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Literature Update March- April 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-


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 and evaluated

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


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.


Ellis JS, Elfeky AF, Moynihan PJ, Seal C, Hyland RM, Thomason M. The impact of dietary advice on edentulous adults’ denture satisfaction and oral health-related quality of life 6 months after intervention. Clin Oral Implants Res 2010;21(4):386-391.

A denture satisfaction and oral health impact profile questionnaires were completed by 26 patients with

conventional dentures and 28 patients with implant overdentures before and 6 months after being given dietary advice (i.e. to consume more fruits, vegetables and fiber-rich food). Scores were significantly greater for denture comfort, stability and perceived chewing ability for the overdenture group after 6 months, compared to no difference between the groups before the dietary advice. There were no differences in oral health-related quality of life between the groups. The authors speculated that the diet may make the conventional denture patients more aware of the shortcomings of their prosthesis.


de  Vicente  JC,  Hernández-Vallejo  G,  Braña-Abascal  P,  Peña  I.  Maxillary  sinus  augmentation  with autologous bone harvested from the lateral maxillary wall combined with bovine-derived hydroxyapatite: clinical and histologic observations. Clin Oral Implants Res 2010;21(4):430-438.

Autogenous bone was harvested from the lateral maxillary wall in each of 34 patients and combined with bovine-derived HA in the sinus cavity; a total of 90 implants were then placed and the access window covered with a collagen membrane. After 9m months, 14 randomly selected biopsies were obtained and evaluated. New bone comprised lamellae with osteocytes in close contact with HA particles. The specimens consisted of 29% newly formed bone, 21% anorganic bovine bone and 50% marrow space. Implant survival was 98.9% (one implant was lost). Outcomes were therefore predictable with this technique.


Kim J-J, Lee D-W, Kim C-K, Park K-H, Moon I-S.  Effect of conical configuration on the maintenance of marginal bone level: preliminary results at 1 year of function. Clin Oral Implants Res 2010;21(4):430-438. Implants with straight and conical neck designs were placed in edentulous areas in 12 patients and the bone loss analyzed after 1 year. There were no significant differences in bone loss between the two groups (0.05

± 0.09 mm for straight and 0.07 ± 0.14 mm for conical neck implants).


Clinical Oral Investigations

Vol. 14 No. 2 (April 2010)

Habre-Hallage  P,  Bou  Abboud-naman  N,  Reychler  H,  van  Steenberghe  D,  Jacobs  R.  Assessment  of changes in the oral tactile function of the soft tissues by implant placement in the anterior maxilla: a

prospective study. Clin Oral Investig 2010;14(2):161-168.

Psychophysical tests were performed to assess somatosensory function in peri-implant soft tissues at implants before and up to 18 months after placement of one or two implants in the anterior maxilla. High intra-individual correlations were observed for light-touch sensation (LTS) and two-point discrimination (2PD) tests. There was no significant change in LTS thresholds over time, but there was a significant increase in

2PD from surgery, and the level was maintained for one year. However, no correlation between LTS and

2PD was found. Control sites remained stable over time for both parameters. The 2PD sensitivity may be the result of regenerated nerves, but this could not be confirmed by LTS.



Implant Dentistry

Vol. 19 No. 1 (February 2010)

Barboza EP, Stutz B, Ferreira VF, Carvalho W. Guided bone regeneration using nonexpanded polytetrafluoroethylene membranes in preparation for dental implant placements a report of 420 cases.

Implant Dent 2010;19(1):2-7.

In 420 cases of alveolar ridge maintenance for implant placement, nonexpanded PTFE membranes were placed over extraction sites and bone allograft used to prevent membrane collapse in the case of buccal wall loss. Soft tissue compatibility and keratinized gingiva were apparent at the time of implant placement, with preservation of the mucogingival position. The use of nonexpanded PTFE membranes therefore resulted in tissue suitable for implant placement.


Anner  R,  Grossman  Y,  Anner  Y,  Levin  L.   Smoking,  diabetes  mellitus,  periodontitis,  and  supportive periodontal treatment as factors associated with dental implant survival: a long-term retrospective evaluation of patients followed for up to 10 years. Implant Dent 2010;19(1):57-64.

