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Literature Update Mar - Apr 2010

Clinical Implant Dentistry and Related Research

Vol. 12 No. 1 (March 2010)

Becker W, Gabitov I, Stepanov M, Kois J, Smidt A, Becker BE. Minimally invasive treatment for papillae deficiencies in the esthetic zone: a pilot study. Clin Implant Dent Relat Res 2010;12(1):1-8.

A total of 11 patients with at least one papillary deficiency in the esthetic zone were treated with a commercially available gel of hyaluronic acid, < 0.2 ml of which was injected 2-3 mm apical to the coronal tip of the affected papillae. Patients were followed up from 6 to 25 months after initial application. Three implant sites and one tooth site showed 100% improvement,  seven sites showed 94-97% improvement, three showed 76-88% improvement, and one showed 57% improvement. The results suggested that papillary deficiencies can be enhanced by hyaluronic acid injection.


Morton D, Bornstein MM, Wittneben J-G, Martin WC, Ruskin JD, Hart CN, Buser D. Early loading after 21 days of 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(1):9-17.

A total of 89 implants were placed in single-tooth gaps or extended edentulous spaces in 56 patients and loaded after 21 days with provisional restorations in full occlusion. Definitive restorations were placed after 6 months. Two implants were removed due to lack of osseointegration and another two required prolonged healing; 85 implants were therefore loaded after 21 days. After 2 years, one further implant was lost to follow-up, but favorable clinical and radiographic outcomes were observed at the 86 loaded implants; the 2-year success rate was 97.7%. Implants with a chemically modified SLA surface can therefore result in predictable osseointegration with full occlusal loading after 21 days.

Östman P-O, Wennerberg A, Albrektsson T.  Immediate occlusal loading of NanoTite PREVAIL implants: a prospective 1-year clinical and radiographic study. Clin Implant Dent Relat Res 2010;12(1):39-47.

A total of 102 implants (66 maxillary, 36 mandibular) with a nanometer scale surface (NanoTite) were placed in 35 patients. Surgical requirements were an ISQ value of ≥ 55 and final torque of ≥ 25 Ncm. A total of 44 prostheses were immediately placed (14 single-tooth restorations, 26 FPDs and four full fixed restorations). Definitive restorations were placed after 4 months. There was one implant failure, giving a 1-year survival rate of 99.2%. Mean bone resorption was 0.37 ± 0.39 mm and the success rate, according to Albrektsson and Zarb criteria, was 93%. Immediate loading of nanometer scale-surface implants was therefore a suitable and predictable treatment option.


Aparicio C, Oazzani W, Aparicio A, Fortes V, Muela R, Pascual A, Codesal M, Barluenga N, Manresa C, Franch M. Extrasinus zygomatic implants:  three year experience from a new surgical approach for patients with pronounced buccal concavities in the edentulous maxilla. Clin Implant Dent Relat Res 2010;12(1):55-61.

Zygomatic implants are normally placed far from the alveolar crest in the case of buccal concavity: This study assessed 36 zygomatic implants placed with an extrasinus approach (the implant body passed from the alveolar crest through the concavity to then zygomatic bone), together with 104 conventional implants, in 20 patients with pronounced buccal concavity. Mean follow-up after occlusal loading was 41 months (range 36-48 months), and there were no implant losses. Emergence of the zygomatic implant was a mean 3.8 ± 2.6 mm palatal to the top of the crest, compared to 11.2 ± 5.3 mm with the conventional technique. The extrasinus approach can therefore be useful and gives predictable results.


Clinical Oral Implants Research

Vol. 21 No. 3 (March 2010)

Vol. 21 No. 4 (April 2010)

Rodrigo D, Aracil L, Martin C, Sanz M. Diagnosis of implant stability and its impact on implant survival: a prospective case series study. Clin Oral Implants Res 2010;21(3):255-261.

