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Literature Update August/September 2009

Australian Dental Journal Vol. 54 No. 3 (September 2009)

Taheri M, Molla R, Radvar M, Sohrabi K, Najafi MH. An evaluation of bovine derived xenograft with and
without a bioabsorbable collagen membrane in the  treatment of mandibular Class I furcation defects
Dent J 2009;54(3):220-227.

In 14 patients with chronic periodontitis, 18 class II furcation defects were treated with bovine xenograft alone
(control) or in combination with a bioabsorbable collagen membrane (test), with clinical parameters assessed
at baseline and at re-entry after 6 months. Open vertical and horizontal furcation depths were reduced in
both groups, and there were significant reductions  in probing depth and vertical and horizontal clinical
attachment levels, but there were no significant differences between the groups. The bioabsorbable collagen
membrane therefore did not show a significant advantage over bovine xenograft alone.
Clinical Implant Dentistry and Related Research Vol. 11 No. 3 (September 2008)

Kallus T, Bessing C, Homsi G, Eklund I. Five-year evaluation of Lifecore Restore implants: a retrospective
comparison with Nobel Biocare MK II implants
Clin Implant Dent Relat Res 2009;11(3):167-177.

In this study 290 LifeCore (LC) implants were analyzed radiologically after 1 year and compared with the
same number of NobelBiocare (NB) implants serving as a historical reference group. After 5 years, 200 LC
implants could be compared with 224 NB implants. No significant differences were found between the two
implant systems regarding survival  rates (LC 100% and NB 99.2%). The implants were also monitored for
exposed threads, compared to baseline. Because of dissimilar onset of threads, about 1 mm more implant-
retaining bone anchorage is gained with the LC as compared to NB implants. Based on the assumption that
> 3 exposed NB threads correspond to > 4 exposed LC threads, significantly more bone loss (p < 0.01) could
be demonstrated for the NB implants after 5 years. 
Degidi M, Daprile G, Piattelli A. RFA values of implants placed in sinus grafted and nongrafted sites after 6
and 12 months.
Clin Implant Dent Relat Res 2009;11(3):178-182. 

In 14 patients, 80 Xive implants (Dentsply Friadent)  were inserted; 63 implants were inserted in a site
previously treated with a sinus lift and 17 implants were inserted in healed or postextraction sites. For each
implant diameter, length, bone density, insertion torque and percentage of implant fixed to a nongrafted bone
were recorded. After 6 and 12 months, grafted sites showed higher implant stability (RFA) values than the
control sites; after 12 months, the difference in the RFA values was statistically significant (p = 0.007). A
statistically significant positive correlation was found between resonance frequency values and bone quality
after 12 months (p = 0.05). No statistically significant correlation between RFA values and all the other
variables considered was found.
Van de Velde T, Thevissen E, Persson R, Johansson C, De Bruyn H. Two-year outcome with Nobel Direct
implants: a retrospective radiographic and microbiologic study in 10 patients
Clin Implant Dent Relat Res

Ten subjects without evidence of active periodontitis received 12 Nobel Direct implants. After 3 to 6 months
implants were loaded with single crowns. At 2 years, the mean bone loss was 2.0 ± 1.1 mm (range 0.0–
3.4 mm). Three out of 12 implants with an early mean bone loss >3 mm were lost. The surviving implants
showed increasing bone loss between 6 and 24 months (p = 0.028). Only 3 out of the 12 implants were
considered successful and showed bone loss of < 1.7 mm after 2 years. High rates of pathogens, including A
actinomycetemcomitans,  Fusobacterium spp.,  P gingivalis,  P aeruginosa and  T forsythia, were found. A
normal histologic image of osseointegration of one failed implant was observed in the apical part of the
retrieved implant. Chemical spectroscopy around three unused implants revealed, despite the normal signals
from Ti, O, and C, also peaks of P, F, S, N, and Ca.
Johansson B, Friberg B, Nilson H. Digitally planned, immediately loaded dental implants with prefabricated
prostheses in the reconstruction of edentulous  maxillae: a 1-year prospective, multicenter study.
Implant Dent Relat Res 2009;11(3):194-200.

