Fig. 9. Comparison of the CBD medians in the immediate implant and the control groups
Fig. 9. Comparison of the CBD medians in the immediate implant and the control groups
Fig. 8. Comparison of the CBD means in the immediate implant and the control groups
Fig. 8. Comparison of the CBD means in the immediate implant and the control groups
Fig. 7. CBD in millimeters plotted over 10 years for the control group
Fig. 7. CBD in millimeters plotted over 10 years for the control group
Fig. 6. CBD in millimeters plotted over 10 years for the immediate implant group
Fig. 6. CBD in millimeters plotted over 10 years for the immediate implant group
Fig. 5. Measurement specifications: clinical realization [6]
Fig. 5. Measurement specifications: clinical realization [6]
Fig. 4. Measurement specifications: outline [6]
Fig. 4. Measurement specifications: outline [6]
Fig. 3. Number of implants in the respective region (anterior region ranging from 13 to 23 and 33 to 43, and posterior region ranging from 18 to 14, 24 to 28, 38 to 34, and 44 to 48)
Fig. 3. Number of implants in the respective region (anterior region ranging from 13 to 23 and 33 to 43, and posterior region ranging from 18 to 14, 24 to 28, 38 to 34, and 44 to 48)
Fig. 2. Prosthodontic indications
Fig. 2. Prosthodontic indications
Fig. 1. On the left, the Tübingen ceramic implant; on the right, the Frialit stepped-screw implant. The transgingival part with the cervical groove of the Tübingen implant has been removed in the Frialit implant; this part is now replaced by a mirror-polished transgingival portion of the Frialit abutment; all the intraosseous portion of the implant has now a thread and is shaped like the origi...
IM vs. CG
Insertion
Prosthetic treatment
1st year after prosthetic treatment
2nd year after prosthetic treatment
...
Implant diameter and length
Formula for the calculation of the CBD
(CBD = coronal bone defect)
(DD = defect depth)
3.8 × 13 mm
CBD = DD + 5 mm
3.8 × 15 mm
CBD = DD + 7 mm
All other diameters
CBD = DD + 3.2 mm
Table 3 Formula for the CBD
Length (mm)
Diameter
10
13
15
3.8 mm
0
...
Age (year)
Gender
15–20
21–40
41–60
61–75
Fe...
Gomez-Roman, G., Launer, S. Peri-implant bone changes in immediate and non-immediate root-analog stepped implants—a matched comparative prospective study up to 10 years.
Int J Implant Dent 2, 15 (2016). https://doi.org/10.1186/s40729-016-0048-0
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Received: 03 November 2015
Accepted: 14 May 2016
Published: 23 May 2016
DOI: https://doi.org/10.1186/s40729-...
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 Prosthodontics, Dental School, University of Tübingen, Osianderstr. 2-8, Tübingen, D-72076, Germanyᅟ
German Gomez-Roman & Steffen Launer
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German Gomez-Roman.
The study was supported by the German Society of Research, Special research project 175, Implantology (DFG—Deutsche Forschungsgemeinschaft, Sonderforschungsbereich 175, Implantologie). The authors of this study express their appreciation to Dr. Detlef Axmann for the expert advice in statistics.
GG-R conceived of the study and participated in its design and coordination and helped to draft the m...
Perry J, Lenchewski E. Clinical performance and 5-year retrospective evaluation of Frialit-2 implants. Int J Oral Maxillofac Implants. 2003;19(6):887–91.
Quirynen M, Van Assche N, Botticelli D, Berglundh T. How does the timing of implant placement to extraction affect outcome? Int J Oral Maxillofac Implants. 2007;22:203–26.
Ortega-Martínez J, Pérez-Pascual T, Mareque-Bueno S, Hernández-Al...
Lsidor F. Clinical probing and radiographic assessment in relation to the histologic bone level at oral implants in monkeys. Clin Oral Implants Res. 1997;8(4):255–64. doi:10.1034/j.1600-0501.1997.080402.x.
Zechner W, Watzak G, Gahleitner A, Busenlechner D, Tepper G, Watzek G. Rotational panoramic versus intraoral rectangular radiographs for evaluation of peri-implant bone loss in the anterior a...
Brånemark P-I. Osseointegration and its experimental background. J Prosthet Dent. 1983;50(3):399–410.
