Patient
Implant region
(FDI)
Implant parameters
Dimensions of implant
Diameter [mm]/length [mm]
...
Fretwurst, T., Grunert, S., Woelber, J.P. et al. Vitamin D deficiency in early implant failure: two case reports. Int J Implant Dent 2, 24 (2016). https://doi.org/10.1186/s40729-016-0056-0
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Received: 04 August 2016
Accepted: 16 November 2016
Published: 25 November 2016
DOI: https://doi.org/10.1186/s40729-016-0056-0
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...
Department of Oral- and Craniomaxillofacial Surgery, Center for Dental Medicine, University Medical Center Freiburg, Hugstetter Straße 55, Freiburg, D-79106, Germany
Tobias Fretwurst, Sebastian Grunert, Katja Nelson & Wiebke Semper-Hogg
Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, USA
Tobias Fretwurst
Department of Operative Dentistr...
We would like to thank Dr. John Nelson for his resourceful and constructive ideas.
The authors Tobias Fretwurst, Sebastian Grunert, Johan Woelber, Katja Nelson, and Wiebke Semper-Hogg declare no conflicts of interest with respect to the research, authorship, and/or publication of this article.
The authors Tobias Fretwurst, Sebastian Grunert, Johan Woelber, Katja Nelson, and Wiebke Semper-Hogg do...
Di Rosa M, Malaguarnera M, Nicoletti F, Malaguarnera L. Vitamin D3: a helpful immuno-modulator. Immunology. 2011;134(2):123–39.
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Kikuta J, Kawamura S, Okiji F, Shirazaki M, Sakai S, Saito H, Ishii M. Sphingosine-1-phosphate-mediated osteoclast precursor monocyte migration is a critical point of control in antibone-resorptive action of active vitamin D. Proc Natl Acad Sci U S A. 2013;110(17):7009–13.
Hewison M, Freeman L, Hughes SV, Evans KN, Bland R, Eliopoulos AG, Kilby MD, Moss PA, Chakraverty R. Differential regulatio...
Hong HH, Chou TA, Yang JC, Chang CJ. The potential effects of cholecalciferol on bone regeneration in dogs. Clin Oral Implants Res. 2012;23(10):1187–92.
Hong HH, Yen TH, Hong A, Chou TA. Association of vitamin D3 with alveolar bone regeneration in dogs. J Cell Mol Med. 2015;19(6):1208–17.
Schulze-Späte U, Dietrich T, Wu C, Wang K, Hasturk H, Dibart S. Systemic vitamin D supplementation and ...
Gallagher JC, Sai AJ. Vitamin D insufficiency, deficiency, and bone health. J Clin Endocrinol Metab. 2010;95(6):2630–3.
Ning Z, Song S, Miao L, Zhang P, Wang X, Liu J, Hu Y, Xu Y, Zhao T, Liang Y, Wang Q, Liu L, Zhang J, Hu L, Huo M, Zhou Q. High prevalence of vitamin D deficiency in urban health checkup population. Clin Nutr. 2016;35(4):859–63.
Spiro A, Buttriss JL. Vitamin D: an overview o...
Maier GS, Horas K, Seeger JB, Roth KE, Kurth AA, Maus U. Is there an association between periprosthetic joint infection and low vitamin D levels? Int Orthop. 2014;38(7):1499–504.
Alvim-Pereira F, Montes CC, Thomé G, Olandoski M, Trevilatto PC. Analysis of association of clinical aspects and vitamin D receptor gene polymorphism with dental implant loss. Clin Oral Implants Res. 2008;19(8):786–...
Esposito M, Thomsen P, Ericson LE, Lekholm U. Histopathologic observations on early oral implant failures. Int J Oral Maxillofac Implants. 1999;14:798–810.
Olmedo-Gaya MV, Manzano-Moreno FJ, Cañaveral-Cavero E, de Dios Luna-Del Castillo J, Vallecillo-Capilla M. Risk factors associated with early implant failure: a 5-year retrospective clinical study. J Prosthet Dent. 2016;115(2):150–5.
Wenn...
To overcome the shortcomings of this case reports, prospective, multicenter, and controlled studies must follow to affirm a potential relationship between vitamin D deficiency, osteoimmunology, and the early failure of dental implants. Currently, a general recommendation for a standardized vitamin D screening in dental implantology cannot be stated due to lack of evidence.
Nevertheless, the vitamin D deficiency prevalence in the European population indicates that a vitamin D deficiency is probably not a sole causative factor for early implant failure; otherwise, the early implant failure rate would be significantly higher. However, a synergistic effect with other factors is conceivable. Some authors stated that implant osseointegration is not simply a wound healing ...
Local and systemic factors can affect the survival rate of dental implants [30–33]. The causes of early implant failure are not fully clarified and an association between vitamin D and dental implant osseointegration has not been investigated properly [8, 13–16]. Some recent animal studies in rodents demonstrated a relationship between vitamin D supplementation and an increased bone to implant...
In this 51-year-old male patient, no grafting procedure was performed as vertical and horizontal alveolar ridge dimension was adequate for implant placement. The implant placement in regions 36 and 37 was performed as guided surgery (Fig. 2a, Table 1). The implant placement was uneventful and the bone appeared clinically healthy. A cortical bone profiling was performed during implant placement. ...
The medical history of this 48-year-old male patient showed a high blood pressure; otherwise, the patient was healthy. A successfully completed periodontal therapy was done before implant therapy. The patient demonstrated stable marginal bone levels. Autologous retromolar bone grafting using local anesthesia was performed in the left mandible (see Fig. 1a). This patient received a postoperative o...