Data were obtained regarding smoking, diabetes, periodontitis and implant survival from 475 patients who received 1,626 implants. Patients were either in a supportive periodontal program (246 patients) or only attended annual implant examination (229 patients). Mean follow-up time was 30.82 ± 28.26 months (range

1 to 114 months). The implant survival rate was 95.3% (77 implants lost). Implant survival was significantly associated with attendance in a supportive periodontal program and smoking status. Implant survival was lower in patients with moderate-to-advanced periodontal disease, but the difference was not significant, and diabetes appeared to have no influence on implant survival.


Akeredolu PA, Adeyemo WL, Omolulu OB, Karunwi O.  Implant restoration of partially edentulous ridges: a review of 121 Nigerian patients. Implant Dent 2010;19(1):57-64.

A data analysis was carried out on 121 patients who had received 227 implants supporting complete

superstructures over a 6-year period. The majority were of high socioeconomic class; 91.7% received 2- stage implant procedures and only 8.3% received immediate implants. The greatest number of implants (39.2%) was placed in the molar region. There were nine implant failures, giving a success rate of 96%.


International Journal of Oral and Maxillofacial Implants

Vol. 24 No. 7 (Suppl 2009) Vol. 25 No. 1 (February 2010)

Bornstein MM, Cionca N, Mombelli A.  Systemic conditions and treatments as risks for implant therapy. Int J Oral Maxillofac Implants 2009;24(Suppl):12-27.

A literature search was performed to identify studies citing implant survival in patients diagnosed with at least

one of 12 systemic diseases. No comparisons with and without the condition in a controlled setting were found for most conditions – only case reports or case series were available for most conditions. There appeared to be no tendency towards a higher failure rate in diabetic patients, but a formal meta-analysis was not possible. Evidence for increased implant failure in osteoporosis was low, but the use of bisphosphonates was considered a risk factor for osteonecrosis of the jaw. A low level of evidence was therefore found for contraindications in implant therapy. Prospective controlled studies are therefore required.


Martin  W,  Lewis  E,  Nicol  A.   Local  risk  factors  for  implant  therapy.  Int  J  Oral  Maxillofac  Implants


Literature on clinical studies evaluating potential local risk factors was reviewed, a total of 19 papers were selected from an initial screen of 2,681. Proximal bone may be at risk when an implant is placed within 3 mm of an adjacent tooth, but data are limited. Implant placement in infected sites may be possible, but data are insufficient. There appeared to be no evidence of soft tissue thickness or keratinized tissue as a risk factor for success. No bone density studies were found, and examination of implant stability was difficult due to a lack of validated measurements.


Heitz-Mayfield LJA, Huynh-Ba G.  History of treated peridontitis and smoking as risks for implant therapy. Int

J Oral Maxillofac Implants 2009;24(Suppl):39-68.

Literature on periodontitis and smoking as risk factors for implant success was examined. Studies were very heterogeneous and most did not account for confounding variables. Survival rates > 90% were found in patients with treated periodontitis, and a higher risk of peri-implantitis was suggested in these patients, compared to patients with no history of periodontitis, by three studies. Smoking appeared to be a significant risk factor, with significantly lower implant survival rates found in smokers versus non-smokers.


Salvi GE, Bragger U.  Mechanical and technical risks in implant therapy. Int J Oral Maxillofac Implants


From a total of 3,568 articles, 111 on the impact of mechanical/technical risk factors were selected, of which

33 were included in the analysis. After grouping according to different types of risk factor, the results indicated that more mechanical/technical complications were noted with an absence of metal framework in overdentures, cantilever extensions > 15 mm, length of construction, history of repeated complications, and bruxism. Type of retention, angled abutments, crown-implant ratio and number of implants were not associated with more complications. Implant survival/success rates did not appear to be affected.


Jung RE, Schneider D, Ganeles J, Wismeijer D, Zwahlen M, Hammerle CHF, Tahmaseb A. Computer technology applications in surgical implant dentistry: a systematic review. Int J Oral Maxillofac Implants


From a literature search on studies assesing the accuracy and performance of computer-assisted implant systems a total of 2,827 articles were identified, and 32 studies (13 clinical and 19 accuracy studies) on 29 guidance systems were selected. The total mean error calculated was 0.74 mm and 0.85 mm at the entry point of the bone and the apex, respectively. The mean implant failure rate for a follow-up of at least 12 months was 3.36% and the intraoperative complication rate was 4.6%. High implant survival and reasonable accuracy were therefore noted, but further studies are recommended.


