Fig. 5. PROMs over 5 years: improvement of satisfaction from loading to study end
Fig. 5. PROMs over 5 years: improvement of satisfaction from loading to study end
Fig. 4. Soft tissue parameters at 5-year post-loading. a Plaque index: score 0, no plaque detected; score 1, plaque only recognized by running a probe across the smooth marginal surface of the implant; score 2, plaque seen by the naked eye; score 3, abundance of soft matter. b Sulcus bleeding index: score 0, no bleeding when a periodontal probe was passed along the gingival margin adjacent to th...
Fig. 3. Standardized peri-apical radiographs representing the bone level changes at the implant level: immediately post insertion (a), at loading (abutment/crown placement) (b), and at 5-year post-loading (c)
Fig. 3. Standardized peri-apical radiographs representing the bone level changes at the implant level: immediately post insertion (a), at loading (abutment/crown placement) (b), and at 5...
Fig. 2. Kaplan-Meier cumulative survival rate
Fig. 2. Kaplan-Meier cumulative survival rate
Fig. 1. Study flow-chart: assessments and reason for dropouts. Study visits were done according to standard procedures in the respective study centers. Blue, mandatory visits; gray, optional visits
Fig. 1. Study flow-chart: assessments and reason for dropouts. Study visits were done according to standard procedures in the respective study centers. Blue, mandatory visits; gray, optional visits
Bone level changenMeanSDInsertion-loading103− 0.520.55Loading-1-year follow-up93− 0.040.37Loading-3-year follow-up90− 0.040.40Loading-5-year follow-up86− 0.090.43Table 3 Mean crestal bone level changes in mm
CharacteristicsCategoryTotalTotal patients/implantsn94/130Center 19/17Center 218/26Center 320/26Center 414/16Center 518/26Center 615/19Gender, n (%)Male30 (31.9)Female64 (68.1)Age at surgery, yearsMean ± SD50.4 ± 13.7Range (min/max)19.1-75.6Age range distribution, n (%)< 30 years8 (8.5)30-45 years22 (23.4)45-60 years38 (40.4)60-75 years25 (26.6)> 75 years1 (1.1)Tobacco use, n (%)Non-sm...
Time periodPatientsImplantsBefore loading58Loading-1 year681-3 years673-5 years13Total1826Table 1 Dropouts over observation time
Ackermann, KL., Barth, T., Cacaci, C. et al. Clinical and patient-reported outcome of implant restorations with internal conical connection in daily dental practices: prospective observational multicenter trial with up to 7-year follow-up.
Int J Implant Dent 6, 14 (2020). https://doi.org/10.1186/s40729-020-00211-z
Download citation
Received: 16 December 2019
Accepted: 12 Ma...
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material...
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
A written consent was given by all patients after being informed of the study. The study was performed following the declaration of Helsinki. Ethics committee approval was obtained from the international ethical committee of Freiburg (Germany, Ref. 010/1833).
Not applicable.
All authors declare that they have no conflicts of interest regarding this study. All authors have been lecturing for Caml...
Filderstadt, Germany
Karl-Ludwig Ackermann
Leipzig, Germany
Thomas Barth
Munich, Germany
Claudio Cacaci
Landsberg a. L., Germany
Steffen Kistler
Forchheim, Germany
Markus Schlee
Department of Maxillofacial Surgery, Goethe University Frankfurt, Frankfurt, Germany
Markus Schlee
Berlin, Germany
Michael Stiller
You can also search for this author in
PubMed Googl...
This study was funded by an unrestricted grant (NISCAM01/10) of the Oral Reconstruction Foundation (previously CAMLOG Foundation).
The authors thank Lucius Keller of Touchpoint Communication AG (Luzern, Switzerland) for the medical writing support.
Chang M, Odman PA, Wennstrom JL, Andersson B. Esthetic outcome of implant-supported single-tooth replacements assessed by the patient and by prosthodontists. Int J Prosthodont. 1999;12(4):335–41.
Kiltz U, Winter J, Schirmer M, Weber U, Hammel L, Baraliakos X, et al. German translation and cross-cultural adaptation of the ASAS health index: an ICF-based instrument for documentation of functional...
Ravald N, Dahlgren S, Teiwik A, Grondahl K. Long-term evaluation of Astra Tech and Branemark implants in patients treated with full-arch bridges. Results after 12-15 years. Clin Oral Implants Res. 2013;24(10):1144–51.
Schwarz F, Alcoforado G, Nelson K, Schaer A, Taylor T, Beuer F, et al. Impact of implant-abutment connection, positioning of the machined collar/microgap, and platform switching...
Gupta S, Sabharwal R, Nazeer J, Taneja L, Choudhury BK, Sahu S. Platform switching technique and crestal bone loss around the dental implants: a systematic review. Ann Afr Med. 2019;18(1):1–6.
Hsu YT, Lin GH, Wang HL. Effects of platform-switching on peri-implant soft and hard tissue outcomes: a systematic review and meta-analysis. Int J Oral Maxillofac Implants. 2017;32(1):e9–e24.
Nelson K,...
Cacaci C, Ackermann KL, Barth T, Kistler S, Stiller M, Schlee M. A non-interventional multicenter study to document the implants success and survival rates in daily dental practices of the CONELOG screw-line implant. Clin Oral Investig. 2019;23(6):2609–16.
Cochran D, Oates T, Morton D, Jones A, Buser D, Peters F. Clinical field trial examining an implant with a sand-blasted, acid-etched surface...