A total of 312 implants in 52 patients from eight Scandinavian clinics were digitally planned, surgically as well
as prosthetically, by using the NobelGuide system and received a prefabricated, immediately loaded Procera
implant bridge in the maxillae. In two cases, the bridges were reconstructed due to misfit. In five patients
difficulties were encountered in getting the surgical guide completely in position, and in five patients problems
were reported in getting the prostheses completely seated. All but four patients fulfilled the 1-year follow-up
(implants were manually tested for stability). Two implants were lost during the study period, resulting in a
cumulative survival rate of 99.4%. The mean marginal bone resorption from implant placement to the 1-year
follow-up was 1.3 ± 1.28 mm. More than 2 mm of marginal resorption was noted in 19% of the implants. The
most frequently reported complications during the first year were gingival hyperplasia and prosthesis-related
Mericske-Stern R, Probst D, Fahrländer F, Schellenberg M.  Within-subject comparison of two rigid bar
designs connecting two interforaminal implants: patients' satisfaction and prosthetic results.
Clin Implant
Dent Relat Res 2009;11(3):228-237.

Patients received an implant-supported  overdenture in the mandible and were randomly allocated to two
groups. Group A received a standard U-shaped bar (Dolder bar), AND in group B precision attachments
were soldered distal to the bar copings. After 3 months, patients answered a questionnaire and the bar
design was exchanged. After a period of another 3 months, the patients had to answer the same questions;
then they had the choice to keep their preferred bar. Patients that entered the study with the attachment bar
gave slightly better ratings to this type for four items. At the end of the 6-month comparison period, all but
one patient wished to continue to wear the attachment bar.  In vivo force measurements of maximum biting
were similar in both bar designs, but exhibited significantly higher axial forces in the attachment bar.
Clinical Oral Implants Research Vol. 20 No. s4 (September 2009)

European Association for Osseointegration Second Consensus Conference, 19-22 February,
Pfäffikon, Schwyz, Switzerland
Sailer I, Philipp A, Zembic A, Pjetursson BE, Hämmerle CHF, Zwahlen M.  A systematic review of the
performance of ceramic and metal implant abutments supporting fixed implant reconstructions
Clin Oral
Implants Res 2009;20(s4):4-31.

A literature search was performed; from a total of 7136 titles, 29 clinical and 22 laboratory studies were
included. Estimated 5-year survival of ceramic and metal abutments was 99.1% and 97.4%, respectively,
and the cumulative incidence of technical complications was 6.9% and 15.9%, respectively. Fracture rates
were similar for all-ceramic crowns supported by ceramic abutments and metal-ceramic crowns supported by
metal abutments. The rate of biological complications was similar for ceramic and metal abutments, but the
rate of esthetic complications tended to be more frequent with metal abutments. There was, therefore, no
evidence of differences in complications between metal and ceramic abutments, but it was noted that the
number of studies and abutments was limited for ceramic abutments.
Andreiotelli M, Wenz MJ, Kohal R-J.  Are ceramic implants a viable alternative to titanium implants? A
systematic literature review.
Clin Oral Implants Res 2009;20(s4):32-47.

From a literature search of over 800 titles, 100 were subjected to additional evaluation and 25 of these were
selected for inclusion in the review, but no randomized controlled trials evaluating the outcome of alumina
and zirconia ceramic implants were found. Histological in vivo studies showed similar BIC between alumina,
zirconia and titanium, and clinical data for alumina implants showed survival rates ranging from 23% to 98%
over 10 years, with zirconia implant studies demonstrating survival rates from 81% (21 months) to 98% (12
months). Alumina implants did no appear to be a viable alternative to titanium implants and clinical data for
ceramic implants are currently insufficient to recommend them for routine clinical use.
Schneider D, Marquardt P, Zwahlen M, Jung RE.  A systematic review on the  accuracy and the clinical
outcome of computer-guided template-based implant dentistry. Clin Oral Implants Res 2009;20(s4):73-86.
A literature search on this topic revealed 3,120 titles, of which eight regarding accuracy and 10 regarding
clinical performance were included. Mean deviation of 1.07 mm at the entry point and 1.63 mm at the apex
was calculated, and there were no significant differences found regarding method of template production or
support/stabilization. Rates for early surgical, early prosthetic and late prosthetic complications were 9.1%,
18.8% and 12%, respectively, and implant survival rates ranged from 91% to 100%.
Madrid C, Sanz M. What impact do systemically administered bisphosphonates have on oral therapy? A
systematic review.
Clin Oral Implants Res 2009;20(s4):87-95.

A literature search for bisphosphonate therapy in relation to dental implants revealed three retrospective and
one prospective study; the latter evaluated patients who did or did not receive bisphosphonate therapy for up
to 36 months prior to implant therapy. Bisphosphonate-related osteonecrosis of  the jaws (BRONJ) did not
occur, and implant outcomes were not affected. Similar  results were observed in the retrospective studies,
where BRONJ did not occur and the  implant survival was 95-100%. Guidelines on BRONJ contraindicate
implants in patients taking intravenous bisphosphonates but not in patients taking oral bisphosphonates.
Chiapasco M, Zaniboni M. Clinical outcomes of GBR procedures to correct peri-implant dehiscences and
fenestrations: a systematic review
Clin Oral Implants Res 2009;20(s4):113-123.