Kapos T, Ashy LM, Gallucci GO, Weber H-P, Wismeijer D.  Computer-aided design and computer-assisted manufacturing in prosthetic implant dentistry. Int J Oral Maxillofac Implants 2009;24(Suppl):110-117.

Long-term follow-up studies focusing on the restorative aspects of CAD/CAM were evaluated; five articles

(189 prostheses supported by 888 implants) fulfilled the search criteria from an initial total of 885. The follow- up times were from 12 to 60 months for three CAD/CAM framework studies. Four implants failed before prosthesis  placement,  46  failed  after  prosthesis  placement,  and  there  was  one  prosthesis  failure.  In CAD/CAM abutment studies, 53 abutments supported by 53 implants were followed for between 12 and 44 months with no failures or significant complications. However, the clinical studies evaluated were too preliminary and underpowered for any conclusions to be drawn.


Brodala N.  Flapless surgery and its effect on dental implant outcomes. Int J Oral Maxillofac Implants


A literature search was performed for clinical studies with flapless surgery form implant placement. The available prospective studies showed an implant survival rate of 98.6%, while retrospective studies showed a survival rate of 95.9%. Mean radiographic bone loss ranged from 0.7 to 2.6 mm. Intraoperative complications reported in four studies included perforation of the buccal or lingual bony plate, and the overall incidence was

3.8%. Flapless surgery therefore appeared to be suitable, but successful outcomes are dependent on a number of factors.


Gallucci GO, Morton D, Weber H-P.  Loading protocols for dental implants in edentulous patients. Int J Oral

Maxillofac Implants 2009;24(Suppl):132-146.

From a total of 2,371 articles, 61 articles on loading protocols for rough-surfaced implants fulfilled the inclusion criteria; the data included 9,701 implants in 2,278 patients. Conventional loading with maxillary fixed prostheses and mandibular overdentures had the highest level of evidence; in contrast, evidence was insufficient for immediate loading of maxillary overdentures and immediately placed implants with foxed or removable prostheses.


Roccuzzo M, Aglietta M, Cordaro L.  Implant loading protocols for partially edentulous maxillary sites. Int J Oral Maxillofac Implants 2009;24(Suppl):147-157.

Articles on early and immediate loading of posterior maxillary implants were reviewed; 18 papers were

identified for evaluation (12 on early loading and six on immediate loading). The results of the papers suggested that early or immediate loading is possible in selected patients, although success appears to be technique-sensitive. Implant surface characteristics and good primary stability seem to be important. No conclusions could be drawn on contraindications, bone quality, stability threshold values, impact of loading forces or surgical technique. Further clinical investigations are therefore necessary.



Cordaro L, Torsello F, Roccuzzo M.  Implant loading protocols for the partially edentulous posterior mandible.

Int J Oral Maxillofac Implants 2009;24(Suppl):158-168.

A total of 19 articles (15 prospective studies and five randomized clinical trials) on early and immediate loading of implants in the posterior edentulous mandible met the inclusion criteria for evaluation. Early loading is supported by the literature and can be a routine and predictable procedure. Immediate loading was also shown to be a viable treatment alternative, however, the exclusion criteria were inconsistent in many immediate loading studies and confounding factors were noted. Further clinical trials are therefore necessary.


Grutter  L,  Belser  UC.   Implant  loading  protocols  for  the  partially  edentulous  esthetic  zone.  Int  J  Oral

Maxillofac Implants 2009;24(Suppl):169-179.

Papers relating to different implant placement and loading protocols were reviewed. The results of 10 prospective cohort studies and one case series showed an implant survival rate of 97.3% for immediately restored or conventionally loaded implants after 12 months, but the survival rate was as low as 10% from four studies with immediately placed and restored implants with full occlusal loading. It was not possible to evaluate success criteria. The authors suggested that objective esthetic success criteria should be used for implant protocols in the anterior maxilla.


Chen ST, Buser D.  Clinical and esthetic outcomes of implants placed in postextraction sites. Int J Oral

Maxillofac Implants 2009;24(Suppl):186-217.