Krennmair G, Seemann R, Weinlander M, Piehslinger E. Comparison of ball and telescopic crown attachments in implant-retained mandibular overdentures: a 5-year prospective study. Int J Oral Maxillofac Implants. 2011;26(3):598–606.
Slot W, Raghoebar GM, Cune MS, Vissink A, Meijer HJA. Four or six implants in the maxillary posterior region to support an overdenture: 5-year results from a randomize...
Adverse event
Bone level change
Distance implant shoulder to first visible bone contact
Orthopantomogram
Plaque index
Patient reported outcome measures
Platform switching
Sulcus bleeding index
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
This prospective observational multicenter study demonstrated successful functional and esthetic outcomes of the study implant restorations (single tooth restoration, fixed partial dentures) with reliable peri-implant hard and soft tissue stability and high patients’ satisfaction. The results are comparable with the outcome of already published controlled randomized clinical studies and retrospe...
In recent years, patients’ needs have increased in terms of the esthetic and functional outcome of the dental restoration. PROMs have been reported in several studies and represent a well-described non-invasive method to measure patient’s satisfaction with these needs; however, they might present a lack of standardization [39, 40] due to the very subjective view on esthetics or functionality o...
Changes in crestal bone level are well-documented in the literature. Bone remodeling is reported to take place between surgery and loading. The reported changes are generally around 0.5 mm [17, 27, 30] but can reach more than 1 mm [31] in randomized or observational trials. The present study is well in accordance with these findings with its bone remodeling of − 0.52 ± 0.55 mm. Nearly 45%...
Endosseous dental implants are a commonly accepted treatment procedure and showed high survival and success rates as well as good functional performance in numerous clinical trials and retrospective analyses, also for Conelog implants as for their specific implant surface [17, 23, 26]. However, in general, one could argue that results of controlled clinical studies do not reflect the real situatio...
Table 3 shows the mean bone level changes of the implants with available radiographs from insertion to 5-year post-loading. Bone remodeling around the implant was noticeable from surgery to loading, presenting a mean value of − 0.52 ± 0.55 mm. From loading to the 5-year follow-up, the mean change in crestal bone remained clinically stable (−0.09 ± 0.43 mm) (Fig. 3).
Split into three g...
The study was started with 94 patients with 130 implants. At the end of the study (5-year post-loading), 76 patients with 104 implants were considered for analysis. Dropouts were distributed over the time of the study as described in Table 1. The majority of dropouts occurred early in the study phase. The reasons for the dropouts were variable as described in Fig. 1.
The demographic and clinica...
The study data, soft and hard tissue parameters as well as the PROMs were descriptively analyzed using IBM SPSS V25.0 (IBM Corp., Armonk, NY, USA): Categorical variables were shown with frequencies and mean values were used for continuous variables. Survival analysis was performed using Kaplan–Meier method. Time of loading was the study baseline as per protocol, and the statistical unit was the ...
Patients were scheduled to follow-ups at 6 months, 1-, 2-, 3-, 4-, and 5-year post-loading for the assessment of the study parameter (Fig. 1). Depending on the investigators’ standard post-operative protocol, follow-up appointments were scheduled slightly differently: One center skipped the control visits at 6 months. Additionally, due to the observational character of the study and the pati...
This is an observational multicenter clinical study, approved by the ethics committee of the Freiburg ethics commission international (feci 010/1833). The study was planned and conducted according to the German medical devices law, the Declaration of Helsinki, good clinical practice, and the reporting is aligned with the STROBE statement. A minimum of 90 to 100 patients were planned to be included...
Features of the chosen implant system for a study may also influence the outcome of the treatment: The degree of the manufacturer’s tolerances of implants with a conical implant-abutment connection heightens the risk of a mispositioning of the abutment, which cannot be corrected by repeated torqueing. Platform switching (PS) implants tend to have a protective effect on hard implant tissue outcom...
Many randomized controlled clinical trials have been published about dental implants. They have demonstrated long-term success in the rehabilitation of edentulous patients [1, 2] as well as patients with single or multiple teeth replacements [3, 4].
While this type of trials have an indispensable place in establishing a new product or a new operation technique regarding safety and efficacy, the r...
The interpretation of the results of randomized clinical trials is often questioned in relation with daily circumstances in practices. This prospective observational multicenter study was instigated to reflect the need for information in real-life situations with dental implants with internal conical implant-abutment connection (Conelog implant system). The implants were followed up at least 5-yea...
Fig. 5. PROMs over 5 years: improvement of satisfaction from loading to study end
Fig. 5. PROMs over 5 years: improvement of satisfaction from loading to study end
Fig. 4. Soft tissue parameters at 5-year post-loading. a Plaque index: score 0, no plaque detected; score 1, plaque only recognized by running a probe across the smooth marginal surface of the implant; score 2, plaque seen by the naked eye; score 3, abundance of soft matter. b Sulcus bleeding index: score 0, no bleeding when a periodontal probe was passed along the gingival margin adjacent to th...
Fig. 3. Standardized peri-apical radiographs representing the bone level changes at the implant level: immediately post insertion (a), at loading (abutment/crown placement) (b), and at 5-year post-loading (c)
Fig. 3. Standardized peri-apical radiographs representing the bone level changes at the implant level: immediately post insertion (a), at loading (abutment/crown placement) (b), and at 5...