A total of 4,114 implants were evaluated and implant stability was classified according to degree of rotation, i.e. A (stable, no rotation), B (unstable, light rotation), C (unstable, rotation without resistance) and D (unstable, rotation and lateral oscillation), RFA was also measured on the day of surgery and at restoration placement. Of the 4,114 implants, 3,899 and 213 were classified as stable and unstable, respectively, with survival rates of 99.1% and 97.2%, respectively. Survival rates were  significantly different between the implants classified as unstable, i.e. B (98.1%), C (94.1%) and D (100%). No association was found between primary implant stability measured by RFA and implant  survival, but there was a  significant association between stability at restoration placement and implant survival.


Schwarz S, Gabbert O, Hassel AJ, Schmitter M, Séché C, Rammelsberg P. Early loading of implants with fixed dental prostheses in edentulous mandibles: 4.5-year clinical results from a prospective study. Clin Oral Implants Res 2010;21(3):284-289.

Each of 37 patients received five implants to support FPDs in the edentulous mandible; the FPDs were connected after 2 weeks. The mean observation period was 4.5 years (range 1-8 years), during which 32 complications occurred. Implant survival was 89.7% (19 implants  lost) and implant success was 84.9%. Signs of peri-implantitis were noted at 2.2% of implants, and complications included one complete prosthesis failure, 10 framework fractures, three adaptations/modifications and repair of facings. Early loading was therefore associated with higher complication rates than in delayed loading studies.

Arısan V, Bölükbaşı N, Ersanlı S, Özdemir T. Evaluation of 316 narrow diameter implants followed for 5-10 years: a clinical and radiographic retrospective study. Clin Oral Implants Res 2010;21(3):296-307.

A total of 139 patients received 316 narrow diameter  implants restored with 120 prostheses andevaluated clinically and radiographically for 60-124 months (mean 9.1 years). Survival and success rates were 92.3% and 91.4%, respectively, and the risk of failure was  increased in smoking patients and with posterior implants. Mean marginal bone loss was 1.32 ± 0.13 mm in the maxilla and 1.28 ± 0.3 mm in the mandible, which predominantly occurred within 2 years of loading. The results suggested that narrow diameter implants can be used where regular diameter implants are not suitable.


Vercruyssen M, Marcelis K, Coucke W, Naert I, Quirynen M. Long-term, retrospective evaluation (implant and patient-centred outcome) of the two implants-supported overdenture in the mandible. Part 1: survival rate. Clin Oral Implants Res 2010;21(4):357-365.

This retrospective evaluation analyzed 495 cases with ≥ 5 years loading time over the past 25 years. Follow-up visits were possible for 248 patients and data were collected by phone from another 121 patients; no contact was possible for the remaining 126 patients, so information from the last visit to the clinic was used. The majority of implants (95.5%) were machined  surface and the most used anchorage system was bar (86.3%) followed by ball attachments (11.7%). Mean survival rate after 20 years of loading was 95.5% and was adversely affected by smoking and one-stage implant placement but not influenced by bone quality or implant length.

Lindeboom JA, van Wijk AJ. A comparison of two implant techniques on patient-based outcome measures: a report of flapless vs. conventional flapped implant placement. Clin Oral Implants Res 2010;21(4):366-370.

Implant placement was performed by either flapless of conventional flapped surgery using a Nobel Guide CT surgical template in 16 patients with edentulous maxillae. A total of 96 implants were placed. The results showed no significant differences in dental anxiety, emotional impact, anxiety, procedure duration or technical difficulty, but scores were higher in the flapless group. The results suggested that flapless implant placement has more of an effect on quality of life than conventional flapped placement.


Degidi M, Nardi D, Piattelli A. Prospective study with a 2-year follow-up on immediate implant loading in the edentulous mandible with a definitive restoration using intra-oral welding.  Clin Oral Implants Res 2010;21(4):379-385.

Four inter-foraminal tapered-connection implants were placed in each of 20 patients and immediately loaded with an intra-orally welded titanium framework supporting a fixed restoration. Marginal bone loss was recorded immediately after surgery and after 6, 12 and 24 months. After 24 months, implant survival was 100%n and no framework fractures occurred. Mean marginal bone growth was 0.21 ± 0.25 mm and the mean probing depth was 1.38 ± 0.41 mm. The intra-oral welding technique therefore did not adversely affect implant survival and marginal bone loss.