A literature search for articles on implants in postextraction sites gathered a total of 1,107 articles, of which

91 studies were selected that met the inclusion criteria. Bone augmentation procedures appeared to be effective for defect resolution at post-extraction sites, more so with immediate and early implant placement than with late placement. Survival rates were over 95% in most studies, and survival rates were similar for immediately and early placed implants. Facial mucosal recession was often noted with immediate placement and was less common with early placement.


Jensen SS, Terheyden H.  Bone augmentation procedures in localized defects in the alveolar ridge: clinical results  with  different  bone  grafts  and  bone-substitute  materials.  Int  J  Oral  Maxillofac  Implants


Articles on different grafting protocols were searched for and a total of 2,006 identified, of which 424 were evaluated and 108 were included and categorized according to the defect type. Most were prospective or retrospective studies with a limited number of patients and only 11 were randomized controlled trials. It was not possible to identify the superiority of any one grafting protocol die to the heterogeneity of studies, but there was a high level of evidence to suggest similar implant survival rates in augmented sites to those in native bone.


Chiapasco M, Casentini P, Zaniboni M.  Bone augmentation procedures in implant dentistry. Int J Oral

Maxillofac Implants 2009;24(Suppl):237-259.

A literature search focusing on different surgical techniques and implant survival/success rates in augmented sites was performed. A review of the relevant articles identified a wide range of surgical procedures, but it was not possible to demonstrate superiority of any one treatment. Moreover, improvement of long-term implant survival was as yet unknown with some procedures, e.g. onlay autogenous bone grafts in edentulous mandibles and maxillary sinus grafting with limited/moderate pneumatisation. The authors suggested that priority should be given to simpler, less invasive procedures with less risk of complications.


Darby I, Chen ST, Buser D.  Ridge preservation techniques for implant therapy. Int J Oral Maxillofac

Implants 2009;24(Suppl):260-271.

A total of 135 abstracts were identified from a literature search on ridge preservation techniques, from which

53 articles were reviewed and 37 were evaluated. Comparisons were difficult due to the number of different techniques, methodologies and materials, but evidence for the effectiveness of ridge preservation for limiting horizontal and vertical ridge alterations in postextraction sites was observed. It was not possible to identify the superiority of any one technique.



Wennerberg A, Albrektsson T.  On implant surfaces: a review of current knowledge and opinions. Int J Oral

Maxillofac Implants 2009;25(1):63-74.

This review examined implant surface characteristics, particularly in terms of micro- and nanometer roughness, surface modifications (e.g. hydrophilicity, biochemical bonding) and suggested a hypothetical common mechanism behind enhanced bone response. Surface roughness (Sa) of implants from four major manufacturers varied from 0.3 to 1.78 μm, while developed surface area ratio varied from 24% to 143%. Implants from Biomet 3i had the lowest Sa  and implants from Straumann had the highest. Novel implants from Biomet 3i, Astra Tech and Straumann all differed from their respective predecessors and all had nano- roughness structure characteristics that were not found in their respective predecessors. It was suggested that  this  may  be  a  common  mechanism  leading  to  the  enhanced  bone  responses  to  these  implants compared to controls.


Akça K, Cehreli MC, Uysal S. Marginal bone loss and prosthetic maintenance of bar-retained implant- supported overdentures: a prospective study. Int J Oral Maxillofac Implants 2009;25(1):137-145.

A total of 35 patients received 124 implants (80 maxillary and 44 mandibular) to support bar-retained

overdentures. There was one early implant failure in the mandible and one late implant failure in the maxilla, both of which were replaced after 12 weeks. Similar soft tissue parameters were noted for maxillary and mandibular implants, and 1- and 5-year survival rates were similar. Mandibular overdentures showed a higher probability of requiring retainer re-tightening and occlusal adjustments, but there appeared to be no difference in other maintenance requirements. The results indicated that maxillary and mandibular implant- supported overdentures have similar survival and soft tissue outcomes.


Hsieh WW, Luke A, Alster J, Weiner S.  Sensory discrimination of teeth and implant-supported restorations.

Int J Oral Maxillofac Implants 2009;25(1):146-152.