Patients treated consecutively in one center (Department of Oral- and Craniomaxillofacial Surgery, University Medical Center Freiburg). None of the patients showed systemic disease. Both patients did not take regular medication and were negative for alcohol, nicotine, and drug use. Bothe male patients (48 and 51 years of age) were not immunosuppressed, irradiated or received chemotherapy. Written...
Long-term stable osseointegrated implants are the primary goal in dental implantology. Although dental implants have proven clinical reliable in the long term, the failure of implants at a very early stage of osseointegration has been described [1, 2]. The pursuit to identify the mechanisms leading to early implant failure is ongoing to date and include the following: tobacco usage, diabetes, wear...
An association between vitamin D deficiency and early dental implant failure is not properly verified, but its role in osteoimmunology is discussed. This article illustrates two case reports with vitamin D deficiency and early implant failure. Prior to implant placement, the first patient received crestal bone grafting with autologous material. Both patients received dental implants from different...
Fig. 1. Approval of the Bioethics Committee of the Santa Maria University
Fig. 1. Approval of the Bioethics Committee of the Santa Maria University
Simeone, S.G., Rios, M. & Simonpietri, J. “Reverse torque of 30 Ncm applied to dental implants as test for osseointegration”—a human observational study. Int J Implant Dent 2, 26 (2016). https://doi.org/10.1186/s40729-016-0060-4
Download citation
Received: 12 September 2016
Accepted: 22 November 2016
Published: 07 December 2016
DOI: https://doi.org/10.1186/s40729-016-0060-4
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 m...
Santa Maria University, Calle La Línea, Residencias El Parque, Piso 5, Apto B–5B. La Carlota. Municipio Sucre, Caracas, 1071, Venezuela
Sabrina G. Simeone, María Rios & Jeannette Simonpietri
You can also search for this author in PubMed Google Scholar
You can also search for this author in PubMed Google Scholar
You can also search for this author in PubMed Google Scholar
Corresponde...
Carvalho C, Carvalho L, Costa L, et al. Titanium implants: a removal torque study in osteopenic rabbits. Indian J Dent Res. 2010;21(3):349–52.
Gehrke S, Dos Santos M, Dedavid B, et al. Potencial de Osseointegra¢ão versus características da superficie microtexturizada Vellox. Revista Implant News. 2011;8:229–37.
Mall N, Dhanasekar B, Aparna I. Validation of implant stability: a measure of ...
Cehreli M, Karasoy D, Akca K, et al. Meta-analysis of methods used to assess implant stability. Int J Oral Maxillofac Implants. 2009;24(6):1015–32.
Gomes J, Campos F, Marin C, et al. Implant biomechanical stability variation at early implantation times in vivo: an experimental study in dogs. J Oral Maxillofac Implants. 2013;28(3):128–34.
Gehrke S. Acondicionamiento de la textura superficial ...
Under the ideal conditions of the study herein, the application of a 30-Ncm reverse torque at the time of the stage 2 surgery, before the prosthetic restoration, allowed the clinical identification of the stability of 40 dental implants.
Primary stability depends on the micro and macroscopic characteristics of the dental implant. Thus, after the application of a 30-Ncm reverse torque, both implan...
In order to exclude risk factors, as there are no previous researches on reverse torque in humans, the research was made following a conventional protocol, only on lower jaw implants, with implants of treated surface, which have benefits that greatly compensate for the risks, allowing for faster osseointegration levels because the rugosity increases the contact surface between the implant and the ...
The reverse torque technique proposed by Roberts in 1984 to evaluate dental implants integration proved to be successful. The most recent researches are aimed at evaluating current results. Thus, the objective of this research was to evaluate, by means of the 30 Ncm reverse torque test, 40 dental implants on the lower jaw, during the stage 2 surgery, as a mechanical and clinical, non-invasive tre...
This study reports on the clinical behavior of 40 dental implants placed on the lower jaw, on ideal bone, and under ideal surgical and systemic conditions, subjected to a 30-Ncm reverse torque during the stage 2 surgery, on 17 patients.
The patients evaluated only showed normal signs and symptoms of post-operatory swelling. According to the distribution of the implants on the mandibular region, 2...
On the data collection table, the existence of any peri-implant radiolucency radiographic images previous to the stage 2 surgery was recorded. After the application of the 30 Ncm reverse torque, the presence or absence of dental implant movement was recorded, as well as any incidence of symptomatology (pain), or presence of any clinical signs.
A clinical trial was carried out, in which 17 patients treated with implants at the School of Dentistry of the Santa Maria University and which had had 40 dental implants placed from two different commercial brands, with NanoTec™ and Vellox® surfaces, on the lower jaw, with the approval of the Bioethics Committee of the Santa Maria University (Fig. 1).
Patients 18 years old or older;
Signed...
Since the study herein is not found in humans [5, 9], last phase of study, and counting on previous results from in vitro and in vivo researches with animal models on long bones (femur, tibia, mandibles) in dogs, pigs, baboons, rabbits, and even in mastoid bones [6, 9–16], which provide necessary information to design human trials, this mechanical test was performed on dental implants in humans,...
The reverse torque test proposed by Roberts et al. in 1984, and developed by Johansson and Albrektsson in 1987 [6], is considered as a special advantage in stage 2 surgery, because it represents a definitive clinical verification of initial integration of the dental implant with the bone surface. The torque level required is commonly expressed in Newton centimeters (Ncm) [7, 8].
