Influence of different risk factors on primary dental implant stability on two types of dental implants

Introduction. The primary stability of dental implants may be impaired by the presence of systemic diseases, such as cardiovascular disease, osteoporosis, diabetes, hepatitis, severe periodontal disease and some conditions that compromise bone regeneration and integration. The main goal of this research was to determine the predictive values of different risk factors on The primary stability of dental implants. Material and method. This clinical study was carried out in one dental clinic "Vita-Dent" in Tetovo. Two types of implants were used, Mis Seven implants and Straumann Standard plus and Bone level implants. The stability of the implants was measured by resonant frequency analysis using the instrument Osstell IDXTM (Osttell AB, Gothenburg, Sweden). Results. The biggest influence on the primary stability in patients with Mis dental implants had smoking (Beta=-0.53), followed by HTA (Beta=-0.53), diabetes (Beta=-0.32), periodontal disease (Beta=-0.26), age (Beta=0.21), and gender (men) (Beta=0.05). Among the all, 50, no risk factors were registered in 30.00 %, 22.00 % were smokers, 12.00 % had diabetes, 20.00 % had HTA, 2.00 % had osteoporosis and 14.00 % had periodontal disease. The biggest influence on the primary stability on Straumann dental implants had the age of the patients (Beta=-0.27), followed by diabetes (Beta=-0.25), gender(Beta=0.25), periodontal disease (Beta=-0.20), smoking (Beta=-0.14), HTA (Beta=0.11), and osteoporosis (Beta=-0.07). Conclusion. The most significant risk factors affecting primary implant stability, and hence the longevity of implants, are tobacco consumption, systemic factors such as diabetes and hypertension and the local negative impact of various forms of periodontal disease

Influence of Resonance Frequency Analysis (RFA) Measurements for Successful Osseointegration of Dental Implants During the Healing Period and Its Impact on Implant Assessed by Osstell Mentor Device

AIM: This study aimed to investigate and assess primary and secondary dental implant stability during the osseointegration period. METHODS: A total of 77 implants were placed in 42 patients with 26 males and 16 females. The study was conducted by comparing the resonance frequency analysis (RFA) values of the implants inserted in the lower jaw. RFA was done immediately after implant insertion and after 12 weeks. Results were statistically evaluated using SPSS Statistics for Windows, Version 7.1. Level of significance was set at P < 0.05. RESULTS: Significant differences were detected between the primary and secondary stability values, respectively. Maximum RFA value of 88 and the minimum value of 52 were observed. Stability values increased during the following three months, and all implants were successfully integrated without complication. CONCLUSION: Our results indicate and suggest that there is a strong linear correlation between implant stability and ISQ values that can be directly estimated by the RFA, especially in the posterior edentulous mandible. Osstell implant device could represent a useful tool which can be used to identify the risk for implant failure

The subcrestal implant placement as factor for crestal bone stability in implant sites with vertically thin gingiva

This prospective comparative study aimed to determine the influence of the implant placement type (subcrestal or equicrestal) on bone level changes in platform-switched implants placed in sites with vertically thin gingiva (<3 mm) and restored with screw-retained or cement-retained restorations. Moreover, the effect of vertical gingival thickness on peri—implant bone loss was analyzed. The clinical significance of the study’s conclusions is in determining a modality of implant placement efficient in preserving stable crestal bone

The effect of subcrestal implant placement on bone loss at sites with vertically thin gingiva

This prospective comparative study aimed to determine the influence of the implant placement type (subcrestal or equicrestal) on bone level changes in platform-switched implants placed in sites with vertically thin gingiva (<3 mm) and restored with screw-retained or cement-retained restorations. Moreover, the effect of vertical gingival thickness on peri—implant bone loss was analyzed. The clinical significance of the study’s conclusions is in determining a modality of implant placement efficient in preserving stable crestal bone

Clinical outcomes of guided tissue regeneration procedure utilized with two different surgical approaches - a comparative study

The guided tissue regeneration (Nyman et al. 1982) is a well-established surgical technique which main goal is to reconstruct the periodontal ligament with functional collagen fibers inserted into a newly formed cementum and alveolar bone. Teeth with periodontal disease resulting in deep infrabony pockets are successfully treated with this technique. Its main prognostic factors from clinical and biological standpoint include: blood clot stabilization, primary closure of the defect, space provision and exclusion from the gingival tissues. Several surgical techniques have been proposed for utilization of GTR. Lately these techniques have been aiming at minimal invasiveness for optimal wound closure and lesser postoperative morbidity. The aim of this presentation was to compare the clinical outcomes of two different techniques for GTR:modified papilla preservation flap (Cortelinni et al, 1995) vs. single flap approach. Results: The obtained data revealed significantly better results in CAL gain (3.6+/-1.3 mm vs. 2.1+/- 1.2 ), PD reduction (2.7+/- 0.8 vs. 1.4 +/-0.6) and REC ( 1.5 +/- 0.9 vs. 2.6 +/- 0.8) at baseline and one year post surgery in test group. Conclusion: Results from our analysis suggest that single flap approach as less invasive provides better clinical outcomes, although without big clinical relevance considering the small number of patients