Vibrational loads of 0.2, 0.4 and 0.6 N were applied to teeth and implant-supported crowns in 10 patients and the magnitude of sensation measured. Patients were able to discriminate between loads on all occasions, but the responses to implant loading were consistently less strong; however, visual analog scale scores between implants and teeth consistently increased with load. Some proprioceptive awareness of implant loading was therefore apparent, despite the lack of periodontal ligament receptors.


Peleg M, Sawatari Y, Marx RN, Santoro J, Cohen J, Bejarano P, Malinin T. Use of corticocancellous allogeneic  bone  blocks  for  augmentation  of  alveolar  bone  defects.  Int  J  Oral  Maxillofac  Implants


Severe ridge volume deficiency in 41 patients was treated with 57 allogeneic corticocancellous bone blocks and covered with a membrane. A total of 84 implants were placed after 3-4 months and radiographs were taken after a further 3-6 months. The grafts were shown to be well integrated and stable. Resorption of

2-5 mm at the buccal aspect was observed with one graft, but no other problems were noted. One implant failed to osseointegrate. The results indicated that the use of such grafts can be a suitable alternative to autogenous grafts in patients with ridge deficiency.


Cehreli  MC,  Karasoy  D,  Kokat  AM,  Akca  K,  Eckert  SE.  Systematic  review  of  prosthetic  maintenance requirements form implant-supported overdentures. Int J Oral Maxillofac Implants 2009;25(1):163-180.

A literature search for studies with implant overdentures gave 3,120 articles, of which 287 were selected for

full-text analysis and 49 were included in the review. No change in the frequency of complications over time was noted, but more matrix replacements were required after 5 years in the maxilla and mandible, and more matrix and patrix fractures occurred after 1 year in the mandible. Dislodged, worn or loose matrices were more common with ball attachments after the first year, but prosthetic complications were comparable for all attachment types, with the exception of peri-implant or inter-abutment-mucosal enlargement after 1 year.


Kronstrom M, Davis B, Loney R, Gerrow J, Hollender L.  A prospective randomized study on the immediate loading of mandibular overdentures supported by one or two implants: a 12-month follow-up report. Int J Oral Maxillofac Implants 2009;25(1):181-188.

A total of 36 patients received new maxillary and mandibular complete dentures. The patients then received

one implant in the symphyseal area (17 patients) or two implants in the canine positions (19 patients) in the interforaminal area of the mandible and the dentures were relined, provided with O-rings and connected to the implants on the day of surgery. Within 12 months there were 10 implant failures in nine patients and three patients (each with two implants) withdrew from the study, giving a 12-month survival rate of 81.8%. Six of the failures were within the first month. Caution should therefore be exercised when considering immediate loading on implant-supported overdentures on one or two implants with ball attachments.



Boronat A, Carrillo C, Peñarrocha M, Peñarrocha M.  Dental implants placed simultaneously with bone grafts in  horizontal  defects:  a  clinical  retrospective  study  with  37  patients.  Int  J  Oral  Maxillofac  Implants


Of a total of 129 implants, 73 were placed simultaneously with 37 intraoral block grafts in 37 patients. After 1 year, partial graft exposure was noted at eight sites, spontaneous re-epithelialization was observed at six sites  following  chlorhexidine  application,  and  infection  was  observed  at  two  sites,  necessitating  graft removal. No donor site complications were noted and no other complications were noted 1 year after prosthesis placement. There were three implant failures, giving an implant success rate of 95.9%.The mean

1-year bone loss was 0.64 mm. Simultaneous bone grafting and implant placement can therefore be a viable option in certain patients.


International Journal of Periodontics and Restorative Dentistry

Vol. 30 No. 2 (March/April 2010)

Shapoff CA, Lahey B, Wasserlauf PA, Kim DM.  Radiographic analysis of crestal bone levels around Laser-

Lok Collar dental implants. Int J Periodontics Restorative Dent 2010;30(2):129-137.

A total of 49 Laser-Lok implants with microtexturing were retrospectively analysed radiographically. Mean crestal bone loss after 2 and 3 years was 0.44 mm and 0.46 mm, respectively, all of which was contained within the height of the implant collar. The results suggested that the concept of a biologic seal around an implant consisting of connective tissue fibers may be clinically relevant.


Cocchetto R, Traini T, Caddeo F, Celletti R. Evaluation of hard tissue response around wider platform- switched implants. Int J Periodontics Restorative Dent 2010;30(2):163-171.