This way, a clini...
Primary stability has been reestablished as a previous clinical requirement to achieve osseointegration. The presence of movements between the surface of the implant and the bone tissue induces a bone resorption that produces fibrointegration, in which the implant is surrounded by an interphase of soft or connective tissue, and not bone tissue [1, 2].
Strategies used to improve bone response incl...
On bone implantology, stability of a dental implant is an essential clinical tool during osseointegration evaluation, as it is a reflection of the structural and functional connection between the bone and the implant.
The sample was comprised by 17 patients with 40 NanoTec™ and Vellox® implants, placed on the lower jaw, under optimum conditions, after a minimum healing period of 3 months, duri...
Fig. 5. Reverse torque at 30 Ncm
Fig. 5. Reverse torque at 30 Ncm
Fig. 4. Reverse torque test
Fig. 4. Reverse torque test
Fig. 3. 30 Ncm, measurement
Fig. 3. 30 Ncm, measurement
Fig. 2. Informed consent for patients
Fig. 2. Informed consent for patients
Fig. 1. Approval of the Bioethics Committee of the Santa Maria University
Fig. 1. Approval of the Bioethics Committee of the Santa Maria University
Simeone, S.G., Rios, M. & Simonpietri, J. “Reverse torque of 30 Ncm applied to dental implants as test for osseointegration”—a human observational study. Int J Implant Dent 2, 26 (2016). https://doi.org/10.1186/s40729-016-0060-4
Download citation
Received: 12 September 2016
Accepted: 22 November 2016
Published: 07 December 2016
DOI: https://doi.org/10.1186/s40729-016-0060-4
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 m...
Santa Maria University, Calle La Línea, Residencias El Parque, Piso 5, Apto B–5B. La Carlota. Municipio Sucre, Caracas, 1071, Venezuela
Sabrina G. Simeone, María Rios & Jeannette Simonpietri
You can also search for this author in PubMed Google Scholar
You can also search for this author in PubMed Google Scholar
You can also search for this author in PubMed Google Scholar
Corresponde...
Carvalho C, Carvalho L, Costa L, et al. Titanium implants: a removal torque study in osteopenic rabbits. Indian J Dent Res. 2010;21(3):349–52.
Gehrke S, Dos Santos M, Dedavid B, et al. Potencial de Osseointegra¢ão versus características da superficie microtexturizada Vellox. Revista Implant News. 2011;8:229–37.
Mall N, Dhanasekar B, Aparna I. Validation of implant stability: a measure of ...
Cehreli M, Karasoy D, Akca K, et al. Meta-analysis of methods used to assess implant stability. Int J Oral Maxillofac Implants. 2009;24(6):1015–32.
Gomes J, Campos F, Marin C, et al. Implant biomechanical stability variation at early implantation times in vivo: an experimental study in dogs. J Oral Maxillofac Implants. 2013;28(3):128–34.
Gehrke S. Acondicionamiento de la textura superficial ...
Under the ideal conditions of the study herein, the application of a 30-Ncm reverse torque at the time of the stage 2 surgery, before the prosthetic restoration, allowed the clinical identification of the stability of 40 dental implants.
Primary stability depends on the micro and macroscopic characteristics of the dental implant. Thus, after the application of a 30-Ncm reverse torque, both implan...
In order to exclude risk factors, as there are no previous researches on reverse torque in humans, the research was made following a conventional protocol, only on lower jaw implants, with implants of treated surface, which have benefits that greatly compensate for the risks, allowing for faster osseointegration levels because the rugosity increases the contact surface between the implant and the ...
The reverse torque technique proposed by Roberts in 1984 to evaluate dental implants integration proved to be successful. The most recent researches are aimed at evaluating current results. Thus, the objective of this research was to evaluate, by means of the 30 Ncm reverse torque test, 40 dental implants on the lower jaw, during the stage 2 surgery, as a mechanical and clinical, non-invasive tre...
This study reports on the clinical behavior of 40 dental implants placed on the lower jaw, on ideal bone, and under ideal surgical and systemic conditions, subjected to a 30-Ncm reverse torque during the stage 2 surgery, on 17 patients.
The patients evaluated only showed normal signs and symptoms of post-operatory swelling. According to the distribution of the implants on the mandibular region, 2...
On the data collection table, the existence of any peri-implant radiolucency radiographic images previous to the stage 2 surgery was recorded. After the application of the 30 Ncm reverse torque, the presence or absence of dental implant movement was recorded, as well as any incidence of symptomatology (pain), or presence of any clinical signs.
A clinical trial was carried out, in which 17 patients treated with implants at the School of Dentistry of the Santa Maria University and which had had 40 dental implants placed from two different commercial brands, with NanoTec™ and Vellox® surfaces, on the lower jaw, with the approval of the Bioethics Committee of the Santa Maria University (Fig. 1).
Patients 18 years old or older;
Signed...
Since the study herein is not found in humans [5, 9], last phase of study, and counting on previous results from in vitro and in vivo researches with animal models on long bones (femur, tibia, mandibles) in dogs, pigs, baboons, rabbits, and even in mastoid bones [6, 9–16], which provide necessary information to design human trials, this mechanical test was performed on dental implants in humans,...
The reverse torque test proposed by Roberts et al. in 1984, and developed by Johansson and Albrektsson in 1987 [6], is considered as a special advantage in stage 2 surgery, because it represents a definitive clinical verification of initial integration of the dental implant with the bone surface. The torque level required is commonly expressed in Newton centimeters (Ncm) [7, 8].
This way, a clini...