Schulte W, Heimke G. Das Tübinger Sofortimplantat. Quintessenz. 1976;27(6):17–23.
Cooper LF, Raes F, Reside G, Garriga JS, Tarrida LG, Wiltfang J, et al. Immediate provisionalization of dental implants placed in healed alvelar ridges and extraction sockets: a 5-year prospective evaluation....
coronal bone defect (part of the implant that has no contact to the bone; a calculated value)
control group
defect depth visible in the radiographs
dots per inch
immediate implant group
interquartile range
The examination and comparison of the peri-implant bone situation in immediate implants and a control group of non-immediate implants that were matched following specific criteria over a long period of time (10 years) has shown statistically significant differences only at the time of insertion and for the Wilcoxon hypothesis in the second year after prosthetic treatment. In our study, immediate ...
When Quirynen et al. did their review on how the time difference between extraction or tooth loss and implantation affects the success of the implant, no significant difference could be found [27]. They as well as Ortega-Martínez et al. clearly demand more studies evaluating the bone situation for the future [28]. This question was the motivation for our study.
Studies that evaluate the peri-implant bone situation specifically in the Frialit 2 implant system were, among others, conducted by Krennmair et al. and Ricci et al. Krennmair et al. found a bone resorption of 1.4 ± 1.2 mm over their follow-up period [24], which compares to the results found in this study. Ricci et al. found a higher bone resorption of the crestal bone after a 5-year follow-...
The fact that the used measurement protocol is reliable has been proven in former studies [7, 8].
The use of intraoral radiographs as well as panoramic radiographs is an accepted method for the peri-implant bone evaluation [11–13]. The radiographic distortions present in panoramic imaging are well known; however, according to several studies, panoramic images are suitable to assess the crestal ...
The primary objective of this study was the assessment of the peri-implant bone situation in immediate implants over a long-term period up to 10 years and to compare it to the situation found in matched non-immediate implants because there are no similar studies published. The hypothesis was that both the immediate implantation and the implantation after a healing period using the Frialit 2 impla...
Comparing the medians (Fig. 9) of the IM and CG, a difference of 0.7 mm at the time of insertion is visible. The respective values were 0 mm for the CG and 0.7 mm for the IM group. While at the time the patients received their definite restorations, a difference of only 0.3 mm was recorded (0.9 mm for IM and 0.6 mm for CG).
Over the years after definite restorations were emplaced, the medi...
The corresponding group of non-immediate implants was named the control group (CG) and analyzed the same way, and the results are shown in Fig. 7.
Like the immediate implant group, the mean values for the CG mainly stayed stable. At the time of insertion, a value of 0.6 mm was found, which was a little smaller than the value found at the time of the prosthetic treatment (1.0 mm). The maximum v...
For the evaluation of the received data, immediate and non-immediate implants were first examined separately.
The immediate implant (IM) group and its CBD plotted against the time, starting at the time of insertion, is shown in Fig. 6. One can see that the data are quite homogeneous.
The arithmetic means of the CBD range from 1.0 to 1.9 mm, most of them lying between 1.1 and 1.5 mm. The lowes...
After this, the data set was imported into the Excel program (Microsoft Corporation, Redmond, WA 980526399, USA) for further breakdown. For the final examination of the observed values, the mesial and distal CBD was compared. Since there were no larger differences of the values, the mesial and distal CBD were averaged and this was used for further assessment. The gained results were visualized usi...
The protocol used for measuring the distances in every radiograph was described by the author [6] and is outlined in Figs. 4 and 5. Crucial is the determination of a reliable reference line for every implant type. Rather than measuring only the bone level, the “coronal bone defect,” described by the author in 1995 [6], is assessed, which is the extent to which the part of the implant that is ...
One hundred and thirty-three patients receiving 174 implants were selected: 87 immediate implants (IM) and as a matched group 87 implants that were inserted in healed bone (control group (CG)).
The mean age of the patients in this study was 42 years, the youngest patient being 15 years old and the oldest 75 years at the time they received their implant. A gender and age distribution of all ins...
All patients within this study were treated at the Dental School of the Eberhard Karls University in Tübingen between the 22nd of February in 1991 and the 24th of October in 2005. Every patient received at least one Frialit implant. The study protocol of the study was approved by the German Society of Research (Sonderforschungsbereich 175 Implantologie). Informed consent was obtained from all pat...