A literature search on studies using GBR in dehiscence and fenestration defects found seven studies
meeting the search criteria, with data on 374 implants in 238 patients. Resorbable and non-resorbable
membranes were used, with exposure/infection found in 5% of the former and 20% of the latter, but complete
or almost complete defect coverage was obtained in most cases. The overall implant survival rate was
95.7%. Conclusions were difficult to draw due to the limited number of patients and the wide number of
grafting techniques used.
Nkenke E, Stelzle F. Clinical outcomes of sinus floor augmentation for implant placement using autogenous
bone or bone substitutes: a systematic review.
Clin Oral Implants Res 2009;20(s4):124-133.

A total of 21 studies on sinus floor augmentation meeting the search criteria were identified from a literature
search. The results suggested that the type of graft was not associated with the success or complications of
the procedure, or with implant survival, and the lack of affect was no influenced by length of healing period,
timing of implant placement, height of residual alveolar crest, sinusitis or graft loss. Donor site morbidity after
harvesting of autogenous bone was documented in three studies, and this extended the operating time.
Support for the selection of autogenous bone or bone substitute was low, and there were no clear reasons to
prefer one over the other.
Thoma DS, Benić GI, Zwahlen M, Hämmerle CHF, Jung RE.  A systematic review assessing soft tissue
augmentation techniques
Clin Oral Implants Res 2009;20(s4):146-165.

Studies on increasing the width of keratinized tissue and/or soft tissue volume were searched for; a total of
25 studies on keratinized tissue augmentation and three in gain in soft tissue volume were found, of which 14
of the keratinized tissue studies met the inclusion criteria. Of these, apically positioned flap/vestibuloplasty
achieved greater gain in keratinized tissue than controls, and combination with autogenous tissue achieved
significantly more attached gingival than controls, while combination with allogenic graft resulted in more
tissue shrinkage than combination with autogenous tissue. There were no significant differences in post-
operative complications. Apically positioned flap/vestibuloplasty is therefore a suitable technique for
keratinized tissue augmentation.
Wennerberg A, Albrektsson T.  Effects of titanium surface topography on bone integration: a systematic
Clin Oral Implants Res 2009;20(s4):172-184.

A literature search for articles on the effects of titanium surface topography on bone integration identified
1184 articles, of which 120 were selected for further analysis and 100 were included in the review. A large
number of studies demonstrated the influence of surface topography, with rough surfaces showing greater
effects on bone response than minimally rough or smooth surfaces. However, comparisons between studies
were difficult due to the varying quality of surface evaluations. Topography has an influence at the
micrometer level and there is some evidence of bone response at the nanometer level.
Junker R, Dimakis A, Thoneick M, Jansen JA. Effects of implant surface coatings and composition on bone
integration: a systematic review.
Clin Oral Implants Res 2009;20(s4):185-206.

A total of 29 articles on recently developed implants and 51 on experimental surface alterations were
identified by literature review. Surface roughening also affects the surface chemical composition and
influences the bone response, but it  is unclear whether this is due to the roughness or the surface
composition. Thin calcium phosphate coatings can avoid some of the issues with thick calcium phosphate
coatings and still achieve good bone integration. However, there is a lack of evidence for a positive effect of
implant coatings including peptide sequences or growth factors on bone integration, and there is some
evidence that BMP-2 coatings may impede the bone-implant response.
Abrahamsson I, Berglundh T.  Effects of different implant surfaces and designs on marginal bone-level
alterations: a review.
Clin Oral Implants Res 2009;20(s4):207-215.

A literature search for articles on the effect of implant surfaces and designs on marginal bone level identified
10 publications: two evaluated the effect of surface characteristics, two evaluated the effect of implant
design, and six evaluated the combined effect. No evidence was found that modified surfaces are superior to
non-modified surfaces, and no implant system was found to be superior for marginal bone preservation, but
one study reported greater marginal bone preservation for implants with a conical and micro-threaded collar
compared to a cylindrical, non-threaded collar.
Renvert S, Polyzois I, Maguire R. Re-osseointegration on previously contaminated surfaces: a systematic
Clin Oral Implants Res 2009;20(s4):216-227.