Primary stability has been reestablished as a previous clinical requirement to achieve osseointegration. The presence of movements between the surface of the implant and the bone tissue induces a bone resorption that produces fibrointegration, in which the implant is surrounded by an interphase of soft or connective tissue, and not bone tissue [1, 2].
Strategies used to improve bone response incl...
On bone implantology, stability of a dental implant is an essential clinical tool during osseointegration evaluation, as it is a reflection of the structural and functional connection between the bone and the implant.
The sample was comprised by 17 patients with 40 NanoTec™ and Vellox® implants, placed on the lower jaw, under optimum conditions, after a minimum healing period of 3 months, duri...
Fig. 3. Example of another case involved in the study. a Preoperative view –premolars and molars are missing in left mandible. b Preoperative CT scan. The width of the ridge was around 4 mm. c Baseline periapical radiograph. Four narrow diameter implants were placed to restore the area. d Buccal view of the final full-contour zirconia restoration. e Periapical radiograph at 1 year after loa...
Fig. 2. Case 1: Example of one case involved in the study. a Preoperative view of a partial edentulism in posterior mandible. b Preoperative CT scan. The width of the ridge was 4 mm. c Four narrow diameter implants were placed and left to a nonsubmerged healing. d Baseline periapical radiograph. e Buccal vieew of the final metal ceramic restoration. f Periapical radiograph at 1 year after loa...
Fig. 1. Characteristics of the implants used in the study: a external macro-design of JDIcon Ultra S, 2.75 mm diameter implant and b external macro-design of JDEvolution S, 3.25 mm diameter implant
Fig. 1. Characteristics of the implants used in the study: a external macro-design of JDIcon Ultra S, 2.75 mm diameter implant and b external macro-design of JDEvolution S, 3.25 mm diameter i...
Diameter 2.75 mm
Follow-up
Mean bone level changes (mm) (n = 69)
0–6 months (95% CI) (n = 67)
0–12 months (95% CI) (n = 67)
...
Follow-up
Mean bone level (mm) (n = 124)
Time
0–6 months (95% CI) (n = 121)
0–12 months (95% CI) (n = 121)
...
Length (mm)
8
18 (14.5%)
10
56 (45.2%)
11.5
...
Number of patients
42
Males (%)
18 (42.9%)
Females (%)
24 (57.1%)
...
Grandi, T., Svezia, L. & Grandi, G. Narrow implants (2.75 and 3.25 mm diameter) supporting a fixed splinted prostheses in posterior regions of mandible: one-year results from a prospective cohort study.
Int J Implant Dent 3, 43 (2017). https://doi.org/10.1186/s40729-017-0102-6
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Received: 23 March 2017
Accepted: 29 August 2017
Published: 08 September 2017
...
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...
Tommaso Grandi serves as a consultant for JDentalCare. Luigi Svezia and Giovanni Grandi declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Private practice, Via Contrada 323, 41126, Modena, Italy
Tommaso Grandi & Luigi Svezia
Department of Obstetrics, Gynecology and Pediatrics, University of Modena and Reggio Emilia, Modena, Italy
Giovanni Grandi
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Esposito M, Grusovin MG, Maghaireh H, Worthington HV. Interventions for replacing missing teeth: different times for loading dental implants (Review). Cochrane Database Syst Rev. 2013;(3):CD003878. https://doi.org/10.1002/14651858.CD003878.pub5.
Esposito M, Grusovin MG, Felice P, Karatzopoulos G, Worthington HV, Coulthard P. The efficacy of horizontal and vertical bone augmentation procedures for...
Within the limits of this prospective cohort study, narrow-diameter implants (2.75 to 3.25 mm) can be successfully used as a minimally invasive alternative to horizontal bone augmentation in posterior mandible up to 1 year of function. This outcome could be related to the fact that these implants have been all splinted to other implants by a fixed prosthesis. These preliminary results must be co...
On the one hand, due to the small sample size of this study and moreover, the short follow-up (only 1 year after loading), it would be hazardous to conclude that the placement of NDIs to support fixed prostheses in posterior mandible is a predictable treatment modality. In order to draw more reliable conclusions, we need to wait for longer follow-ups, since it may be possible that after several y...
Dental implants with a reduced diameter are commonly used where bone width is narrow or in cases of restricted mesiodistal anatomy such as laterally maxillary and mandibular incisors. They could also be a viable alternative to bone augmentation especially in challenging situations such as the posterior regions of the mandible. While it has been shown that it is possible to horizontally augment bon...
The radiographic data are summarized in Tables 3 and 4. The group lost statistically significant marginal peri-implant bone at 6 months (−0.20; 95% C −0.14: −0.26, p
Forty-eight patients were screened for eligibility, but six subjects were not included for the following reasons: five patients (10.4%) were hesitant to receive implant treatment, and one patient (2.1%) was treated with intravenous amino-bisphosphonates. Forty-two patients were then considered eligible and were consecutively enrolled in the study. All patients were treated according to the allocat...
Primary outcome measures were as follows:
Implant failure: evaluated as implant mobility and removal of stable implants dictated by progressive marginal bone loss or infection. The stability of each implant was measured manually by tightening the abutment screw with a wrench delivering a torque of 20 Ncm. Implant stability assessment was performed at delivery of definitive crowns (3 months afte...
The present prospective study was conducted at a private practice (Tommaso Grandi, Modena) in Italy between October 2014 and January 2016.