Comparative evaluation of implant stability between osseodensification and underdrilling osteotomy technique

Background: Different implant bed drilling techniques have been proposed to increase the implant stability in order to facilitate better implant survival rates. Most of these techniques are indicated in areas with low bone density and aim at its increase. Aim: The aim of this study was to evaluate the effect of two different implant osteotomy methods in terms of implant stability during the period of osseointegration in bone with low density. Material and methods: This prospective randomized clinical study included 22 patients that received a total of 37 implants in the posterior maxillary region. They were divided into two groups: in 11 patients, 18 implants were placed using the underdrilling method (UD), while the other 11 patients received 19 implants using the osseodensification method (OD). Within the OD group, 10 implants were placed with simultaneous crestal sinus floor elevation (max 5 mm) without bone graft use. All implants were placed in a dual-stage manner. The implant stability was measured through their ISQ values at the time of surgery and at the time of their uncovery, four months later. The data were analyzed using paired two-way ANOVA test and the probability value <0.0001 was considered statistically significant. Results: The early implant survival rate was 94,6%, since 35 implants were osseointegrated. There was no statistically significant difference in the primary implant stability values between the two groups. The values of secondary implant stability were significantly higher in the OD group (p<0.05). Within the OD group, there were no statistically significant differences in the secondary stability values between the implants placed with and without sinus floor elevation. Conclusion: The osseodensification method of implant osteotomy results in higher secondary implant stability values that the underdrilling method, which may have clinical relevance regarding the long-term implant survival

ASSESSMENT OF PRIMARY AND SECONDARY IMPLANT STABILITY BY RESONANCE FREQUENCY ANALYSIS IN ANTERIOR AND POSTERIOR SEGMENTS OF MAXILLARY EDENTULOUS RIDGES

Purpose: The aim of this study was to analyze the implant stability quotient (ISQ) results of the resonance frequency (RF) during the first day of surgery and 3 months after dental implant placement in the maxilla. Material and methods: This study was approved by 40 patients with total or partial edentulous maxillary jaws underwent with 85 dental implants. The ISQ values were measured from these 85 implants at baseline and 3 months after placement. Osttell Mentor device was invented to measure the RF value of the implant fixture through the transducer or pin. Measurements were taken 4 times in each direction of the inserted oral dental implant. OPG X-ray images were also obtained to evaluate the bone and neighbouring anatomical structures. Results: The ISQ at baseline had a mean value of 58 (SD 5.91) for all implants placed in anterior and posterior sectors of maxillary ridges. The mean ISQ value on the 3rd month (secondary stability) after placement for all implants was 65 (SD 5.55). An ISQ value ≥65 was observed in 65 implants (78.82%) after 3 months of placement. Differences between primary and secondary mean ISQ values were statistically significant (p < 0.001). The one year cumulative success rate was 98.3% for tested and inserted oral implants. Conclusion: The results of presented study demonstrates and suggests that the influence and reliability of Osstell ISQ values, measured immediately and 3 months after placement it’s predictable for the oral implant outcomes, especially analyzing the sensibility of secondary RFA values

Implant Site Guided Bone Regeneration and Pontic Site Ridge Preservation: A Case Report

Guided bone regeneration (GBR) is a therapeutic modality to achieve bone regeneration with the use ofbarrier membranes. The use of deproteinized bovine bone material (DBBM) for ridge preservation allows thepreservation of the edentulous ridge dimensions. Here, we present a case of horizontal GBR using DBBMand a resorbable membrane, with simultaneous implant placement. Simultaneously, ridge preservation ofthe pontic area, using DBBM within a “socket seal” procedure was performed. Two implants were placesat sites 23 and 26 to support a fixed partial denture (FPD). The mesial implant showed exposed buccalthreads, which were then covered with autogenous bone particles and small size granules of DBBM. Thecollagen membrane was stabilized with periosteal mattress suture. Six months postoperatively, CBCT im-ages revealed a stable buccal bone layer at the implant site, indicating a successful GBR procedure. At thispoint in time, tooth 24 was atraumatically extracted. A ridge preservation was done utilizing DBBM, anda soft tissue graft form the tuber. A ceramic-metal FPD with excellent “white aesthetics” and a harmonictransition zone to the soft tissue was fabricated. At 3 years follow up, the peri-implant bone levels werestable, and the clinical outcomes were excellent. It is concluded that a GBR procedure, utilizing DBBMand a collagen barrier membrane with simultaneous implant placement, as well as ridge preservationusing DBBM, are predictable therapeutic methods. However, gentle manipulation of the soft tissues, andwound stability, with tension-free passive closure of the wound margins are prerequisites for a long-termclinical success.Keywords: implants, guided bone regeneration, ridge preservation, deproteinized bovine bone material