This literature review identified 25 preclinical studies on re-osseointegration following peri-implantitis. Re-
osseointegration was positively influenced by access surgery with closed healing compared to non-surgical
decontamination with open healing. Open debridement  also has a positive effect, and this was more
pronounced on rough surfaces. Re-osseointegration is therefore possible with previously contaminated
surfaces but the amount varies and may be influenced by implant surface characteristics.
Clinical Oral Implants Research Vol. 20 No. 8 (August 2009)

Bilbao A, Hernández-De Oliveira M, Varela-Centelles PI, Seoane J. Assessment of dental implant stability in
osseodistraction-generated bone: a resonance frequency analysis.
Clin Oral Implants Res 2009;20(8):772-

Twenty female patients received 71 dental implants, 39 placed in native bone and 32 in osseodistraction-
generated (ODG) bone, after an 8-week consolidation period. Although implants placed in both bone types
indicated good primary stability, a statistically significant difference in favor of implants placed in pristine
bone could be identified in terms  of osteogenic distraction (as ,measured by the Osstell®mentor device).
After a 1.5-month integration period, none of the implants failed, but implant stability still recorded higher
values for implants located in the pristine bone. A positive linear correlation could be established between the
implant stability quotient (ISQ) values at implant placement and the post-integration ISQ score for both bone
types, but only 16% of the post-integration ISQ in the ODG bone could be attributed to the primary stability.
Zembic A, Sailer I, Jung RE, Hämmerle CHF. Randomized-controlled clinical trial of customized zirconia and
titanium implant abutments for single-tooth implants in canine and posterior regions: 3-year results.
Clin Oral
Implants Res 2009;20(8):802-808.

Twenty-two patients receiving 40 single-tooth implants  in canine and posterior regions were included. The
implant sites were randomly assigned to 20 zirconia and 20 titanium abutments. All-ceramic and metal–
ceramic crowns were fabricated. Follow up visits were done after 6, 12 and 36 months. Eighteen patients
with 18 zirconia and 10 titanium abutments were examined at a mean follow-up of 36 months. Both exhibited
100% survival. At two metal–ceramic crowns supported by titanium abutments chipping of the veneering
ceramic occurred. No difference of the biological outcome of zirconia and titanium abutments was observed
in terms of probing depth, plaque control record, BOP and the bone level. Both zirconia and titanium
abutments induced a similar amount of discoloration of the mucosa compared with the gingiva at natural
teeth, as measured by means of a spectrophotometer.
Krieger O, Matuliene G, Hüsler J, Salvi GE, Pjetursson B, Brägger U. Failures and complications in patients
with birth defects restored with fixed dental prostheses and single crowns on teeth and/or implants.
Clin Oral
Implants Res 2009;20(8):809-816.

Young adult patients with birth defects affecting the formation of teeth that had single unit crowns (SCs) and
fixed dental prostheses (FDPs) inserted more than 5 years ago were asked to participate in a re-
examination. The median age of the patients was 19.3 years. Over the median observation period of 15.7
years 19 out of 33 patients (58%) with reconstructions on teeth has no complications. From the patients with
FDPs and SCs on implants followed over a median observation period of 8 years, 8 out of 17 (47%) showed
a failure or a complication. From the three groups of patients, the cases with amelogenesis/dentinogenesis
imperfecta demonstrated the highest failure and complication rates. In the cases with cleft lip, alveolus and
palate (CLAP) or hypodontia/oligodontia, 71% of  the SCs and 73% of the FDPs on teeth remained
complication free over a median observation period of about 16 years. Sixty-two percent of the SCs and 64%
of the FDPs on implants remained complication free over 8 years. Complications occurred earlier with
implant-supported reconstructions.
Göllner P, Jung BA, Kunkel M, Liechti T, Wehrbein H. Immediate vs. conventional loading of palatal implants
in humans.
Clin Oral Implants Res 2009;20(8):833-837.

From 2000 to 2006, two independent groups of patients, requiring maximum anchorage, were treated. Group
1 (n = 36) was subjected to immediate functional loading within the first 24 h after insertion while group 2
(n = 40) received conventional implant loading after 12 weeks. The magnitude of orthodontic forces ranged
between 1 and 3 N. Histological workup was performed for nearly the last third of palatal implants removed
after treatment. All implants reached primary stability. However, 3/36 in group 1 and 1/40 in group 2 were
lost. The remaining implants were clinically stable and no mobility was recognized. The median BIC rates
were 76% in group 1 (n = 10) and 84% in group 2 (n = 12); the difference was not statistically significant.
Clinical Oral Investigations Vol. 13 No. 3 (September 2009)

Shirmohammadi A, Chitsazi MT, Lafzi A. A clinical comparison of autogenous bone graft with and without
autogenous periodontal ligament graft in the treatment of periodontal intrabony defects.
Clin Oral Investig

Two-wall intrabony periodontal defects in 13 patients (two defects per patient) were treated with autogenous
bone graft alone or in combination with periodontal ligament graft. Significant improvements in hard and soft
tissue parameters were observed after 6 months, but only gain in clinical attachment level was significantly
different between the two groups (significantly higher in the group with periodontal ligament graft). The
combined treatment therefore appeared to give enhanced results.
International Journal of Oral and Maxillofacial Implants Vol. 24 No. 4 (July/August 2009)

Lee D-W, Pi S-H, Lee S-K, Kim E-C. Comparative histomorphometric analysis of extraction sockets healing
implanted with bovine xenografts, irradiated cancellous allografts, and solvent-dehydrated allografts in
Int J Oral Maxillofac Implants 2009;24(4):609-615.