Any patient with partial edentulism in posterior regions of mandible (premolar/molar areas), requiring one multiple tooth implant-supported restoration (2-, 3-, or 4-unit bridge), having a residual bone height of at least 8 mm and a thickness of at least 4 m...
The aim of this cohort study was to evaluate the outcome of narrow-diameter implants (2.75 and 3.25 mm diameter) used as definitive implants in patients with insufficient bone ridge thickness for placing standard-diameter implants in posterior regions of the mandible. The present study reports the clinical outcome up to 1 year after loading. It is planned to follow up this patients’ cohort to ...
Historically, implants have been used and documented mainly with diameters between 3.7 and 4.3 mm. Employing these diameters for numerous indications, scientifically substantiated treatment protocols with excellent long-term results have been established [1]. One disadvantage of a standard-diameter implant is the fact that, in clinical use, the available horizontal crestal dimensions of the alveo...
Can multiple splinted narrow-diameter implants be used as definitive implants in patients with insufficient bone ridge thickness in posterior regions of the mandible? With this aim, we evaluated their outcomes in this set up to 1 year after loading.
Forty-two patients with a mean age of 61.3 years old (range 49–73) in need of fixed prosthetic implant-supported rehabilitations in the posterior...
Simeone, S.G., Rios, M. & Simonpietri, J. “Reverse torque of 30 Ncm applied to dental implants as test for osseointegration”—a human observational study.
Int J Implant Dent 2, 26 (2016). https://doi.org/10.1186/s40729-016-0060-4
Download citation
Received: 12 September 2016
Accepted: 22 November 2016
Published: 07 December 2016
DOI: https://doi.org/10.1186/s40729-0...
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...
Santa Maria University, Calle La Línea, Residencias El Parque, Piso 5, Apto B–5B. La Carlota. Municipio Sucre, Caracas, 1071, Venezuela
Sabrina G. Simeone, María Rios & Jeannette Simonpietri
You can also search for this author in
PubMed Google Scholar
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PubMed Google Scholar
You can also search for ...
Carvalho C, Carvalho L, Costa L, et al. Titanium implants: a removal torque study in osteopenic rabbits. Indian J Dent Res. 2010;21(3):349–52.
Gehrke S, Dos Santos M, Dedavid B, et al. Potencial de Osseointegra¢ão versus características da superficie microtexturizada Vellox. Revista Implant News. 2011;8:229–37.
Mall N, Dhanasekar B, Aparna I. Validation of implant stability: a measure of ...
Cehreli M, Karasoy D, Akca K, et al. Meta-analysis of methods used to assess implant stability. Int J Oral Maxillofac Implants. 2009;24(6):1015–32.
Gomes J, Campos F, Marin C, et al. Implant biomechanical stability variation at early implantation times in vivo: an experimental study in dogs. J Oral Maxillofac Implants. 2013;28(3):128–34.
Gehrke S. Acondicionamiento de la textura superficial ...
Under the ideal conditions of the study herein, the application of a 30-Ncm reverse torque at the time of the stage 2 surgery, before the prosthetic restoration, allowed the clinical identification of the stability of 40 dental implants.
Primary stability depends on the micro and macroscopic characteristics of the dental implant. Thus, after the application of a 30-Ncm reverse torque, both implan...
In order to exclude risk factors, as there are no previous researches on reverse torque in humans, the research was made following a conventional protocol, only on lower jaw implants, with implants of treated surface, which have benefits that greatly compensate for the risks, allowing for faster osseointegration levels because the rugosity increases the contact surface between the implant and the ...
The reverse torque technique proposed by Roberts in 1984 to evaluate dental implants integration proved to be successful. The most recent researches are aimed at evaluating current results. Thus, the objective of this research was to evaluate, by means of the 30 Ncm reverse torque test, 40 dental implants on the lower jaw, during the stage 2 surgery, as a mechanical and clinical, non-invasive tre...
This study reports on the clinical behavior of 40 dental implants placed on the lower jaw, on ideal bone, and under ideal surgical and systemic conditions, subjected to a 30-Ncm reverse torque during the stage 2 surgery, on 17 patients.
The patients evaluated only showed normal signs and symptoms of post-operatory swelling. According to the distribution of the implants on the mandibular region, 2...
On the data collection table, the existence of any peri-implant radiolucency radiographic images previous to the stage 2 surgery was recorded. After the application of the 30 Ncm reverse torque, the presence or absence of dental implant movement was recorded, as well as any incidence of symptomatology (pain), or presence of any clinical signs.
A clinical trial was carried out, in which 17 patients treated with implants at the School of Dentistry of the Santa Maria University and which had had 40 dental implants placed from two different commercial brands, with NanoTec™ and Vellox® surfaces, on the lower jaw, with the approval of the Bioethics Committee of the Santa Maria University (Fig. 1).
Patients 18 years old or older;
Signed...
Since the study herein is not found in humans [5, 9], last phase of study, and counting on previous results from in vitro and in vivo researches with animal models on long bones (femur, tibia, mandibles) in dogs, pigs, baboons, rabbits, and even in mastoid bones [6, 9–16], which provide necessary information to design human trials, this mechanical test was performed on dental implants in humans,...
The reverse torque test proposed by Roberts et al. in 1984, and developed by Johansson and Albrektsson in 1987 [6], is considered as a special advantage in stage 2 surgery, because it represents a definitive clinical verification of initial integration of the dental implant with the bone surface. The torque level required is commonly expressed in Newton centimeters (Ncm) [7, 8].
This way, a clini...