Fig. 2. Kaplan-Meier cumulative survival rate
Fig. 2. Kaplan-Meier cumulative survival rate
Fig. 1. Study flow-chart: assessments and reason for dropouts. Study visits were done according to standard procedures in the respective study centers. Blue, mandatory visits; gray, optional visits
Fig. 1. Study flow-chart: assessments and reason for dropouts. Study visits were done according to standard procedures in the respective study centers. Blue, mandatory visits; gray, optional visits
Bone level changenMeanSDInsertion-loading103− 0.520.55Loading-1-year follow-up93− 0.040.37Loading-3-year follow-up90− 0.040.40Loading-5-year follow-up86− 0.090.43Table 3 Mean crestal bone level changes in mm
CharacteristicsCategoryTotalTotal patients/implantsn94/130Center 19/17Center 218/26Center 320/26Center 414/16Center 518/26Center 615/19Gender, n (%)Male30 (31.9)Female64 (68.1)Age at surgery, yearsMean ± SD50.4 ± 13.7Range (min/max)19.1-75.6Age range distribution, n (%)< 30 years8 (8.5)30-45 years22 (23.4)45-60 years38 (40.4)60-75 years25 (26.6)> 75 years1 (1.1)Tobacco use, n (%)Non-sm...
Time periodPatientsImplantsBefore loading58Loading-1 year681-3 years673-5 years13Total1826Table 1 Dropouts over observation time
Ackermann, KL., Barth, T., Cacaci, C. et al. Clinical and patient-reported outcome of implant restorations with internal conical connection in daily dental practices: prospective observational multicenter trial with up to 7-year follow-up.
Int J Implant Dent 6, 14 (2020). https://doi.org/10.1186/s40729-020-00211-z
Download citation
Received: 16 December 2019
Accepted: 12 Ma...
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material...
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
A written consent was given by all patients after being informed of the study. The study was performed following the declaration of Helsinki. Ethics committee approval was obtained from the international ethical committee of Freiburg (Germany, Ref. 010/1833).
Not applicable.
All authors declare that they have no conflicts of interest regarding this study. All authors have been lecturing for Caml...
Filderstadt, Germany
Karl-Ludwig Ackermann
Leipzig, Germany
Thomas Barth
Munich, Germany
Claudio Cacaci
Landsberg a. L., Germany
Steffen Kistler
Forchheim, Germany
Markus Schlee
Department of Maxillofacial Surgery, Goethe University Frankfurt, Frankfurt, Germany
Markus Schlee
Berlin, Germany
Michael Stiller
You can also search for this author in
PubMed Googl...
This study was funded by an unrestricted grant (NISCAM01/10) of the Oral Reconstruction Foundation (previously CAMLOG Foundation).
The authors thank Lucius Keller of Touchpoint Communication AG (Luzern, Switzerland) for the medical writing support.
Chang M, Odman PA, Wennstrom JL, Andersson B. Esthetic outcome of implant-supported single-tooth replacements assessed by the patient and by prosthodontists. Int J Prosthodont. 1999;12(4):335–41.
Kiltz U, Winter J, Schirmer M, Weber U, Hammel L, Baraliakos X, et al. German translation and cross-cultural adaptation of the ASAS health index: an ICF-based instrument for documentation of functional...
Ravald N, Dahlgren S, Teiwik A, Grondahl K. Long-term evaluation of Astra Tech and Branemark implants in patients treated with full-arch bridges. Results after 12-15 years. Clin Oral Implants Res. 2013;24(10):1144–51.
Schwarz F, Alcoforado G, Nelson K, Schaer A, Taylor T, Beuer F, et al. Impact of implant-abutment connection, positioning of the machined collar/microgap, and platform switching...
Gupta S, Sabharwal R, Nazeer J, Taneja L, Choudhury BK, Sahu S. Platform switching technique and crestal bone loss around the dental implants: a systematic review. Ann Afr Med. 2019;18(1):1–6.
Hsu YT, Lin GH, Wang HL. Effects of platform-switching on peri-implant soft and hard tissue outcomes: a systematic review and meta-analysis. Int J Oral Maxillofac Implants. 2017;32(1):e9–e24.
Nelson K,...
Cacaci C, Ackermann KL, Barth T, Kistler S, Stiller M, Schlee M. A non-interventional multicenter study to document the implants success and survival rates in daily dental practices of the CONELOG screw-line implant. Clin Oral Investig. 2019;23(6):2609–16.
Cochran D, Oates T, Morton D, Jones A, Buser D, Peters F. Clinical field trial examining an implant with a sand-blasted, acid-etched surface...
Krennmair G, Seemann R, Weinlander M, Piehslinger E. Comparison of ball and telescopic crown attachments in implant-retained mandibular overdentures: a 5-year prospective study. Int J Oral Maxillofac Implants. 2011;26(3):598–606.
Slot W, Raghoebar GM, Cune MS, Vissink A, Meijer HJA. Four or six implants in the maxillary posterior region to support an overdenture: 5-year results from a randomize...
Adverse event
Bone level change
Distance implant shoulder to first visible bone contact
Orthopantomogram
Plaque index
Patient reported outcome measures
Platform switching
Sulcus bleeding index
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
This prospective observational multicenter study demonstrated successful functional and esthetic outcomes of the study implant restorations (single tooth restoration, fixed partial dentures) with reliable peri-implant hard and soft tissue stability and high patients’ satisfaction. The results are comparable with the outcome of already published controlled randomized clinical studies and retrospe...
In recent years, patients’ needs have increased in terms of the esthetic and functional outcome of the dental restoration. PROMs have been reported in several studies and represent a well-described non-invasive method to measure patient’s satisfaction with these needs; however, they might present a lack of standardization [39, 40] due to the very subjective view on esthetics or functionality o...
