algorithm and Cox regression did not reveal any statistical differences among the studied variables also as regards the success rate.Implants inserted FFB and bearing overdentures have a high survival rate and success rates, which are comparable to those of implants inserted in non-grafted bone. FFB bone is a reliable material for alveolar ridge augmentation. No difference was detected among removable prostheses supported by two or more implants

Retrospective study of standard-diameter implants inserted into allografts

PURPOSE: In the last decade, several investigators reported that standard-diameter implants (SDIs) achieved excellent results. However, no report is available regarding SDIs inserted into fresh-frozen bone (FFB). We conducted a retrospective study on a series of SDIs (diameter, 3.75 mm) inserted into homologous FFB to evaluate their clinical outcome. MATERIALS AND METHODS: The SDIs inserted with FFB were analyzed. Several variables were investigated regarding patients, anatomic sites, implants, and prosthetic restoration. Implant failure and peri-implant bone resorption were considered predictors of clinical outcome. A Kaplan-Meier algorithm and Cox regression were performed to detect those variables statistically associated with clinical outcomes. RESULTS: One hundred thirty-three SDIs were inserted in 41 patients. Implant length ranged from 10 to 15 mm. Implants were inserted to replace 6 incisors, 13 cuspids, 60 premolars, and 54 molars. The mean follow-up was 23 months. Only 1 of 133 implants was lost (ie, survival rate=99.2\%), and no differences were detected among study variables. On the contrary, crestal bone resorption correlates with type of prosthetic restoration, with a better outcome for removable dentures. CONCLUSION: The SDIs had high survival and success rates, similar to those reported in previous studies of 2-stage procedures in nongrafted bone. The SDIs inserted into FFB are reliable, although a greater marginal bone loss is to be expected if fixed prosthetic restorations are used

Implants inserted into homografts bearing fixed restorations

PURPOSE: In the last decade several studies have evaluated the clinical outcome of implants inserted into autografts and rehabilitated with fixed restorations in either one- or two-step surgical protocols. However, no study has investigated implants placed into homografts; thus, a case series analysis was performed to verify the clinical outcome of implants inserted into fresh frozen bone (FFB) and bearing fixed prosthetic restorations. MATERIALS AND METHODS: Fifty-eight patients underwent iliac crest homograft transplants and 238 implants were inserted. Seventy-one double-etched, 19 sandblasted and acid-etched-1 (SLA1), 10 grit-blasted and acid-etched, 73 anodic oxidized, 39 CaPo4 ceramic-blasted, 19 SLA2, and seven additional implants of various types were used. Implant diameter and length ranged from 3 to 5 mm and from 7 to 16 mm, respectively. Implants were inserted to replace 15 incisors, 14 canines, 102 premolars, and 107 molars. A total of 111 restorations were performed. RESULTS: No implants were lost. Cox regression analysis showed that implant type and type of edentulism directly correlated with a lower bone resorption and thus had a better clinical outcome and success rate. CONCLUSION: Implants bearing fixed restorations and inserted into FFB have higher survival and succes rates compared to those placed in nongrafted and grafted jaws reported in previous studies

Clinical outcome of narrow diameter implants inserted into allografts

OBJECTIVE: Narrow diameter implants (NDI) (i.e. diameter <3.75 mm) are a potential solution for specific clinical situations, such as reduced interradicular bone, thin alveolar crest and replacement of teeth with small cervical diameter. NDI have been available in clinical practice since the 1990s, but only few studies have analyzed their clinical outcome and no study have investigated NDI inserted in fresh-frozen bone (FFB) grafts. Thus, a retrospective study on a series of NDI placed in homologue FFB was designed to evaluate their clinical outcome. MATERIAL AND METHODS: In the period between December 2003 and December 2006, 36 patients (22 females and 14 males, mean age 53 years) with FFB grafts were selected and 94 different NDI were inserted. The mean follow-up was 25 months. To evaluate the effect of several host-, surgery-, and implant-related factors, marginal bone loss (MBL) was considered an indicator of success rate (SCR). The Kaplan Meier algorithm and Cox regression were used. RESULTS: Only 5 out of 94 implants were lost (i.e. survival rate - SVR 95.7\%) and no differences were detected among the studied variables. On the contrary, the Cox regression showed that the graft site (i.e. maxilla) reduced MBL. CONCLUSIONS: NDI inserted in FFB have a high SVR and SCR similar to those reported in previous studies on regular and NDI inserted in non-grafted jaws. Homologue FFB is a valuable material in the insertion of NDI

Effectiveness of fresh frozen and cryopreserved homologue iliac crest grafts used in sinus lifting: a comparative study

