Does traumatic occlusal forces lead to peri-implant bone loss? a systematic review

Observational studies have indicated that crestal bone level changes at implants are typically associated with clinical signs of inflammation, but still mechanical overload has been described as possible factor leading to hard-tissue deficiencies at implant sites without mucosal inflammation. The aim of this paper was systematically review the literature regarding the possible effect of traumatic occlusal forces on the peri-implant bone levels. Literature search was conducted using PubMed, Scielo and Lilacs, including the following terms: oral OR dental AND implant$AND (load OR overload OR excessive load OR force$ OR bruxism) AND (bone loss OR bone resorption OR implant failure$). Databases were searched for the past 10 years of publications, including: clinical human studies, either randomized or not, cohort studies, case control studies, case series and animal research. Exclusion criteria were review articles, guidelines and in vitro and in silico (finite element analysis) research, as well as retrospective studies. The PICO questions formulated was: "does traumatic occlusal forces lead to peri-implant bone loss?" The database searches as well as additional hand searching, resulted in 807 potentially relevant titles. After inclusion/exclusion criteria assessment 2 clinical and 4 animal studies were considered relevant to the topic. The included animal studies did not reveal an association between overload and peri-implant bone loss when lower overloads were applied, whereas in the presence of excessive overload it seemed to generate peri-implant bone loss, even in the absence of inflammation. The effect of traumatic occlusal forces in peri-implant bone loss is poorly reported and provides little evidence to support a cause-and-effect relationship in humans, considering the strength of a clinically relevant traumatic occlusal force33

Peri-Implant Bone Behavior after Single Drill versus Multiple Sequence for Osteotomy Drill

Objectives. The present study aims to compare the drilling protocol effect on osseointegration event in three commercially available titanium dental implants with different drill protocol using a rabbit tibia model. Materials and Methods. Three different drilling sequences were compared as follows: drilling sequence using a single unique drill of 4.2 mm conical implant (Group 1), drilling sequence using 3 consecutive cylindrical drills for a 4.1 mm cylindrical implant (Group 2), and drilling sequence using 3 consecutive conical drills for a 4.3 mm conical implant (Group 3). For each group, 18 drilling procedures and implant placements were performed, totalizing 54 commercially available titanium dental implants. The samples were removed 6 weeks after implantation. Resonance frequency analyses (RFA) were performed immediately after the implantation, and at 6 weeks removal torque test (RTt) and histological analysis were performed. Results. The RFA measured showed statistical difference between the groups in time 1 and no significant statistical differences in time 2 (p>0.05). In the RTt no significant difference was found between the 3 groups tested. Histomorphometric analysis showed no significant difference between groups in the bone-to-implant contact% (p>0.05). Conclusion. In the present preclinical study, osteotomy using a single bur did not show differences regarding the proposed and evaluated tests parameters for assessing the peri-implant behavior

Convergence and divergence of elite sport policies: is there a one-size-fits-all model to develop international sporting success?

This study is based on a detailed international comparison of the elite sport policies of 15 nations as part of the SPLISS (Sports Policy Factors Leading to International Sporting Success) study. It aims to provide deeper insights into the phenomena of convergence and divergence of elite sport policies. The research uses a mixed methods approach based on document reviews, interviews with high performance directors and surveys of 3142 athletes, 1376 coaches and 246 performance directors. There appears to be no generic blueprint for achieving international sporting success. Nations that perform well in international competition show varying patterns of relative strengths and weaknesses across nine pillars, 96 critical success factors, and 750 sub-factors. While the basic raw ingredients of the recipe might be common in broad terms, the combinations in which they are mixed are diverse. Much of this diversity appears to be driven by social, cultural and political factors

Effects Of Electromagnetic Field On Bone Healing Around Commercially Pure Titanium Surface: Histologic And Mechanical Study In Rabbits.

PURPOSE: The purpose of this pilot study was to evaluate the histologic and mechanical healing process in dental implants under the action of pulsed electromagnetic field (PEMF). MATERIALS AND METHODS: Forty-eight commercially pure implant fixtures were implanted in tibiae metaphysis of 12 New Zealand white rabbits divided into experimental (PEMF) and control groups. A PEMF with pulse width of 85 microseconds and a pulse frequency of 20 Mc was applied for 30 minutes per day. The animals were killed 21 and 42 days after implantation. The mechanical tests were performed in all animals and bone biopsies were prepared for decalcified sections analysis. RESULTS: Mechanical tests did not show significant differences between the groups (P > 0.05); however, statistically significant differences were observed over time (P < 0.0001). Similar histologic features were achieved for both groups. CONCLUSIONS: These results suggest that PEMF stimulation does not improve the bone-healing process around commercially pure dental implants.12218218

Esthetic evaluation of single-tooth Morse taper connection implants placed in fresh extraction sockets or healed sites.