Changes in crestal bone level are well-documented in the literature. Bone remodeling is reported to take place between surgery and loading. The reported changes are generally around 0.5 mm [17, 27, 30] but can reach more than 1 mm [31] in randomized or observational trials. The present study is well in accordance with these findings with its bone remodeling of − 0.52 ± 0.55 mm. Nearly 45%...
Endosseous dental implants are a commonly accepted treatment procedure and showed high survival and success rates as well as good functional performance in numerous clinical trials and retrospective analyses, also for Conelog implants as for their specific implant surface [17, 23, 26]. However, in general, one could argue that results of controlled clinical studies do not reflect the real situatio...
Table 3 shows the mean bone level changes of the implants with available radiographs from insertion to 5-year post-loading. Bone remodeling around the implant was noticeable from surgery to loading, presenting a mean value of − 0.52 ± 0.55 mm. From loading to the 5-year follow-up, the mean change in crestal bone remained clinically stable (−0.09 ± 0.43 mm) (Fig. 3).
Split into three g...
The study was started with 94 patients with 130 implants. At the end of the study (5-year post-loading), 76 patients with 104 implants were considered for analysis. Dropouts were distributed over the time of the study as described in Table 1. The majority of dropouts occurred early in the study phase. The reasons for the dropouts were variable as described in Fig. 1.
The demographic and clinica...
The study data, soft and hard tissue parameters as well as the PROMs were descriptively analyzed using IBM SPSS V25.0 (IBM Corp., Armonk, NY, USA): Categorical variables were shown with frequencies and mean values were used for continuous variables. Survival analysis was performed using Kaplan–Meier method. Time of loading was the study baseline as per protocol, and the statistical unit was the ...
Patients were scheduled to follow-ups at 6 months, 1-, 2-, 3-, 4-, and 5-year post-loading for the assessment of the study parameter (Fig. 1). Depending on the investigators’ standard post-operative protocol, follow-up appointments were scheduled slightly differently: One center skipped the control visits at 6 months. Additionally, due to the observational character of the study and the pati...
This is an observational multicenter clinical study, approved by the ethics committee of the Freiburg ethics commission international (feci 010/1833). The study was planned and conducted according to the German medical devices law, the Declaration of Helsinki, good clinical practice, and the reporting is aligned with the STROBE statement. A minimum of 90 to 100 patients were planned to be included...
Features of the chosen implant system for a study may also influence the outcome of the treatment: The degree of the manufacturer’s tolerances of implants with a conical implant-abutment connection heightens the risk of a mispositioning of the abutment, which cannot be corrected by repeated torqueing. Platform switching (PS) implants tend to have a protective effect on hard implant tissue outcom...
Many randomized controlled clinical trials have been published about dental implants. They have demonstrated long-term success in the rehabilitation of edentulous patients [1, 2] as well as patients with single or multiple teeth replacements [3, 4].
While this type of trials have an indispensable place in establishing a new product or a new operation technique regarding safety and efficacy, the r...
The interpretation of the results of randomized clinical trials is often questioned in relation with daily circumstances in practices. This prospective observational multicenter study was instigated to reflect the need for information in real-life situations with dental implants with internal conical implant-abutment connection (Conelog implant system). The implants were followed up at least 5-yea...
Fig. 4. PPS mean crestal bone level change plotted against time (mean, 95 % CI)
Fig. 4. PPS mean crestal bone level change plotted against time (mean, 95 % CI)
Fig. 3. Participant flow diagram
Fig. 3. Participant flow diagram
Fig. 2. Restorative flow diagram
Fig. 2. Restorative flow diagram
Fig. 1. Clinical pictures in each procedure. a Before implant placement. b After abutment connection. c Temporary prosthesis. d Final prosthesis
Fig. 1. Clinical pictures in each procedure. a Before implant placement. b After abutment connection. c Temporary prosthesis. d Final prosthesis
Indicator
Prosthetic comforta
Appearanceb
Ability to chewc
Ability to tasted
Fittinge
General satisfactionf
Treatment arm
...
Treatment arm
Summary statistics
Baseline
6 months
Change from baseline to 6 months
...
Characteristics
Early loading arm
Conventional loading arm
Total
(N = 38)
(N =...
Loading criteria 1
Loading criteria 2
• Sufficient oral hygiene
• At least 1 mm bone volume around the implanta
• No major dehiscence (
Inclusion criteria
Age over 20 Patient who have missing teeth in premolar or molar site Good oral hygiene Predicted implant site has 1–3 quality of bone densityand enough quantity of bone Extraction socket in predicted implant site is completely healed (16 weeks or more)
...
Dard, M., Shiota, M., Sanda, M. et al. A randomized, 12-month controlled trial to evaluate non-inferiority of early compared to conventional loading of modSLA implants in single tooth gaps.
Int J Implant Dent 2, 10 (2016). https://doi.org/10.1186/s40729-016-0040-8
Download citation
Received: 25 September 2015
Accepted: 23 March 2016
Published: 04 April 2016
DOI: https://d...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Michel Dard, Makoto Shiota, Minoru Sanda, Yasutomo Yajima, Hideshi Sekine, and Shohei Kasugai state that there are no conflicts of interest.
MD mainly prepared the manuscript and figures. MS arranged this study, participated in its design and coordination, and helped to draft the manuscript. YY, HS, and SK managed the data collection from each centers of Tokyo Dental College Chiba Hospital (TDCC)...
