SEM and fractography analysis of screw thread loosening in dental implants.

Biological and technical failures of implants have already been reported. Mechanical factors are certainly of importance in implant failures, even if their exact nature has not yet been established. The abutment screw fracture or loosening represents a rare, but quite unpleasant failure. The aim of the present research is an analysis and structural examination of screw thread or abutment loosening compared with screw threads or abutment without loosening. The loosening of screw threads was compared to screw thread without loosening of three different implant systems; Branemark (Nobel Biocare, Gothenburg, Sweden), T.B.R. implant systems (Benax, Ancona, Italy) and Restore (Lifecore Biomedical, Chaska, Minnesota, USA). In this study broken screws were excluded. A total of 16 screw thread loosenings were observed (Group I) (4 Branemark, 4 T.B.R and 5 Restore), 10 screw threads without loosening were removed (Group II), and 6 screw threads as received by the manufacturer (unused) (Group III) were used as control (2 Branemark, 2 T.B.R and 2 Restore). The loosened abutment screws were retrieved and analyzed under SEM. Many alterations and deformations were present in concavities and convexities of screw threads in group I. No macroscopic alterations or deformations were observed in groups II and III. A statistical difference of the presence of microcracks were observed between screw threads with an abutment loosening and screw threads without an abutment loosening

Interconnection abutment fixture

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High-precision, cost-effective cutting system for producing thin sections of oral tissues containing dental implants

A new high-precision, cost-effective cutting system, able to produce thin (20-30 mu m) sections of oral tissues, containing dental implants, is presented. With this system the authors have been able to obtain, in a reproducible and consistent way, thin slides containing biomaterials and biological tissues. Very high cellular detail was possible, even at high magnifications (x1200). Histochemical reactions (e.g. acid and alkaline phosphatases) have also been obtained in a reproducible way, without sputter ground staining. The time involved in specimen cutting was significantly reduced, and about five slides per specimen were obtained with minimal loss of tissue. In almost all cases it has been possible to eliminate the grinding process with its inherent problems, such as formation of ledging at the bone-titanium interface. With this system it was also possible to obtain thin slides of soft tissue lesions (i.e. benign mucous membrane pemphigoid). (C) 1997 Elsevier Science Limited

Peri-implantitis fibroblasts respond to host immune factor C1q

Background and Objective: Current therapies for peri-implantitis apply the same clinical protocols as those used for the treatment of periodontitis; however, outcomes remain unpredictable. We hypothesized that resident fibroblasts of the peri-implantitis stroma and periodontitis stroma differ in their phenotype and response to host immune factors. Fibroblasts are highly heterogeneous and comprise discrete subtypes with the potential of modulating inflammatory activities. The aim of the present study was to characterize the expression of receptors for complement C1q of innate immunity on human peri-implantitis fibroblasts and investigate effects of C1q on the proinflammatory properties of the cells. Material and methods: Fibroblasts were cultured from gingival tissues exhibiting peri-implantitis and periodontitis, and from healthy gingivae as a control. Expression of C1q receptors for the collagen (cC1qR) and globular domains (gC1qR) of the protein was determined by flow cytofluorometric analysis (FITC) of specific antibodies bound to the surface of the cells. Secretion of C1q-inducible proinflammatory mediators was quantified after 24 h incubation using array-based ELISAs. Results: The percentage of fibroblasts FITC-positive for cC1qR was 67, 75 and 12% in peri-implantitis, healthy and periodontitis cultures, respectively, whereas the percentage of gC1qR FITC-positive fibroblasts was 5, 3 and 59%, respectively. The C1q interactions with peri-implantitis and healthy fibroblasts increased secretion of the chemokines interleukin-6 and interleukin-8 twofold, and monocyte chemoattractant protein-1 fourfold over baseline values, whereas periodontitis fibroblasts were unresponsive. Complement C1q increased levels of vascular endothelial growth factor sevenfold and transforming growth factor-beta 1 12-fold over baseline values in peri-implantitis cultures, only. Conclusions: Peri-implantitis fibroblasts differ from periodontitis fibroblasts in phenotypic expression of cC1qR and function, and from healthy fibroblasts in proinflammatory, angiogenic and fibrogenic function. Peri-implantitis fibroblasts may represent a novel subtype

[Failures and surgical complications in oral implants. Follow-up of 327 osseointegrated implants].

The study analyses the short- and long-term clinical results in 112 patients with total or partial edentulia of the jaw undergoing oral implantology in order to assess the type of surgical complications. A total of 327 implants were inserted with an internal hexagonal screw, a diameter of between 3.25 and 5.5 mm and between 11 and 15 mm long. Each patient received three types of implant: overdentures, bridges supported by implants alone and bridges supported by implants and natural teeth. In line with other data reported in the literature, the failure rate at 7 years was 3%. After a general discussion of the possible surgical complications arising during implantology, the authors describe and analyse all the surgical complications that occurred in this series, regarding both implants alone, bridges supported by implants and natural teeth