Primary stability has been reestablished as a previous clinical requirement to achieve osseointegration. The presence of movements between the surface of the implant and the bone tissue induces a bone resorption that produces fibrointegration, in which the implant is surrounded by an interphase of soft or connective tissue, and not bone tissue [1, 2].
Strategies used to improve bone response incl...
On bone implantology, stability of a dental implant is an essential clinical tool during osseointegration evaluation, as it is a reflection of the structural and functional connection between the bone and the implant.
The sample was comprised by 17 patients with 40 NanoTec™ and Vellox® implants, placed on the lower jaw, under optimum conditions, after a minimum healing period of 3 months, duri...
Figure 3. Example of another case involved in the study. a Preoperative view –premolars and molars are missing in left mandible. b Preoperative CT scan. The width of the ridge was around 4 mm. c Baseline periapical radiograph. Four narrow diameter implants were placed to restore the area. d Buccal view of the final full-contour zirconia restoration. e Periapical radiograph at 1...
Figure 2. Case 1: Example of one case involved in the study. a Preoperative view of a partial edentulism in posterior mandible. b Preoperative CT scan. The width of the ridge was 4 mm. c Four narrow diameter implants were placed and left to a nonsubmerged healing. d Baseline periapical radiograph. e Buccal vieew of the final metal ceramic restoration. f Periapical radiograph at ...
Diameter 2.75 mm
Follow-up
Mean bone level changes (mm) (n = 69)
0–6 months (95% CI) (n = 67)
0–12 months (95% CI) (n = 67)
p inter-groups
Baseline
0.02 ± 0.07
−0.18 (−0.09; −0.27)
−0.47 (−0.27; −0.67)
p = 0.786
6 months
0.20 ± 0.12
p intra-group
12 months
0.49 ± 0.30
p
Length (mm)
8
18 (14.5%)
10
56 (45.2%)
11.5
43 (34.7%)
13
7 (5.6%)
Diameter (mm)
2.75
69 (55.6%)
3.25
55 (44.4%)
Insertion torque (Ncm)
30
21 (16.9%)
35
16 (12.9%)
40
10 (8.1%)
45
11 (8.9%)
50
32 (25.8%)
55
7 (5.6%)
60
16 (12.9%)
65
5 (4.1%)
70
6 (4.8%)
Number of patients
42
Males (%)
18 (42.9%)
Females (%)
24 (57.1%)
Mean age at insertion (range)
62.6 (49–73)
Smokers (less than 10 cigarettes/die)
12 (28.6%)
Diseases in history
Controlled diabetes type 2
11 (26.2%)
Hypertension
19 (45.2%)
Site of insertion
Premolar
81 (65.3%)
Molar
43 (34.7%)
Opposite dentition
...
Figure 1. Characteristics of the implants used in the study: a external macro-design of JDIcon Ultra S, 2.75 mm diameter implant and b external macro-design of JDEvolution S, 3.25 mm diameter implant
References
Esposito M, Grusovin MG, Maghaireh H, Worthington HV. Interventions for replacing missing teeth: different times for loading dental implants (Review). Cochrane Database Syst Rev. 2013;(3):CD003878. https://doi.org/10.1002/14651858.CD003878.pub5.
Esposito M, Grusovin MG, Felice P, Karatzopoulos G, Worthington HV, Coulthard P. The efficacy of horizontal and vertical bone augmenta...
Klein et al., in a recent systematic review, reported that the survival rate of implants with a diameter of
Discussion
Dental implants with a reduced diameter are commonly used where bone width is narrow or in cases of restricted mesiodistal anatomy such as laterally maxillary and mandibular incisors. They could also be a viable alternative to bone augmentation especially in challenging situations such as the posterior regions of the mandible. While it has been shown that it is possible to horizo...
Results
Forty-eight patients were screened for eligibility, but six subjects were not included for the following reasons: five patients (10.4%) were hesitant to receive implant treatment, and one patient (2.1%) was treated with intravenous amino-bisphosphonates. Forty-two patients were then considered eligible and were consecutively enrolled in the study. All patients were treated according to ...
Secondary outcome measures were as follows:
Peri-implant marginal bone level changes: evaluated on intraoral radiographs taken with the paralleling technique at implant placement, 6 months and 1 year after loading. All measurements were taken by an independent assessor (LS). Radiographs were scanned, digitized in JPG format, converted to TIFF format with a 600 dpi resolution, and stored in...
On the day of surgery, patients were treated under local anesthesia.
Full-thickness crestal flaps were elevated with a minimal extension to reduce patient discomfort. The implant sites were prepared according to the procedure recommended by the implant manufacturer (JDentalCare, Modena, Italy).
Tapered narrow-diameter implants titanium grade 5 (2.75 and 3.25 mm diameter, respectively, JDIcon Ult...
Methods
The present prospective study was conducted at a private practice (Tommaso Grandi, Modena) in Italy between October 2014 and January 2016.
Any patient with partial edentulism in posterior regions of mandible (premolar/molar areas), requiring one multiple tooth implant-supported restoration (2-, 3-, or 4-unit bridge), having a residual bone height of at least 8 mm and a thickness of at ...
Background
Historically, implants have been used and documented mainly with diameters between 3.7 and 4.3 mm. Employing these diameters for numerous indications, scientifically substantiated treatment protocols with excellent long-term results have been established [1]. One disadvantage of a standard-diameter implant is the fact that, in clinical use, the available horizontal crestal dimension...
Narrow implants (2.75 and 3.25 mm diameter) supporting a fixed splinted prostheses in posterior regions of mandible: one-year results from a prospective cohort study
Abstract
Background
Can multiple splinted narrow-diameter implants be used as definitive implants in patients with insufficient bone ridge thickness in posterior regions of the mandible? With this aim, we evaluated their out...