College of Dentistry, New York University, New York, NY, USA
Michel Dard
Tokyo Medical and Dental University, Tokyo, Japan
Makoto Shiota, Minoru Sanda & Shohei Kasugai
Suidobashi Hospital, Tokyo Dental College, Tokyo, Japan
Yasutomo Yajima
School of Dentistry, Ohu University, Fukushima, Japan
Hideshi Sekine
Department of Oral Implantology and Regenerative Dental Medicine, Tokyo Medical ...
This trial was sponsored by Straumann Japan KK. The authors would like to acknowledge the assistance of Eusaku Watanabe and Nariyuki Maezawa (both Straumann Japan KK) for their contributions to the study.
Krebs M, Schmenger K, Neumann K, Weigl P, Moser W, Nentwig GH. Long-term evaluation of ANKYLOS® dental implants, part I: 20-year life table analysis of a longitudinal study of more than 12,500 implants. Clin Implant Dent Relat Res. 2013. doi:10.1111/cid.12154.
Lops D, Bressan E, Pisoni G, Cea N, Corazza B, Romeo E. Short implants in partially edentulous maxillae and mandibles: a 10 to 20 years ...
Salvi GE, Gallini G, Lang NP. Early loading (2 or 6 weeks) of sandblasted and acid-etched (SLA) ITI implants in the posterior mandible. A 1-year randomised controlled clinical trial. Clin Oral Implants Res. 2004;15:142–9.
El-Sheikh AM, Shihabuddin OF, Ghoraba SM. A prospective study of early loaded single implant-retained mandibular overdentures: preliminary one-year results. Int J Dent. 2012. ...
Morton D, Bornstein MM, Wittneben JG, et al. Early loading after 21 days healing of nonsubmerged titanium implants with a chemically modified sandblasted and acid-etched surface: two-year results of a prospective two-center study. Clin Implant Dent Relat Res. 2010;12:9–17.
Cochran DL, Jackson JM, Bernard JP, et al. A 5-year prospective multicenter study of early loaded titanium implants with a ...
Bornstein MM, Wittneben JG, Brägger U, Buser D. Early loading at 21 days of non-submerged titanium implants with a chemically modified sandblasted and acid-etched surface: 3-year results of a prospective study in the posterior mandible. J Periodontol. 2010;81:809–18.
Ganeles J, Zöllner A, Jackowski J, ten Bruggenkate C, Beagle J, Guerra F. Immediate and early loading of Straumann implants wit...
Bornstein MM, Valderrama P, Jones AA, Wilson TG, Seibl R, Cochran DL. Bone apposition around two different sandblasted and acid-etched titanium implant surfaces: a histomorphometric study in canine mandibles. Clin Oral Implants Res. 2008;19:233–41.
Lai HC, Zhuang LF, Zhang ZY, Wieland M, Liu X. Bone apposition around two different sandblasted, large-grit and acid-etched implant surfaces at site...
Esposito M, Grusovin MG, Maghaireh H, Worthington HV. Interventions for replacing missing teeth: different times for loading dental implants. Cochrane Database of Syst Rev. 2013;3:CD003878.
Esposito M, Grusovin MG, Willings M, Coulthard P, Worthington HV. The effectiveness of immediate, early, and conventional loading of dental implants: a Cochrane systematic review of randomized controlled clini...
Blanes RJ, Bernard JP, Blanes ZM, Belser UC. A 10-year prospective study of ITI dental implants placed in the posterior region. I: clinical and radiographic results. Clin Oral Implants Res. 2007;18:699–706.
Covani U, Chiappe G, Bosco M, Orlando B, Quaranta A, Barone A. A 10-year evaluation of implants placed in fresh extraction sockets: a prospective cohort study. J Periodontol. 2012;83:1226–...
In conclusion, this study demonstrated that early implant loading was non-inferior to conventional implant loading in terms of crestal bone level change in a Japanese patient population in short follow-up period and single tooth gaps in molar regions. High implant survival and patient satisfaction rates, and a good safety profile, were also achieved.
Early loading of the implants showed a good safety profile, with a similar incidence in AEs between the early and conventional loading groups. The benefits to the patient for the early loading procedure were demonstrated by the patient satisfaction question “What does the patient think about the time taken until occlusal loading was started after implantation surgery?” All patients in the earl...
The implant survival rate of 100 % after 12 months is also in line with the results from previous studies with chemically modified SLA implants in various situations, including 100 % survival in early loading of mandibular overdentures [55], 100 % survival in single-tooth applications in the anterior maxilla [56], 96.8 % with maxillary sinus floor augmentation [57], and 98 and 97 % with imme...
This was a randomized, controlled, multicenter clinical trial to investigate whether the outcomes for chemically modified SLA implants in terms of change in crestal bone level from implant surgery to 6 months were non-inferior with early loading (25 ± 3 days) compared to conventional loading (13 ± 1 weeks). The difference in mean crestal bone level change between the early loading and...
In the PPS and FAS, the implant survival rate was 100 % after 12 months. In the PPS, the implant success rate was 100 % at all time points in both the conventional and early loading arms; however, in the FAS, the success rate in the conventional loading arm was 100 % at all time points, while in the early loading arm, success was 100 % at suture removal at 12-month follow-up and 95 % at the ...
The study enrolled 84 Japanese patients who had single missing tooth in the molar region. Since four patients were withdrawn due to the exclusion criteria (systemic disease, adjacent teeth with probing pocket depth deeper than 4 mm, mental disorder, and bone deficiency, respectively), 80 patients underwent implant placement. Two further patients were withdrawn before randomization because the ins...