Abstract Aim: The aim of this study was to compare the esthetic outcome of single implants placed in fresh extraction sockets with that of fully healed sites of the anterior maxilla. Materials and methods: This retrospective study was based on data from patients treated with single-tooth Morse taper connection implants placed in fresh extraction sockets and in fully healed sites of the anterior maxilla. Only single implant treatments were considered with both neighboring teeth present. Additional prerequisites for immediate implant treatment were intact socket walls and a thick gingival biotype. The esthetic outcome was objectively rated using the pink esthetic/white esthetic score (PES/WES). The Mann-Whitney test was used to compare the PES and WES scores between the two groups. Results: Twenty-two patients received an immediate implant and 18 patients had conventional implant surgery. The mean follow-up was 31.09 months (SD 5.57; range 24-46) and 34.44 months (SD 7.10; range 24-48) for immediate and conventionally inserted implants, respectively. No implants were lost. All implants fulfilled the success criteria. The mean PES/WES was 14.50 (SD 2.52; range 9-19) and 15.61 (SD 3.20; range 8-20) for immediately and conventionally placed implants, respectively. Immediate implants had a mean PES of 7.45 (SD 1.62; range 4-10) and a mean WES of 7.04 (SD 1.29; range 5-10). Conventional implants had a mean PES of 7.83 (SD 1.58; range 4-10) and a mean WES of 7.77 (SD 1.66; range 4-10). The difference between the two groups was not significant.Conclusions: Immediate and conventional single implant treatment yielded comparable esthetic outcomes

Clinical outcome of narrow-diameter (3.3-mm) locking-taper implants: a prospective study with 1 to 10 years of follow-up

To evaluate the outcome of narrow-diameter (3.3-mm) locking-taper implants used in the rehabilitation of partially and fully edentulous patients over a 10-year period. Between January 2002 and December 2011, all patients referred to a private dental clinic for treatment with narrow-diameter implants were enrolled in this study. At each annual follow-up session, clinical and radiographic parameters were assessed; the outcome measurements were implant failure, peri-implant marginal bone loss (distance between the implant shoulder and the first visible bone-to-implant contact [DIB]), and biologic and technical complications. The cumulative survival rate (CSR) was assessed using the Kaplan-Meier survival estimator; Tarone-Ware and chi-square analyses were used to evaluate correlations between the study variables. The statistical analysis was performed at the patient- and implant-level. A total of 324 narrow-diameter implants were placed in 279 patients (159 men, 120 women; age: 25 to 73 years). Four implants failed, for an overall CSR of 98.5% (patient-based) and 98.7% (implant-based) at the 10-year follow-up. The survival rate did not differ significantly with respect to patients' sex, age, smoking or parafunctional habits, bone type, prosthetic restoration, or implant location, position, or length. Among the surviving implants, a mean DIB of 0.31 \ub1 0.23 mm, 0.45 \ub1 0.27 mm, and 0.69 \ub1 0.28 mm was observed at the 1-, 5-, and 10-year follow-up examinations, respectively. A few biologic (1.2%) and technical complications (7.5%) were reported. Within the limitations of this study, it can be concluded that narrow-diameter locking-taper implants represent a good treatment option for the prosthetic rehabilitation of partially and totally edentulous patients

Evaluation of the insertion torque, implant stability quotient and drilled hole quality for different drill design : an in&#160;vitro Investigation

Objective: The purpose of the present study was to compare the insertion torque and implant stability quotient between different drill design for implant site preparation. Materials and Methods: Synthetic blocks of bone (type I density) were used for drilling procedures. Three groups were evaluated: Group G1 - drilling with a single bur for a 4.2\ua0mm conical implant; Group G2 and Group G3 - drilling with three consecutive burs for a 4.1\ua0mm cylindrical implant and for a 4.3\ua0mm conical implant respectively. For each group, 15 drilling procedures were performed without irrigation for 10-mm in-depth. The drilled hole quality (HQ) after the osteotomy for implant site preparation was measured in the five-first holes through a fully automated roundness/cylindricity instrument at three levels (top, middle, and bottom of the site). The insertion torque value (ITV) was achieved with a computed torquimeter and the implant stability quotient (ISQ) values were measured using a resonance frequency apparatus. Results: The single drill (group 1) achieved a significantly higher ITV and ISQ than the multiple drills for osteotomy (groups 2 and 3). Group 1 and 3 displayed significantly better HQ than group 2. Conclusions: Within the limitations of the study, the results suggest that the hole quality, in addition to the insertion torque, may significantly affect implant primary stability