Bone grafting in extraction sockets in 20 patients was performed using deproteinized bovine bone mineral
(DBBM), irradiated cancellous graft  (ICA) or solvent-dehydrated allograft (SDA). Biopsies taken after 4-6
months showed that more new bone deposition peripheral to native bone with DBBM, with more residual
bone graft particles, and that ICA and SDA were more often surrounded by fibrous tissue. A more
osteoconductive effect was therefore observed with DBBM, which may make it more suitable for the
preservation of extraction sockets.
Subramani K, Jung RE, Molenberg A, Hämmerle CHF. Biofilm on dental implants: a review of the literature.
Int J Oral Maxillofac Implants 2009;24(4):616-626.

From a literature search on biofilm formation on implants, a total of 53 articles were identified. Analysis of the
articles showed that the literature on this subject is more descriptive rather than consisting of hard data. The
results showed that biofilm formation is facilitated by an increase the surface roughness and surface free
energy, although this is mainly on the basis of descriptive data, but implant-abutment design and surface
chemistry also play a role.
Geckili O, Bilhan H, Bilgin T. A 24-week prospective study comparing the stability of titanium dioxide grit-
blasted dental implants with and without fluoride treatment.
Int J Oral Maxillofac Implants 2009;24(4):684-

A total of 27 patients each received two implants (titanium dioxide grit-blasted, with or without fluoride
treatment, placed in the right and left canine regions, respectively). Resonance frequency analysis was
performed at implant placement and after 1, 2, 3, 4, 5, 6, 12 and 24 weeks. Fluctuations in implant stability
were observed over 6 weeks in the implants without fluoride treatment but remained stable throughout the
study period in those with fluoride treatment, with no early decreases in implant stability.
Sbordone L, Toti P, Menchini-Fabris GB, Sbordone C, Guidetti F.  Implant survival in maxillary and
mandibular osseous inlay grafts and native bone: a 3-year clinical and computerized tomographic follow-up
Int J Oral Maxillofac Implants 2009;24(4):695-703.

This was a retrospective analysis of 40 edentulous patients who received 109 implants in 48 onlay grafts and
88 implants in native bone. Cumulative three-year implant survival rates were 98.9% and 99.1% for implants
placed in native bone and onlay grafts, respectively; there was therefore no significant difference. With chin
grafts, mean resorption was 4.6 mm and 3.8 mm buccally and palatally, respectively, and mean resorption in
iliac crest grafts was 3.4 mm and 2.6 mm buccally and palatally, respectively. Buccal and palatal mean
resorption in native bone was 3.2 mm and 2.1 mm, respectively.
Linkevicius T, Apse P,  Grybauskas S, Puisys A.  The influence of soft tissue thickness on crestal bone
changes around implants: a 1-year prospective controlled clinical trial.
Int J Oral Maxillofac Implants

In 19 patients, a total of 46 implants were placed either at bone level (control) or 2 mm supracrestally (test);
tissue thickness was measured prior to implant placement and the implants assigned to two groups
according to tissue thickness (thick and thin). After 1 year, mean bone loss was greater for test implants in
the thin mucosa group than the thick mucosa group at both mesial and distal aspects. Mean mesial and
distal bone loss for the control implants was not significantly different. Stability of the marginal bone may
therefore be significantly influenced by the tissue thickness at the bone crest.
Nedir R, Nurdin N, Szmukler-Moncler S, Bischof M. Placement of tapered implants using an osteotome sinus
floor elevation technique without bone grafting: 1-year results.
Int J Oral Maxillofac Implants

Osteotome sinus floor elevation without bone grafting was performed in 32 patients and 54 tapered implants
were placed in sites with a residual bone height of between 1 and 6 mm (mean height 3.8 ± 1.2 mm). All
implants achieved primary stability and were loaded after a mean 4.2 ± 1.6 months. One-year implant
survival and success rates were 100% and 94.4%, respectively, and mean bone gain was 2.5 ± 1.7 mm and
the mean crestal bone loss was 0.2 ± 0.8 mm. Primary stability can therefore be achieved with tapered
implants in the posterior maxilla without bone grafting.
International Journal of Periodontics and Restorative Dentistry Vol. 29 No. 4 (July/August 2009)

Nevins ML, Camelo M, Nevins M, Schupbach P, Friedland B, Camelo JMB, Kim DM. Minimally invasive
alveolar ridge augmentation procedure (tunnelling technique) using rhPDGF-BB in combination with three
matrices: a case series.
Int J Periodontics Restorative Dent 2009;29(4):371-383.