In addition, periodontal examination, in the form of probing depth (PD) and bleeding on probing (BoP), was performed at pre-screening and at the 12-month follow-up.
Descriptive summary statistics were computed for all parameters, and quantitative parameters were described using mean, standard deviation, median, quartiles, minimum, and maximum. For qualitative variables, absolute and relative freq...
The primary endpoint was a change of crestal bone level between implant surgery (baseline) and final restoration (6 months), assessed by measuring the distance from the implant shoulder to the first bone-to-implant contact both mesially and distally to the implant.
Bone level was measured by a single reader on standardized periapical radiographs taken at baseline (day 0), suture removal (7–14...
When a patient fulfilled all inclusion criteria and had no exclusion criteria, then he/she got implant surgery and checked the condition met first criteria for loading (loading criteria 1 (LC1)) (Table 2).
All patients received Ti grade IV Straumann Standard Plus Regular Neck (SP RN) implants, 4.1 mm in diameter and 8, 10, or 12 mm in length, with SLActive® surface (Institut Straumann AG, Bas...
This study was designed as a randomized, controlled, multicenter clinical trial to evaluate non-inferiority of early loading compared to conventional loading of dental implants with a chemically modified SLA surface placed in single tooth gaps, involving three centers in Japan (Tokyo Medical and Dental University (TMDU), Tokyo Dental College Chiba Hospital (TDCC), and Tokyo Dental College Suidobas...
Early loading protocols have become relatively common procedures in many countries for implant restoration, but the procedure is much less common in Japan. The purpose of this study, therefore, was to investigate whether the chemically modified SLA implant with early loading was non-inferior to conventional loading, based on the amount of crestal bone change between baseline and 6 months after su...
The use of dental implants to replace missing or compromised teeth has been well documented clinically over many years. High implant survival rates have been demonstrated for over 10 [1–3], 15 [4], and 20 years [5, 6]. Long-term survival rates for single-tooth implants have been shown to be greater than those for tooth-supported restorations, e.g., fixed partial dentures (FPDs) [7, 8]. Good lon...
The aim of the study was to evaluate whether early loading of implants with a chemically modified sandblasted, large-grit, acid-etched (SLA) (SLActive®) surface was non-inferior to conventional loading in terms of change in crestal bone level.
This was a randomized, controlled, multicenter study. Patients requiring single-tooth rehabilitation in the posterior maxilla or mandible received implant...
Fig. 3. Peri-implant bone level at baseline, 3 months post-operative, and 6 months post-operative. a Mesial defect depth. b Mesial defect width. c Distal defect depth. d Distal defect width
Fig. 3. Peri-implant bone level at baseline, 3 months post-operative, and 6 months post-operative. a Mesial defect depth. b Mesial defect width. c Distal defect depth. d Distal defect width
Fig. 2. Test group (PRF augmentation)
Fig. 2. Test group (PRF augmentation)
Fig. 1. Control group (no PRF augmentation)
Fig. 1. Control group (no PRF augmentation)
Illustration 11. ive (a), 1 week post-operative (b), 1 month post-operative (c), and 3 months post-operative (d)
Illustration 11. a–d Post-operative healing process at 3 days post-operative (a), 1 week post-operative (b), 1 month post-operative (c), and 3 months post-operative (d)
Illustration 10. a–d Second measuring, reentry, and insertion of a screwed, full ceramic crown
Illustration 10. a–d Second measuring, reentry, and insertion of a screwed, full ceramic crown
Illustration 9. a–c Radiographic control a at time of implant placement (a), 3 months post-operative (b), and 6 months post-operative (c)
Illustration 8. Fixation of the flap with Seralene® 6.0
Illustration 8. Fixation of the flap with Seralene® 6.0
Illustration 7. Insertion of PRF membranes in a double-layered technique for tissue augmentation
Illustration 7. Insertion of PRF membranes in a double-layered technique for tissue augmentation
Illustration 6. PRF membrane made by centrifugating and pressing the patient’s blood
Illustration 6. PRF membrane made by centrifugating and pressing the patient’s blood
Illustration 5. Implant placed with a split-flap technique
Illustration 5. Implant placed with a split-flap technique
Illustration 4. NobelSpeedy Replace® (source: https://www.nobelbiocare.com/de/de/home/products-and-solutions/implant-systems/nobelspeedy.html)
Illustration 4. NobelSpeedy Replace® (source: https://www.nobelbiocare.com/de/de/home/products-and-solutions/implant-systems/nobelspeedy.html)
Illustration 3. Insertion of the implant
Illustration 3. Insertion of the implant
Illustration 2. Crestal incision and preparation of a split-flap
Illustration 2. Crestal incision and preparation of a split-flap
Illustration 1. Measurement of tissue thickness with an endodontic micro-opener
Illustration 1. Measurement of tissue thickness with an endodontic micro-opener
Hehn, J., Schwenk, T., Striegel, M. et al. The effect of PRF (platelet-rich fibrin) inserted with a split-flap technique on soft tissue thickening and initial marginal bone loss around implants: results of a randomized, controlled clinical trial.
Int J Implant Dent 2, 13 (2016). https://doi.org/10.1186/s40729-016-0044-4
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Received: 30 July 2015
Accepted: 23 ...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Julia Hehn, Thomas Schwenk, Marcus Striegel, and Markus Schlee declare that they have no competing interests. This study was self-supported.