In the last decade, several investigators have reported that autologous and homologous fresh frozen bones (FFB) are effective materials to restore alveolar ridges previous to insert dental implants. Recently we have used cryopreserved homologue grafts (CFFB). Here we reported a retrospective comparative study between implants inserted in FFB and CFFB evaluate their clinical outcome. Patients were treated with a split mouth scheme for bone grafting with FFB and CFFB and spiral family implants (SPI) were inserted in the same surgical time. Several variables (patient, grafts, anatomic site, implant, prosthetic restoration) were investigated. Implant' failure and peri-implant bone resorption were considered as predictor of clinical outcome. A total of 84 SFIs were inserted in 12 patients. Implants were inserted to replace 8 incisors, 4 cuspids, 31 premolars and 41 molars. The mean follow-up was 14 months. Three out of 84 implants was lost (i.e. survival rate SVR = 96.4\%) and no differences were detected among the studied variables. Similar result was obtained by analyzing the crestal bone resorption around implant' neck (i.e. success rate). FFB and CFFB have high and comparable survival and success rate. Implants inserted with one step surgical procedure in native (i.e. not grafted) bone, FFB and CFFB have similar clinical outcome

IMPLANTS INSERTED IN MAXILLARY SINUS GRAFTED WITH FRESH FROZEN HOMOLOGUE ILIAC BONE: A RETROSPECTIVE STUDY

In the last decade, several investigators have reported that autologous and homologous fresh frozen bones (FFB) are effective materials to restore alveolar ridges previous to insert dental implants. Here we reported a comparative study between spiral implants inserted in FFB and native bone to evaluate their clinical outcome. Patients were grafted and spiral implants were inserted in the same surgical time. Several variables (patient, grafts, anatomic site, implant, prosthetic restoration) were investigated. Implant’ failure and peri-implant bone resorption were considered as predictor of clinical outcome. 51 implants were inserted in 12 patients. Implants were inserted to replace 8 incisors, 4 cuspids, 18 premolars and 21 molars. The mean follow-up was 14 months. No implant was lost. Peri-implant bone resorption (i.e. success rate) was used as predictor of clinical outcome but Kaplan Meier algorithm demonstrates that no studied variable has a statistical significant impact on clinical outcome. FFB and native bone havehigh and comparable survival and success rate. Spiral implants can be successfully inserted in native e grfted bone to performe an oral rehabilitatio

A retrospective study on 287 implants installed in resorbed maxillae grafted with fresh frozen allogenous bone

Background: Several studies have been performed to evaluate the clinical outcome of implants inserted into maxillae grafted with autogenous bone but few reports have focused on maxillae grafted with fresh-frozen allogenous bone (FFAB). Purpose: The purpose of this study is to retrospectively evaluate the clinical outcome of implants installed in resorbed maxillae augmented with FFAB. Materials and Methods: A total of 69 patients whom had been treated with FFAB grafts to their maxillae and implant placement 4 to 6 months later were retrospectively evaluated. Edentulism was total and partial in 22 and 47 cases, respectively. A total of 287 implants of various systems had been used. A life table analysis was performed. Marginal bone loss was calculated in radiographs. Results: Five of the 287 implants were lost, giving a survival rate (SVR) of 98.3% over a mean follow-up time of 26 months. The marginal bone resorption at the implants was 1.68 mm (SD = 0.44) after 1 year and 1.85 mm (SD = 0.98) after 4 years. The cumulative success rate based on defined criteria was 96% in the first year but decreased to 40% at 4 years because of marginal bone loss. The Kaplan-Meier algorithm demonstrated a better outcome for female patients, removable dentures, and total edentulism. No differences were detected among diameters, lengths, and implant site. Conclusion: Implants placed in FFAB showed a high SVR similar to that reported in previous studies on maxillae grafted with autogenous iliac crest bone. Although our data point to more marginal bone loss in partially edentulous patients and for fixed prosthetic restorations, the use of FFAB for reconstruction of the atrophic jaw prior to implant placement can be considered as a reliable alternative to autogenous bone

RECONSTRUCTION OF SEVERELY ATROPHIC JAWS USING HOMOGRAFTS: BONE DENSITY EVALUATION OVER TIME

Bone augmentation to reconstruct atrophic jaws provides the base for sufficient functional and aesthetic implant-supported oral rehabilitation. Although autografts are the standard procedure for bone grafting, the use of homologue bone provides a reasonable alternative. Here bone density of native and grafted bone was evaluated over time by using Computed Tomography (CT) output and a specific computer program. Five patients were grafted with Fresh Frozen Bone (i.e. FFB) and 41 implants were inserted in the same operation. Pearson’s chi-square test was used to investigate difference in bone density (i.e. BD) between native and grafted immediately over time. BD of both native bone and FFB located far away from implants do not change over time. Native bone has about a double BD than FFB BD is growing over time: it became about 3/4of native BD after 12 months of follow-up (and after 8 months of loading). CT scan represents a valuable and accurate pre-operative mathod to obtain information about bone quality and quantity (i.e. volume of available bone