A tunneling ridge augmentation procedure was performed  in 12 patients using rhPDGF-BB in combination
with freeze-dried bone allograft (group A), anorganic bone graft (group B) or anorganic bone graft with
mineralized collagen bone substitute (group C). Adequate bone was present for implant placement after 14
weeks in groups A and B, and new bone formation was consistently observed; however, only half the
patients in group C had adequate bone for implant placement and new bone formation was limited, with
fibrous encapsulation of graft particles. Freeze-dried bone allograft and anorganic bone graft are therefore
suitable carriers for rhPDGF-BB in ridge augmentation.
Alhezaimi K, Al-Shalan T, O’Neill R, Shapurian T, Naghshbandi J, Levi P Jr, Griffin T. Connective tissue-
cementum regeneration: a new histologic regeneration  following the use of enamel matrix derivative in
dehiscence-type defects. A dog model
Int J Periodontics Restorative Dent 2009;29(4):425-433.

A total of 30 dehiscences were created on the maxillary canines and second and fourth premolars of five
dogs; EMD was applied in the test group, while no EMD was used in the controls. After 4 months, functional
connective tissue fibers in regenerated cementum  (mean amount 3.74 ± 0.43 mm) was found at all EMD
sites, but no cementum was formed in the control sites. EMD therefore effectively promotes new cementum
and connective tissue formation.
International Journal of Prosthodontics Vol. 22 No. 4 (July/August 2009)

Alfadda SA, Attard NJ, David LA. Five-year results of immediately loaded dental implants using mandibular
Int J Prosthodont 2009;22(4):368-373.

A total of 35 patients received 70 TiUnite implants that were immediately loaded plus 69 Brånemark implants
as a backup. Another 42 patients with 111 Brånemark implants acted as a historical control. Both groups
received bar overdentures. Implant success in  both groups was approximately 98%, and there was
significant improvement in total, mandibular and functional satisfaction scores in the immediate group over 5
years, and there was a significant  positive correlation between baseline and 1-year maxillary satisfaction
scores. Immediate loading of mandibular overdentures on two implants is therefore a predictable treatment
Implant Dentistry Vol. 18 No. 4 (August 2009)

Mijiritsky E, Mardinger O, Mazor Z, Chaushu G.  Immediate provisionalization of single-tooth implants in
fresh-extraction sites at the maxillary esthetic zone: up to 6 years of follow-up.
Implant Dent 2009;18(4):326-

Non-functional immediate provisionalization with fixed restorations was performed on 24 implants in the
anterior maxilla in 16 patients and evaluated for up to 72 months. The mean follow-up time was 40.7 months.
There was one implant failure 1 month after placement, giving a survival rate of 95.8%. The mean marginal
bone loss was 0.9 ± 1.1 mm. Non-functional immediate loading can therefore result in successful implant
integration and stable peri-implant conditions.
Journal of Clinical Periodontology Vol. 36 No. 8 (August 2009)

Pretzl B, Wiedemann D, Cosgarea R, Kaltschmitt J, Kim T-S, Staehle H-J, Eickholz P. Effort and costs of
tooth preservation in supportive periodontal treatment in a German population.
J Clin Periodontol

Clinical examinations, questionnaires and IL-1 level measurements were performed on 98 patients who had
received active periodontal treatment 10 years previously to assess the effort and costs of supportive
periodontal therapy (SPT). The mean number of visits for SPT was 14.8 ± 7.4 over 10 years, with
significantly more visits for patients with a mean plaque control record  ≥ 24%. Identifying confounders
included tooth type, initial bone loss, furcation involvement, abutment status and previous regenerative
surgery. Mean costs of therapy were between €60.52 and €91.99, which were low compared to the
alternatives, even in periodontally impaired teeth.
Torres J, Ramimi F, Martinez P-P, Alkhraisat MH, Linares R, Hernández G, Torres-Macho J, López-
Cabarcos E.  Effect of platelet-rich plasma on sinus lifting: a randomized-controlled clinical trial. 
J Clin
Periodontol 2009;36(8):677-687.