JH was responsible for the study design and recruitment of the patients, carried out the implant surgery and follow-up examinations, and drafted the manuscript. TS participated in the surgical treatment and follow-up examinations. MS performed the digital me...
Periodontology, Edel & Weiß Clinic, Ludwigsplatz 1a, 90403, Nuremberg, Germany
Julia Hehn
Esthetic Dentistry, Edel & Weiß Clinic, Nuremberg, Germany
Thomas Schwenk & Markus Striegel
Private Clinic for Periodontology, Forchheim and Department of Maxillofacial Surgery, Goethe University, Frankfurt, Germany
Markus Schlee
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The authors thank Dr. Wolfgang Reimers of MedCommTools for performing the statistics.
Abrahamsson I, Berglundh T. Effects of different implant surfaces and designs on marginal bone-level alterations: a review. Clin Oral Implants Res. 2009;20 Suppl 4:207–15.
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Dohan DM et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(3):e45–50.
Choukroun J, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part IV: clinical effects on tissue healing. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(3)...
Cardaropoli G et al. Tissue alterations at implant-supported single-tooth replacements: a 1-year prospective clinical study. Clin Oral Implants Res. 2006;17(2):165–71.
Fickl S et al. Dimensional changes of the alveolar ridge contour after different socket preservation techniques. J Clin Periodontol. 2008;35(10):906–13.
Vela-Nebot X et al. Benefits of an implant platform modification techniqu...
platelet-derived growth factor
platelet-rich fibrin
standard deviation
transforming growth factor-b
Soft tissue augmentation with PRF using a split-flap technique cannot be recommended to alter thin gingiva types. Future experimental and clinical studies will be necessary to evaluate whether augmentation with PRF is suitable for mucosa thickening.
With respect to marginal bone loss, it could be shown that there were no significant differences when comparing dimension of bone loss between test and control groups. The study of present research data shows, to the best knowledge of the authors, no other RCTs about tissue thickening with PRF and peri-implant bone loss. However, several studies focused on mucosa thickening with tissue grafts and ...
In this study over a period of 6 months, it could be demonstrated that mucosal tissue thickening above implants with PRF led to reduced tissue thickness when performed in a split-flap technique.
The initial post-operative dehiscence and the associated complete loss of mucosal and augmented tissue above the implant were observed in all test patients.
PRF is supposed to be a good healing aid in v...
The mean marginal bone level alterations are displayed in Fig. 3.
Six months after surgery, both groups showed a statistically significant peri-implant bone loss.
The mesial resp. distal defect depth was 0.70 mm ± 0.72 SD resp. 0.64 mm ± 0.66 SD at baseline. Six months later, the marginal bone defect increased to 1.47 mm ± 0.65 SD on the mesial side resp. 1.46 mm ± 0.54 ...
At time of surgery, the patients ranged in age from 33 to 79 years (mean age 53.8 years).
The first surgeries for implant placement in the test group were carried out as described above. Two layers of a PRF matrix were placed on top of the implant. Though surgical flaps were all sutured completely free of tension, a post-operative dehiscence above the implant could be observed in all test pati...
Comparison of bone level alterations between test and control groups.
Data were expressed as means ± standard deviation. Comparisons were made using the Wilcoxon test, the Mann–Whitney U test, and the multiple comparisons test by Schaich-Hamerle (p = 0.05).
After the implantation, standardized digital X-rays were taken with parallel technique (baseline) (illustration 9). For each patient, an individual customized digital film holder was fabricated to ensure a reproducible radiographic analysis. Patients were instructed to avoid chewing hard nutrition in the treated area and to use chlorhexidine mouthwash and a soft brush twice a day for the first 2 ...
Patients aged 18+ who required an implant in the posterior mandible were eligible for this study.
Exclusion criteria were the following:
general contraindications to implant surgery
insufficient oral hygiene and periodontitis
patients with a history of severe periodontitis
bone augmentation required
smokers
substance abuse
uncontrolled diabetes
severe cardiovascular problems
treated or u...
As a consequence, recent research focused on soft tissue augmentation of thin gingiva types prior to or simultaneous to implant insertion. Wiesner et al. published a significant gain of soft tissue by thickening the gingiva with a connective soft tissue graft harvested from the palate [12]. Soft tissues at augmented sites were 1.3 mm thicker than on control sites and had a better pink esthetic sc...
The initial bone modeling around implants within the first year after insertion presents a challenging topic in current research. Previous studies have shown that this process is characterized by a remodeling of the horizontal and vertical bone dimension with a range of 0.7 to 3 mm within the first year [1].
First attempts to reduce this loss of tissue focused on changes of implant shapes, impla...
Previous studies have shown that adequate thickness or initial augmentation of soft tissue has a positive effect on the stability of peri-implant bone. This randomized, controlled trial aimed to evaluate the influence of augmenting soft tissue with platelet-rich fibrin (PRF) on crestal bone and soft tissue around implants.
After randomization, 31 fully threaded titanium implants were inserted in ...
Fig. 2. PTG observed in radiographs at the 8-year follow-up
Fig. 2. PTG observed in radiographs at the 8-year follow-up
Fig. 1. Consort flowchart
Fig. 1. Consort flowchart
Patient/implants
Radiographic defect height at deepest site (mm)
The site with the deepest PPD (mm)
PlI
BoP
...
Characteristic
Case (PTG) group (n = 6)
Control group (n = 6)
Age (year), mean ± SD
67 ± 12.9 range, 45–79
...