Ten patients received a total of 15 implants with body and collar diameters of 5.0 and 5.8 mm, respectively,

with healing abutments of 4.1 mm in diameter. Radiographs were taken after 2, 12 and18 months of loading. Mean peri-implant one loss was 0.30 mm after 18 months, indicating that the platform switching concept may reduce the extent of peri-implant bone loss.


Wu S-Y, Chen Y-T, Chen C-W, Chi L-Y, Hsu N-Y, Hung S-L, Ling L-J. Comparison of clinical outcomes following guided tissue regeneration treatment with a polylactic acid barrier or a collagen membrane. Int J Periodontics Restorative Dent 2010;30(2):173-179.

Guided tissue regeneration using a polylactic acid barrier or a collagen membrane was performed in 30

patients with chronic periodontitis and one or more intrabony defects of 4 mm. Clinical measurements were performed 1 week before and 6 months after surgery. Probing depth was significantly reduced and clinical attachment level was significantly increased in both groups, with no significant differences between the groups. However, bone fill was significantly greater with the collagen membrane compared to the polylactic acid barrier.


International Journal of Prosthodontics

Vol. 23 No. 2 (March/April 2010)

Rentsch-Kollar A, Huber S, Mericske-Stern R.  Mandibular implant overdentures followed for over 10 years:

patient compliance and prosthetic maintenance. Int J Prosthodont 2010;23(2):91-98.

Follow-up periods of over 10 years were completed for 147 patients with 314 implants supporting mandibular ovedentures between 1984 and 2008, at which time 101 patients were available for re-evaluation. A high compliance rate (over 90%) was found and over 80% of dentures were still in service. Major prosthetic maintenance was uncommon, and retention device complications consisted mainly of the mounting of new female retainers, bar repair and changing of ball anchors; complications and the need for prosthetic service were significantly higher with ball anchors compared to bar attachments. Implant overdentures are therefore a useful treatment, provided there is regular maintenance and prosthetic service.



Ma S, Payne AGT. Marginal bone loss with mandibular two-implant overdentures using different loading protocols: a systematic literature review. Int J Prosthodont 2010;23(2):91-98.

From a literature search of studies with two-implant overdentures, a total of 25 articles met the inclusion

criteria. Long-term results were found for conventional loading, but only short-term results were found for early and immediate loading; however, high success rates were found with all loading protocols. Long-term outcomes on marginal bone loss were not found, and there was a lack of standardization of radiographic methods for bone loss evaluation. Marginal bone loss values in the first year ranged from 0.2 to 0.7 mm for two-stage and from 0.0 mm to 2-0 mm for one-stage conventional loading protocols, while marginal bone loss ranged from 0.0 to 2.0 mm for early loading and was around 0.7 mm for immediate loading. Early and immediate loading of mandibular overdentures showed no detrimental effects, but no long-term data were available.


Journal of Biomedical Materials Research Part A

Vol. 93 No. 1 (April 2010) Vol. 93 No. 2 (May 2010) Vol. 93 No. 3 (June 2010)

Lai H-C, Zhuang L-F, Liu X, Wieland M, Zhang Z-Y, Zhang Z-Y.  The influence of surface energy on early

adherent events of osteoblast on titanium substrates. J Biomed Mater Res A 2010;93(1):289-296.

Cell morphology and cell attachment of human alveolar osteoblasts were measured on hydrophilic SLA and hydrophobic modified SLA (modSLA) surfaces, and the expression of focal adhesion kinase measured. Attachment rates were significantly higher on the modSLA surface after 3 h, and after 6 h focal adhesion kinase expression was significantly higher and more defined actin stress fibers were apparent. Cell adhesion was therefore enhanced by modSLA in the early stages of cell response.


An N, Schedle A, Wieland M, Andrukhov O, Matejka M, Rausch-Fan X.  Proliferation, behavior, and cytokine gene expression of human umbilical vascular endothelial cells in response to different titanium surfaces. J Biomed Mater Res A 2010;93(1):364-372.