Sinus augmentation procedures (144) were performed in 87 patients using anorganic bovine bone alone or
with PRP, and a total of 286 implants were placed. An ancillary study evaluated bone biopsies taken from
implant sites in five patients. Implant success rates were 96.2% and 98.6% for the bovine bone and bovine
bone + PRP groups, respectively, and both groups demonstrated similar densitometry measurements and
graft resorption. However, histological analysis demonstrated significantly greater bone augmentation in the
bovine bone + PRP group. Smoking and lack of initial bone support had a negative effect on the outcomes.
PRP is not a determining factor but can improve the osseointegration properties.
Journal of Clinical Periodontology Vol. 36 No. 9 (September 2009)

Fickl S, Thalmair T, Kebschull M, Böhm S, Wachtel H. Microsurgical access flap in conjunction with enamel
matrix derivative for the treatment of intra-bony defects: a controlled clinical trial.
J Clin Periodontol

A total of 70 intrabony defects were treated using microsurgical access flap alone or with EMD and assessed
after 6 and 12 months. There was significant radiographic bone fill, gain in clinical attachment level and
reduction in probing depth in both groups, but the improvements were greater with EMD. There was no
significant difference in gingival recession increase between the groups, and primary wound closure was
obtained at 97% of the control sites and 91% of the test sites. EMD plus microsurgical flap therefore appears
to be superior to mucosurgical flap alone.
Meijer HJA, Raghoebar GM, Batenburg RHK, Vissink A.  Mandibular overdentures supported by two
Brånemark, IMZ or ITI implants: a ten-year prospective randomized study.
J Clin Periodontol

A total of 90 edentulous patients were treated with two ITI, IMZ or Brånemark implant each (30 patients per
group) to support mandibular overdentures, with clinical and radiographic parameters assessed after 1, 5
and 10 years. 10-year implant survival rates were 100%, 98% and 93% for ITI, Brånemark and IMZ implants,
respectively, and mean marginal bone loss was limited. Satisfaction and aftercare were similar in all groups.
Mandibular overdentures supported by two implants is therefore a valid and reliable treatment technique for
edentulous patients.
Schwarz F, Sahm N, Bieling K, Becker J. Surgical regenerative treatment of peri-implantitis lesions using a
nanocrystalline hydroxyapatite or a natural bone mineral in combination with a collagen membrane: a four-
year clinical follow-up report.
J Clin Periodontol 2009;36(9):807-814.

Moderate peri-implantitis in 20 patients was treated with access flap surgery in combination with either
natural bone mineral and collagen membrane or with nanocrystalline HA. After 48 months, mean probing
depth reductions and gains in clinical attachment level were significantly higher with natural bone mineral and
collagen membrane, and radiographic bone fill was observed for eight sites compared to five sites for
nanocrystalline HA. Long-term outcomes for nanocrystalline HA without a membrane were therefore
considered to be poor.
Journal of Oral and Maxillofacial Surgery Vol. 67 No. 9 (September 2009)

Jensen OT, Cullum DR, Baer D. Marginal bone stability using 3 different  flap approaches for alveolar split
expansion for dental implants – a 1-year clinical study.
J Oral Maxillofac Surg 2009;67(9):1921-1930.

Alveolar split procedures and immediate implant placement were performed in 40 patients using three
different flap approaches (minimal flap, partial thickness flap and full mucoperiosteal flap). Retrospective
analysis after 1 year showed facial bone of ≥ 2 mm in 11 sites (10 full flap and one osteoperiosteal flap).
Implant osseointegration for the osteoperiosteal flaps, partial thickness flaps and full thickness flaps were
92.5%, 93.3% and 94.4%, respectively.
Journal of Periodontology Vol. 80 No. 7 (July 2009)

Koldsland OC, Scheie AA, Aass AM. Prevalence of implant loss and the influence of associated factors. J
Periodontol 2009;80(7):1069-1075.

Clinical and radiographic examination was performed on a total of 109 volunteers (who had received 374
implants) available for examination, from 164 invited to participate. Mean time from implant loading to
examination was 8.4 years. In 10 subjects, 18 implants were lost (4.8%) – 11 before loading, three in the first
5 years and four between 5 and 10 years. All late losses were preceded by an earlier loss. No implants were
lost after 10 years. There was a significant association between implant loss and history of smoking and
Journal of Periodontology Vol. 80 No. 8 (August 2009)

Lambert FE, Weber H-P, Susarla SM, Belser UC, Gallucci GO.  Descriptive analysis of implant and
prosthodontic survival rates with fixed implant-supported rehabilitations in the edentulous maxilla.
Periodontol 2009;80(8):1220-1230.