Andersen, H., Aass, A.M. & Wohlfahrt, J.C. Porous titanium granules in the treatment of peri-implant osseous defects—a 7-year follow-up study.
Int J Implant Dent 3, 50 (2017). https://doi.org/10.1186/s40729-017-0106-2
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Received: 03 July 2017
Accepted: 12 October 2017
Published: 04 December 2017
DOI: https://doi.org/10.1186/s40729-017-0106-2
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
The present study was approved by the Regional Committee for Medical and Health Research Ethics, South East Norway (REK 2015/90). A writen informed consent was signed by all study participants
Dr. Johan Caspar Wohlfahrt has received lecture fees from the producers of the material used in the study and is a previous shareholder in the company (Tigran AB, Malmoe, Sweden). Heidi Andersen and Anne Me...
Department of Periodontology, Institute of Clinical Dentistry, University of Oslo, Pb. 1109 Blindern, 0317, Oslo, Norway
Heidi Andersen, Anne Merete Aass & Johan Caspar Wohlfahrt
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The authors would like to thank Dr. Christine Dæhli Oppedal for her participation in the data collection phase of the study and Dr. Janet M. Østrem for English proof-reading of the manuscript.
Roccuzzo M, et al. Surgical therapy of peri-implantitis lesions by means of a bovine-derived xenograft: comparative results of a prospective study on two different implant surfaces. J Clin Periodontol. 2011;38(8):738–45.
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Jepsen K, et al. Reconstruction of peri-implant osseous defects: a multicenter randomized trial. J Dent Res. 2016;95(1):58–66.
Serino G, Turri A. Outcome of surgical treatment of peri-implantitis: results from a 2-year prospective clinical study in humans. Clin Oral Implants Res. 2011;22(11):1214–20.
Faggion CM Jr, Listl S, Tu YK. Assessment of endpoints in studies on peri-implantitis treatm...
Mombelli A, et al. The microbiota associated with successful or failing osseointegrated titanium implants. Oral Microbiol Immunol. 1987;2(4):145–51.
Lindhe J, Meyle J. Peri-implant diseases: consensus report of the Sixth European Workshop on Periodontology. J Clin Periodontol. 2008;35(8 Suppl):282–5.
Zitzmann NU, Berglundh T. Definition and prevalence of peri-implant diseases. J Clin Periodo...
This long-term follow-up of surgical treatment of peri-implant osseous defects showed unpredictable results. Loss of implants was only recorded in PTG-treated patients.
The present study used a non-resorbable, alloplastic material (PTG) in intra-osseous defects as a reconstructed material. This technique attempts to fill the osseous defect and not solve the disease. With regard to defect fill, it is very important to keep in mind that a non-resorbable graft material such as PTG will be left unresorbed. In this study, PTG graft particles were easily seen on radiog...
A strict maintenance program every 3–6 months followed by a high standard of oral hygiene may hold a stable peri-implant condition after peri-implantitis surgery [16].
In the present study, access to perform sufficient plaque control at the treated implants was considered acceptable due to previous corrections of the prostheses. The frequency of supportive periodontal care (SPT) was reported t...
Few studies report long-term results after treatment of peri-implantitis. In this context, it is important to remember that the only true end point for such therapies will be the loss of implants, but most studies solely report clinical and subclinical parameters which are only surrogate markers for the disease state and true result of the performed therapy [17].
In a meta-analysis by Khoskham et...
Radiographic findings demonstrated similar values after 7 years as the baseline regarding defect depth height in 6/12 treated implants. Three implants, one in the PTG group and two in the OFD group, had progression of radiographic defect depth height, measured at the deepest site, compared to baseline.
Assessing the results after 12 months, five of the implants in the PTG group and five of the ...
Three different manufactures represented the implants included in the analysis. Seven subjects had Brånemark implants, four subjects had been treated with Astra Tech implants and one subject had a Straumann implant. Eleven subjects had periodontal supportive care performed by their hygienist or general dentist at a frequency of 6 months to once yearly. One subject reported sporadic visits. About...
For each radiograph, the width of the implant was used for image calibration.
The defect height was measured from a well-defined reference point at the most coronal part of the implant body, on radiographs taken at baseline, 12 months and 7 years. The radiographic measurements were performed by one investigator (AMA), blinded to the examination timepoint. The changes in vertical defect depth we...
After 7 years (7.3 years [6.7–8]), all patients who completed the original study were invited for a re-examination. After a multitude of recall strategies including telephone and letters, 17 subjects responded and were recalled to the university dental clinic between April and November 2015. After signing the written informed consent, medical and dental history were recorded and a clinical exa...
In 2012, the same group of researchers presented results from a randomized parallel arm case-control clinical study, using porous titanium granules as a bone substitute in the corrective surgical treatment of peri-implant osseous defects. Grafting of the defects with PTG was compared with open flap debridement alone. No clinical differences between groups were found after 12 months, but a better ...
Peri-implantitis was suggested [1] as an infectious and pathological site-specific disease in surrounding peri-implant tissues.
At the 6th European Workshops on Periodontology, consensus was made on the definitions related to the peri-implant diseases, peri-implant mucositis and peri-implantitis, respectively [2].
Peri-implant mucositis describes an established inflammatory lesion in the soft ti...
A great number of different treatment protocols for peri-implantitis have been suggested but there is no consensus regarding the most effective intervention. The aim of the present study was to evaluate the long-term clinical and radiographic results from a study on peri-implant osseous defect reconstruction.
Patients having participated in a randomized clinical study 7 years earlier were invit...