Patient
Implant region(FDI)
Implant parameters
Dimensions of implantDiameter [mm]/length [mm]
Explantation[Days after placement]
1
3637
First placementStraumannRN SLactive®(TiZr)
First placementØ: 4.1; L: 10Ø: 4.1; L: 8
3
3637
Second placementStraumannTissue level(TiZr)
Second placementØ :4.1, L: 8Ø :4.1, L: 8
3
36
Third placementConelog ScrewLine(...
Figure 2. a Patient 2. Postoperative orthopantomogram one day after implant placement. b Patient 2. Postoperative orthopantomogram after second Implant placement
Figure 1. a Patient 1. Post grafting orthopantomogram. The bone block was secured with a single microscrew. b Patient 1. The radiograph demonstrates veritable inserted Straumann bone level implants after the first implant placement (1 day after implant placement). A peri-implant osteolysis is not visible. c Patient 1. Postoperative orthopantomogram (1 day after implant placement) afte...
References
Esposito M, Thomsen P, Ericson LE, Lekholm U. Histopathologic observations on early oral implant failures. Int J Oral Maxillofac Implants. 1999;14:798–810.
Olmedo-Gaya MV, Manzano-Moreno FJ, Cañaveral-Cavero E, de Dios Luna-Del Castillo J, Vallecillo-Capilla M. Risk factors associated with early implant failure: a 5-year retrospective clinical study. J Prosthet Dent. 2016;115...
However, a synergistic effect with other factors is conceivable. Some authors stated that implant osseointegration is not simply a wound healing phenomenon but rather complex foreign body reaction with activation of the immune system. Titanium and metal particle release is discussed as cause for implant failure as well as implant dentistry. It is assumed that metal particles influence the ma...
However, a present human study cannot confirm an effect due to vitamin D supplementation on bone formation or graft resorption after maxillary sinus augmentation. Satue et al. found a positive influence of 7-dehydrocholesterol (7-DHC), the precursor of vitamin D, coated implants on osteoblast differentiation in vitro. But whether vitamin D-coated dental implants have an effect of osseo...
Discussion
This article demonstrated that implant placement was successful after vitamin D supplementation in patients with vitamin D deficiency and early failed implants. None of the patients showed systemic disease or did take regular medication, alcohol, nicotine, or drugs. The patients were not immunosuppressed, irradiated, or received chemotherapy. All implants were inserted with the s...
After vitamin D supplementation and a healing period of 6 months, a third surgical intervention was planned and one implant (Conelog ScrewLine) was inserted in region 36 (see Table 1 and Fig. 1d). During implant placement, the former explantation site appeared clinically fully re-ossified. The patient received an intraoperative intravenous single-dose antibiotic therapy with Isocillin 1.2 mega. At...
Patient
The medical history of this 48-year-old male patient showed a high blood pressure; otherwise, the patient was healthy. A successfully completed periodontal therapy was done before implant therapy. The patient demonstrated stable marginal bone levels. Autologous retromolar bone grafting using local anesthesia was performed in the left mandible (see Fig. 1a). This patient received a pos...
Case presentation
Patients and surgical procedure
Patients treated consecutively in one center (Department of Oral- and Craniomaxillofacial Surgery, University Medical Center Freiburg). None of the patients showed systemic disease. Both patients did not take regular medication and were negative for alcohol, nicotine, and drug use. Bothe male patients (48 and 51 years of age) were not immunosu...
Background
Long-term stable osseointegrated implants are the primary goal in dental implantology. Although dental implants have proven clinical reliable in the long term, the failure of implants at a very early stage of osseointegration has been described. The pursuit to identify the mechanisms leading to early implant failure is ongoing to date and include the following: tobacco usage, diabete...
Abstract
An association between vitamin D deficiency and early dental implant failure is not properly verified, but its role in osteoimmunology is discussed. This article illustrates two case reports with vitamin D deficiency and early implant failure. Prior to implant placement, the first patient received crestal bone grafting with autologous material. Both patients received dental implants fr...
Figure 6. Figure 6. a–d Von Mises stress distribution on bone. From a to d: L-M, ZL-M, L-V, and ZL-V respectively. The stress concentration occurred in the cortical bone around the neck of the implant. Groups L-M and ZL-M were quite similar and reduced stress
Figure 5. a–d Von Mises stress distribution on abutment. From a to d: L-M, ZL-M, L-V, and ZL-V respectively. Von Mises stresses were relatively similar and concentrated at the coronal part of the abutment in all groups
Figure 5. a–d Von Mises stress distribution on abutment. From a to d: L-M, ZL-M, L-V, and ZL-V respectively. Von Mises stresses were relatively similar and concentrated ...