The present study was designed as a retrospective long-term study which compares the peri-implant bone situation of immediate implants and non-immediate implants as a control group (matched with specific criteria) using reliable measurement specifications [6–8]. The hypothesis was that both the immediate implantation and the implantation after a healing period using the Frialit 2 implant system ...
The success of dental implants has become more and more predictable since Brånemark first observed what he later called osseointegration, in 1960 [1], meaning the direct structural and functional interlocking of the natural bone and titanium implant surfaces. With implantation becoming a predictable treatment for dental restorations, patients also have become more critical towards the esthetic ou...
The purpose of this retrospective long-term study was to evaluate the peri-implant bone changes in immediate implants and matched non-immediate implants as a control group using a specific and proven measurement protocol over a 10-year period, because there are no similar studies published.
One hundred and thirty-three patients received 174 implants (immediate implants (IM) n = 87; control gr...
Fig. 6. Immunohistochemical staining of osteocalcin (a) and collagen I (c) in sections from mini pigs mandible from 9M and IR osteocalcin (b) and collagen I (d). There were statistically significant differences to osteocalcin in 9M samples and no statistically significant differences to collagen I samples. Magnification: ×40 (a, b) and ×100 (c, d)
Fig. 6. Immunohistochemical staining of ost...
Fig. 5. Representative photomicrographs of each third of the peri-implant bone of IR experimental condition (H&E, ×40). a First third (cervical third). b Intermediate third. c Apical third. Note the edges of bone grooving present rounded contour, mainly in the last third
Fig. 5. Representative photomicrographs of each third of the peri-implant bone of IR experimental condition (H&E, ×40). a...
Fig. 4. Representative photomicrographs of each third of the peri-implant bone of 9M experimental condition (H&E, ×40). a First third (cervical third). b Intermediate third. c Apical third. Bone grooving with no altered contour
Fig. 4. Representative photomicrographs of each third of the peri-implant bone of 9M experimental condition (H&E, ×40). a First third (cervical third). b Intermediat...
Fig. 3. Prothesis fixed installed on the three implants
Fig. 3. Prothesis fixed installed on the three implants
9M
IR
Third
Mean
Standard deviation
Mean
...
9M
IR
Third
Mean
Standard deviation
Mean
...
Animal
Mean
Standard deviation
Minimum
Maximum
1
150.1
30.2
122.7
184.4
2
163.3
35.1
132.4
205.3
3
175.2
15.2
153.2
204.6
4
163.6
15.4
157.3
185.1
5
153.3
15.2
146.2
174.2
6
150.3
26.4
129.2
174.6
Table 2 Removal torque value (Ncm) of three implants removed after 9 months (9M) per animal
Animal
Mean
Standard deviation
Minimum
Maximum
1
98.3
5.5
92.2
103.3
2
91.6
9.1
82.1
102.5
3
105.3
8.3
100.4
115.0
4
71.6
10.5
61.2
82.2
5
78.6
5.8
72.7
83.1
6
88.6
6.6
81
93.6
Table 1 Removal torque value (Ncm) of three implants immediate removed (IR) per animal
Silva, R.d., Passador, F. & Caria, P.H.F. Twist removal of healed vs. nonhealed implants—a mechanical and histological study in mini pigs. Int J Implant Dent 2, 23 (2016). https://doi.org/10.1186/s40729-016-0059-x
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Received: 27 April 2016
Accepted: 18 November 2016
Published: 25 November 2016
DOI: https://doi.org/10.1186/s40729-016-0059-x
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...
FOP/UNICAMP, Piracicaba, SP, Brasil
Ricardo de Oliveira Silva & Paulo Henrique Ferreira Caria
CPG São Leopoldo Mandic, Campinas, SP, Brasil
Fabrício Passador
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Correspondence to Ricardo de Oliveira Silva.
We would like to thank Mario Perussi for supplying us with the customized system, implants, and prosthetic components, Dentifix®, FESB, veterinary professors Rafael Rodrigues and Alexander Correa Borghesan, and CAPES for the scholarship and financial support.
ROS conceived the study, held surgical procedures, and drafted the manuscript. FP did the preparation and helped in reading the histologic...
