Immediate function in edentulous maxilla implant rehabilitation: a 1-year retrospective clinical study

Aim: To evaluate the survival rate of immediately loaded, acidetched implants (Osseotites) in the edentulous maxilla over a period of 12 months. Materials and methods: Sixteen patients (mean age 59 years) with residual compromised maxillary teeth were made edentulous and rehabilitated with a screw-retained fixed provisional prosthesis with a gold-alloy framework and composite teeth in 24 h after surgery supported by a minimum of four implants to a maximum of six ones. To obtain the highest primary stability in all post-extractive sockets tapered implants were used whereas in parental bone cylindrical implants were inserted. After a mean healing time of 18 weeks, a definitive prosthesis was carried out. A total of 89 implants were analyzed. All patients were maintained in a regular recall program. Radiological examinations were made at implant placement, at definitive prosthesis delivery and at 12 months. Results: At 12 months follow-up the implants survival rate was 92.2% whereas the prostheses survival rate was 100%. No statistical difference was found between the survival of implants placed in post-extractive sockets and those in parental bone and between cylindrical and tapered implants. Seven implants failed during the first 3 months. Seventy one percent of lost implants were in distal areas. The mean reduction in marginal bone was 1.3mm. Conclusions: According to a severe surgical and prosthetic protocol, four to six implants seem to be enough to support an edentulous maxilla implant fixed rehabilitation. Treatment planning has to carefully consider primary implant stability and its maintenance during the healing period

Chemical EDX analyis of different surface modified implant systems

The main used processes of modification of the implant surface are: machining, sandblasting, etching and oxiding. They have the purpose to reduce the times of the osseointegration and to improve its quality. The aim of this study was to investigate how these processes macroscopically (at 5 m depth) modify the implant surface and its chemical composition. The originality of this investigation was that all the implants were tested as manufactured for clinical use. Ten of the major used implant systems were the object of this study: they were divided by the surface treatment in: Machined: Mk III Branemark; Sandblasted: Ankylos, Silhouette and Galant (experimental fixture); Etched: Osseotite, Mac System, MK 4 (experimental fixture), ITI; Oxided: Ti Unite, Pilot . Each fixture was analyzed by SEM (Leo 420) at 50x and 5000x at 15 KV of scanning power. The EDX analysis (Energy Dispersion X-ray analysis) was considered to study eventual inclusion of material left from the processes of surface modification, cleaning and decontamination. The EDX analysis scans the implant surface at a 5m of depth and is performed during SEM observations using a specific micro tip that identify the chemical elements. The results from SEM analysis shown macroscopical residuals of aluminum oxide on the SLA surface and some oil spots on the machined surface. The results from the EDX analysis are below summarized: Sandblasted surfaces showed particles of Alumina Oxided surfaces showed very high peaks of O2 Etched surfaces showed only Titanium peaks Machined surfaces showed low peaks of O

Effects of pulsed electromagnetic fields on swelling and pain after implant surgery: a double-blind, randomized study

The aim of this split-mouth, double-blind, randomized study was to determine whether pulsed electromagnetic field therapy (PEMF) can improve swelling and the management of pain after full-arch immediate loading implant surgery. Eleven patients were selected for the study. Each patient received four distal tilted implants in the upper or lower jaw and underwent full-arch immediate loading rehabilitation. After surgery, two PEMF devices were applied to each patient, one on each cheek. In a random manner, one of these PEMF devices was switched on (test side); the other served as a placebo (control side). Forty-eight hours after surgery clinicians estimated postoperative swelling through photographic documentation, comparing the condition before and after surgery, while pain was assessed using a verbal rating scale. The patient's degree of comfort in relation to the PEMF devices was analyzed by questionnaire using a numerical rating scale. No statistically significant difference was observed between the test and control sides for swelling or pain (P>0.05). Most of the patients did not present swelling or pain at 48h after surgery, regardless of whether the PEMF device was activated or not. Various outcomes were found in the comfort evaluation. Within the limitations of this study, PEMF does not reduce postoperative swelling or pain after implant surgery

Carbon fibre versus metal framework in full-arch immediate loading rehabilitations of the maxilla \ue2\u80\u93 a cohort clinical study

Frameworks made of carbon fibre-reinforced composites (CFRC) seem to be a viable alternative to traditional metal frameworks in implant prosthodontics. CFRC provide stiffness, rigidity and optimal biocompatibility. The aim of the present prospective study was to compare carbon fibre frameworks versus metal frameworks used to rigidly splint implants in full-arch immediate loading rehabilitations. Forty-two patients (test group) were rehabilitated with full-arch immediate loading rehabilitations of the upper jaw (total: 170 implants) following the Columbus Bridge Protocol with four to six implants with distal tilted implants. All patients were treated with resin screw-retained full-arch prostheses endowed with carbon fibre frameworks. The mean follow-up was 22 months (range: 18\ue2\u80\u9324). Differences in the absolute change of bone resorption over time between the two implant sides (mesial and distal) were assessed performing a Mann\ue2\u80\u93Whitney U-test. The outcomes were statistically compared with those of patients rehabilitated following the same protocol but using metal frameworks (control group: 34 patients with 163 implants \ue2\u80\u93 data reported in Tealdo, Menini, Bevilacqua, Pera, Pesce, Signori, Pera, Int J Prosthodont, 27, 2014, 207). Ten implants failed in the control group (6\uc2\ub71%); none failed in the test group (P = 0\uc2\ub7002). A statistically significant difference in the absolute change of bone resorption around the implants was found between the two groups (P = 0\uc2\ub7004), with greater mean peri-implant bone resorption in the control group (1 mm) compared to the test group (0\uc2\ub78 mm). Carbon fibre frameworks may be considered as a viable alternative to the metal ones and showed less marginal bone loss around implants and a greater implant survival rate during the observation period

Peri-implantitis: A systematic review of recently published papers.

Aims: This systematic review considers possible etiological factors and definitions of \u201cperi-implantitis\u201d, as reported in the recent literature. Methods: An electronic search of databases plus a hand search of the most relevant journals published between January 2005 and September 2012 was performed. Results: The electronic search revealed 640 titles and the manual search yielded 14 ti-tles. From the independent double-check of the titles and abstracts 24 full texts were downloaded (18 clinical studies and 6 animal studies). From the reading of the full texts, 10 articles (4 clinical studies and 6 animal studies) were included in the present review. None of the human articles selected provided sufficient evidence to address the re-search question. In particular, no clinical evidence is available on a cause-effect rela-tionship between peri-implantitis and bacterial accumulation and/or overload. History of periodontitis and smoking seem to be correlated with a higher incidence of peri-implantitis. The animal literature is not unanimous about peri-implantitis etiology ei-ther. Conclusion: On the base of the available scientific literature, it is evident that there is not a unanimous consensus on peri-implantitis etiological factors and evidence is lack-ing about the etiology of peri-implantitis. Further, the definition itself of peri-implantis differs among studies. Based on the present findings, the soundness of using the term \u201cperi-implantitis\u201d appears controversial