Figure 4. a–d Von Mises stress distribution on implant. From a to d: L-M, ZL-M, L-V, and ZL-V respectively
Figure 4. a–d Von Mises stress distribution on implant. From a to d: L-M, ZL-M, L-V, and ZL-V respectively
Figure 3. a–d Maximum principal stress distribution on crown restoration. From a to d: L-M, ZL-M, L-V, and ZL-V respectively
Figure 3. a–d Maximum principal stress distribution on crown restoration. From a to d: L-M, ZL-M, L-V, and ZL-V respectively
Figure 2. The graph of the interaction of the materials and restoration design
Group
N
Mean (N)
Standard deviation
Minimum
Maximum
L-M
12
2891.88a
410.12
2079.74
3486.96
L-V
12
2077.37bc
356.59
1220.96
2493.39
ZL-M
12
1750.28c
314.96
1084.36
2163.95
ZL-V
12
2202.55b
503.14
1292.20
2912.81
Material
Young’s modulus (GPa)
Poisson ratio
Reference
E.max CAD
95
0.20
[1]
Vita Suprinity
65
0.23
[2]
Vita VM 11
65
0.23
*
E.max Ceram
64
0.23
[4]
Implant and abutment
114
0.34
[5]
Cortical bone
13.7
0.3
[5]
Spongious bone
1
0.3
[5]
Figure 1. Crown restoration design
Groups
N
Materials
L-M
12
IPS e-max CADIPS e.max CAD glaze
L-V
12
IPS e-max CADe.max Ceram DentinIPS e.max Ceram Glaze
ZL-M
12
Vita SuprinityVita Akzent Plus
ZL-V
12
Vita SuprinityVM-11Vita Akzent Plus
Material
Chemical composition (%)
Coefficient of thermal expansion (10−6 K−1)
Flexural strength (MPa)
Manufacturer
IPS e.max CAD; lithium disilicate glass ceramic (LDS)
SiO2 (57–80), Li2O (11–19), K2O (0–13), P2O5 (0–11), ZrO2 (0–8), ZnO (0–8), Al2O3 (0–5), MgO (0–5), coloring oxides (0–8)
10.2
360
Ivoclar Vivadent
IPS e.max Ceram; low-fusing nan...
Conclusions
Within the limitation of the present study, it can be concluded that the restoration design affected the failure load of ceramics. Monolithic design had a statistically significant effect on the failure load of two different ceramics (LDS > ZLS). Veneer application had opposite effects on two different ceramics which increased the failure load of ZLS and reduced it for LDS witho...
Zheng et al. compared the stress distribution of the same veneering ceramic on different cores and concluded that the zirconia core was clearly different from other materials with higher tensile stresses at the veneer core interface because the increasing differences between the elasticity modulus of the core and the veneer transmitted higher stress concentrations to the cores. Con...
Veneer application provided additional strength to the ZLS crowns in contrast to the LDS crowns. The higher failure load of the veneered ZLS crowns (2202.55 N; group L-V 2077.37 N) may be associated with the higher flexural strength of the veneering porcelain VM-11 (100 MPa; emax Ceram 90 MPa). These veneered groups had a statistically significant difference from the monoli...
Similar results were presented in a study of Traini et al. as it was concluded that ZLS was comparable to that of existing zirconia-based ceramics and was suitable for oral function even in the posterior regions. In the literature, there have been few studies on this ceramic and a limited number of them include the failure load of the material. In one of these studi...
In literature, it has been stated that the failure load of LDS crowns was higher than veneered zirconia and could be comparable with metal ceramic systems. Doğan et al. evaluated the fracture strength of different CAD/CAM-manufactured crowns and concluded that the monolithic LDS crowns had the highest fracture resistance. Present study confirmed as monolithic LDS crowns demonstrated so satisfying...
Discussion
Implant-supported restorations have been accepted as an alternative treatment for the rehabilitation of edentulous spaces. Despite the high success rates, implant failures are inevitable and classified as early or late implant failures. Late implant failures are observed after prosthetic restoration which is primarily related to biomechanical complications. Since occlusal loads are t...
Results
Descriptive analysis (mean, standard deviation (SD), minimum, maximum) of the groups is presented in Table 4.
Group L-M exhibited the highest failure load values (2891.88 N ± 410.12 N), and the lowest values were observed in group ZL-M (1750.28 N ± 314.96 N). Two-way ANOVA indicated a statistically significant difference between materials and veneering technique (p = 0.00 < ...
Statistical analysis
The statistical analysis was performed with SPSS 24.0 (SPSS Inc, Chicago, USA). The Kolmogorov–Smirnov normality test was used to evaluate whether the data distribution of the groups was normal. The homogeneity of the variances was analyzed by Levene’s test. Since test results indicated that data distribution of the groups was normal and the variances were homogenous,...
All crowns were subjected to a combination firing that included crystallization and glaze firing according to each manufacturer’s guidelines in the ceramic furnace (Vita Vacumat 6000 M, Vita Zahnfabrik, Bad Sackingen, Germany).
For veneered restorations, the design mode was changed to “split,” and the core was constructed in 0.6-mm thickness. In group L-V (n = 12), e.max ...
Methods
Preparation of test groups
This study tested the current glass ceramic ZLS by comparing LDS with monolithic and conventional veneering techniques in implant-supported crowns: group L-M: lithium disilicate ceramic (monolithic), group L-V: lithium disilicate ceramic (conventional veneering), group ZL-M: zirconia-reinforced lithium silicate ceramic (monolithic), group ZL-V: zirconia-reinf...
Background
Implants have been successfully used to replace missing teeth for many years. Notwithstanding the high success rates, complications such as screw loosening and/or fracture, prosthesis fracture, and even implant fracture are inevitable. The reasons of the complication may be related to decreased proprioception and low tactile sensitivity which makes implant-supported crowns more susc...
Abstract
Background
Present study compared the failure load of CAD/CAM-manufactured implant-supported crowns and the stress distribution on the prosthesis-implant-bone complex with different restoration techniques.
Methods
The materials were divided into four groups: group L-M: lithium disilicate ceramic (LDS, monolithic), group L-V: LDS ceramic (veneering), group ZL-M: zirconia-reinforced l...