Cell behavior of human umbilical vascular endothelial cells on acid-etched (A), grit-blasted/acid-etched (SLA)

and modified acid-etched (modA) and modified grit-blasted/acid-etched (modSLA) was evaluated. The greatest cell proliferation, mobility and cluster formation were observed with modA, and little cell aggregation was observed on SLA and modSLA surfaces. Gene expression of thrombomodulin, endothelial cell protein C receptor, von Willebrand factor and adhesion molecules was greatest with modSLA, suggesting that this surface is optimal for proliferation and angiogenic behavior of endothelial cells, and promoted the expression of genes that play an important role in controlling inflammation and revascularization.


Journal of Clinical Periodontology

Vol. 37 No. 3 (March 2010) Vol. 37 No. 4 (April 2010)

Holtfreter B, Kocher T, Hoffmann T, Desvarieux M, Micheelis W. Prevalence of periodontal disease and

treatment demands based on a German dental survey (DMS IV). J Clin Periodontol 2010;37(3):211-219. The survey, conducted in 2005, recorded data from 925 adults and 1040 elderly patients and performed dental examinations and social- and health-related interviews. Clinical attachment level 3 mm was found in

95.0% and 99.2% of adult and elderly patients, respectively, and probing depth 4 mm was found in 76.9%

and 87.7% of adults and elderly subjects, respectively. Periodontitis prevalence was 70.9% in adult and

87.4% in elderly subjects, with severe periodontitis apparent in one quarter of adults and half of the elderly subjects. Periodontal treatment and maintenance should therefore be an integral part of dental practice.


Fardal Ø, Linden GJ. Long-term outcomes for cross-arch stabilizing bridges in periodontal maintenance patients – a retrospective study. J Clin Periodontol 2010;37(3):299-304.

This study retrospectively analyzed 80 patients with reduced periodontal support who received a total of 94

cross-arch stabilizing bridges and who were maintained for at least 7 years (mean 10 years). Bridge loosening occurred in four patients and bridge fracture occurred in one patient. Five patients lost a total of eight abutment teeth, but no patients lost implant abutments. Rates of tooth loss were low for patients with stabilizing  bridges  and  for  patients  with  no  bridges,  but  were  higher  in  the  bridge  group.  Cross-arch stabilizing bridges as part of periodontal maintenance therapy therefore had few complications and low rates of abutment tooth loss.


O’Dowd LK, Durham J, McCracken GI, Preshaw PM. Patients’ experiences of the impact of periodontal disease. J Clin Periodontol 2010;37(4):334-339.

Data were obtained from patients with periodontal disease using semi-structured interviews conducted with a

topic guide; the data were then organized and themes identified. Effects on patients’ daily lives included impairment, functional limitation, discomfort and disability, many of the themes related to Locker’s conceptual model of oral health, with stigma and retrospective regret identified as two additional themes. Patients’ lives are therefore affected by periodontitis in a number of different ways.


Trombelli L, Rizzi A, Simonelli A, Scapoli C, Carrieri A, Farina R.  Age-related treatment response following non-surgical periodontal therapy. J Clin Periodontol 2010;37(4):346-352.

Two groups of periodontitis patients (mean age 34.7 ± 4.4 years and 58.9 ± 5.3 years) who received non-

surgical periodontal therapy were retrospectively selected and analyzed. Probing depth and bleeding on probing were significantly improved in both groups, and there were no significant differences between the groups for any of the clinical parameters; however, the risk of residual pockets following treatment was significantly greater in the older group. Age therefore has a limited effect on treatment response to non- surgical periodontal treatment.


Nygaard-Østby P, bake V, Nesdal O, Susin C, Wikesjö UME.  Periodontal healing following reconstructive surgery: effect of guided tissue regeneration using a bioresorbable barrier device when combined with autogenous   bone   grafting.   A   randomized-controlled   trial   10-year   follow-up.   J   Clin   Periodontol


Autogenous bone with or without GTR in intra-bony defects was evaluated in 40 patients; 39 patients were available for a 10-year follow-up evaluation. Probing depth and clinical attachment level were significantly improved in both groups up to 9 months, with significant changes in bone probing and gingival recession for autogenous bone + GTR but not for autogenous bone alone. At 10 years, significantly greater probing depth reduction and probing bone level gain were observed for autogenous bone + GTR, and there was a borderline  significant  improvement  in  clinical  attachment  level  gain  versus  autogenous  bone  alone. Significant  differences  were therefore  observed  with  adjunctive autogenous grafting and GTR, but the authors suggested that the results be interpreted with caution.