Studies with 1- to 15-year follow-up data, identified by electronic search, were evaluated; a total of 33 studies
were included in the analysis. Total implant survival rates ranged from 94% for 1 year to 87.7% for 15 years,
while survival rates for rough-surfaced implants were 97% and 98% for 1 and 15 years, respectively. Survival
rates were greater for implants in native bone; survival rates for machined surface implants in augmented
bone were significantly lower, but there was no significant difference in implant survival in native or
augmented bone for rough surfaced implants. Calculated prosthodontic survival rates were 98.2% and 92.1%
for 1 and 10 years, respectively.
Bornstein MM, Heynen G, Bosshardt DD, Buser D. Effect of two bioabsorbable barrier membranes on bone
regeneration of standardized defects in calvarial bone: a comparative histomorphometric study in pigs.
Periodontol 2009;80(8):1289-1299.

Standardized defects (6 x 6 x 6 mm or 9 x 9 x 9 mm) were created in pig calvariae and filled with
deproteinized bovine bone mineral (DBBM) with collagen membrane, cross-linked collagen membrane or no
membrane; a fourth group was left unfilled with non  membrane as a control. After 16 weeks, semi-
quantitative histology showed significantly greater bone regeneration when a membrane was used, with no
significant difference between the membrane groups. The membrane groups also showed a significantly
higher percentage on bone immediately below the surface on histomorphometric analysis for 9 x 9 x 9 mm
defects. Membranes therefore significantly enhanced bone regeneration, but the cross-linked collagen
membrane provided no additional advantage over the collagen membrane.
Schwarz F, Sager M, Ferrari D, Mihatovic I, Becker J.  Influence of recombinant human platelet-derived
growth factor on lateral ridge augmentation using biphasic calcium phosphate and guided bone regeneration:
a histomorphometric study in dogs.
J Periodontol 2009;80(8):1315-1323.

Lateral ridge defects in eight dogs were treated with biphasic calcium phosphate plus collagen membrane,
with or without recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and assessed after 3
weeks. Comparable bone and blood vessel formation was observed in both groups, but greater
transglutaminase II activity was observed in the rhPDGF-BB group, resulting in significantly higher mean
augmented area and mineralized tissue.
Journal of the Canadian Dental Association Vol. 75 No. 7 (September 2009)

Locker D, Quiñonez C. Functional and psychosocial impacts of oral disorders in Canadian adults: a national
population survey.
J Can Dent Assoc 2009;75(7):521-521e.

Telephone interviews were conducted with 3,033 participants using the short form Oral Health Impact Profile
(OHIP-14) to collect data on functional and psychosocial impacts due to oral problems. Of the 3,019
sufficient data sets produced, one or more impact was reported ‘fairly often’ or ‘very often’ by 19.5% of
respondents, and was higher among edentulous respondents (30.7%). Prevalence and severity were
greatest among denture wearers, received public dental care or visited the dentists irregularly. Reported
impacts were also greater among the lowest income households.
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, Endodontology Vol. 108 No. 2 (August 2009)

Kim Y-K, Kim S-G, Oh H-K, Choi Y-G, Cho Y-S, Oh Y-H, Son J-S, Ong JL. Evaluation of peri-implant tissue
in nonsubmerged dental implants: a multicenter retrospective study.
Oral Surg Oral Med Oral Pathol Oral
Radiol Endod 2009;108(2):189-195.

In 108 patients, 339 implants were placed over a 5-year period. The mean follow-up time was 30 months,
and the mean survival and success rates were 99.1% and 95.1%, respectively, while mean bone loss was
0.43 mm and mean width of buccal keratinized mucosa was 2.43 mm. Good survival and success rates were
therefore obtained with 1-stage nonsubmerged implants.
Tissue Engineering Part B: Reviews Vol. 15 No. 3 (September 2009)

Rathe F, Junker R, Chesnutt BM, Jansen JA. The effect of enamel matrix derivative (Emdogain) on bone
formation: a systematic review
Tiss Eng B Rev 2009;15(3):215-224.

A total of 20 studies were included in the review to assess the effect of EMD on bone formation. The results
indicated the following: that bone regeneration appeared to be greater with guided tissue regeneration; that
the combination of guided tissue regeneration and EMD may be similar to guided tissue regeneration alone
in intrabony defects and furcation defects; that bone regeneration is greater with EMD compared to open flap
debridement in intrabony defects; that bone formation may be greater with EMD in supporting compared to
non-supporting defects; and that EMD appears not to promote external jaw/parietal bone formation in the
titanium capsule mode.

Nhan Tam Dental Clinic – Dental Implant And Cosmetic Restoration
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