Yun H-M, Ahn S-J, Park K-R, Kim M-J, Kim J-J, Jin G-Z, et al. Magnetic nanocomposite scaffolds combined with static magnetic field in the stimulation of osteoblastic differentiation and bone formation. Biomaterials [Internet]. 2016;85:88–98. [cited 2016 Feb 10] Available from: http://www.sciencedirect.com/science/article/pii/S0142961216000491.
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Implant removal torque should be higher to remove implants with long-time installation than implants removed immediately after installation. Although, removal torque causes microscopical fractures and smooth on the peri-implant bone grooves, it does not compromised the bone healing.
According to Christenson R.H. [24], the bone structure, metabolism, and regulation are reflected by markers of resorption, formation, and/or turnover. Among the markers of bone resorption is the type 1 collagen degradation and maker of bone formation: Osteocalcin. Bone formation markers derive from the osteoblastic activity, formed during the different stages of osteoblasts proliferation, differen...
In order to better use a model which reproduce the natural conditions of dental implant in action, minipigs (BR-1) have been used in this study [44], the nonprimate animal model that is most appropriate for the study of human mastication [45] and commonly used in research because suine and human share important anatomic and physiologic characteristics [46, 47].
The osseointegration process is qui...
Dental implant revolutionized oral rehabilitation, becoming the natural teeth replacement by a titanium implant, a successful alternative to treat total or partial edentulism [14, 26, 27]. Nowadays, dental implants are definitely a current procedure in many dental offices [3, 28, 29]. Despite the long-term success shown by different studies [14, 30], implant failure is inevitable [31–33]. Since,...
Duplicate sections of peri-impant bone were obtained from each implant sample to evaluate the percentage of stained areas in order to differentiate markers of collagen I and osteocalcin within both experimental conditions (Fig. 6). The highest collagen I expression values were observed at the IR experimental condition, and osteocalcin expression was higher at the 9M.
There was a statistically si...
No remarkable complications were found during the healing period. At sacrifice, all 18 implants fixed after 9 months were considered successfully integrated at the time of the removal and none showed any mobility or signal of infection at sacrifice. There was no difference in the healing between animals who had the implants immediately removed after installation, and animal whose implants were re...
Hematoxylin-eosin-stained section images were digitized and analyzed in order to recognize the presence of native bone tissue by the presence of osteocyte lacunae-containing cells and the newly formed bone tissue recognized by the absence of lacunae. Also, the characteristics of peri-implant bone, presence or absence of bone fractures, and the shape and contour of bone grooving resultant of the tr...
The mandibles were sectioned into left and right segments, and each peri-implant bone was sectioned again to individualize them. Each peri-implant bone block was fixed in buffered formalin solution, pH 7.0, for 6 days, demineralized in 10% formic acid, and dehydrated through progressing alcohol concentrations and paraffin-embedded. Paraffin blocks were sectioned at 7-μm thick mounted on poly-l-...
This study was approved by the University Animal Ethics Committee-CEUA/UNICAMP-(Campinas, SP) (no.2730-1/12). Six adult male mini pigs (BR-1 mini pigs, São Paulo, Brazil) with ~36 months old and weighed ~55 kg were used in the experiment. The mini pigs were kept in the Experimental Center of the Veterinary Faculty (FESB-Bragança Paulista, SP) and were allowed to adapt to the environment 1 wee...
Many authors investigated bone reactions around dental implants [17–21]. What happens in the peri-implant bone implants removed is not reported in scientific articles. This study evaluated the peri-implant bone after his immediate removal and after 9 months of osseointegration. The aim of the present study was to evaluate the peri-implant bone after dental implant removal.
Since the discovery of osseointegration by Branemark in Sweden in 1960, where found that when titanium screws left undisturbed in bone, the osteocytes grow in close apposition to the titanium surfaces and provide firm anchorage. This discovery was successfully applied in dental and craniofacial reconstructive surgery in 1965 [1, 2]. Dental implants became a common procedure in the modern dental tr...
The objective of this study was to evaluate the effect of removal torque (reverse torque) of titanium implants in peri-implant bone.
The P1-M1 teeth were extracted bilaterally of 6 mini pigs (BR-1). Each animal received 6 titanium implants, three for each side of mandible. On the right side of mandible, 3 implants reminded 9 months (9M) under masticatory activity and on the left side, other 3 im...