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Literature Update May - Jun 2010

British Dental Journal

Vol. 208 No. 7 (April 2010) Vol. 208 No. 8 (April 2010) Vol. 208 No. 9 (May 2010) Vol. 208 No. 10 (May 2010)

Zadik Y, Bechor R, Galor S, Levin L.  Periodontal disease might be associated even with impaired fasting

glucose. Br Dent J 2010;208(10):E20.

Medical data from 815 non-diabetic patients were analyzed. Blood samples were taken after a 14-hour fast and the distance from the cemento-enamel junction to the alveolar bone crest at inter-proximal sites was measured. Alveolar bone loss was found to be more prevalent in individuals with fasting glucose 100 mg/dL than in those with < 100 mg/dL, and was associated with serum triglycerides 200 mg/dL, total cholesterol ≥ 200 mg/dL and LDL-cholesterol of 130 mg/dL. Periodontal disease may therefore serve as a predictor for future diabetes.


Clinical Implant Dentistry and Related Research

Vol. 12 No. 2 (June 2010)

Carinci F, Brunelli G, Franco M, Viscioni A, Rigo L, Guidi R, Strohmenger L.  A retrospective study on 287

implants installed in resorbed maxillae grafted with fresh frozen allogenous bone. Clin Implant Dent Relat

Res 2010;12(2):91-98.

This  study  evaluated  69  patients  who  received  fresh  frozen  allograft  in  the  maxilla  with  subsequent placement of implants 4-6 months later; a total of 287 implants were placed. The mean follow-up time was 26 months, and the implant survival rate was 98.3% (five implants were lost); the corresponding success rate was 96% in the first year but only 40% after 4 years due to bone loss. Mean marginal bone resorption after 1 and 4 years was 1.68 ± 0.44 mm and 1.85 ± 0.98 mm, respectively. Better outcomes were observed for female patients, removable dentures and totally edentulous patients.


Cehreli MC, Uysal S, Akca K. Marginal bone level changes and prosthetic maintenance of mandibular overdentures supported by 2 implants: a 5-year randomized clinical trial. Clin Implant Dent Relat Res


Two implants (Straumann or Brånemark) were placed in each of 28 patients, with early loading of ball- retained  mandibular  overdentures.  Prosthetic  complications  were  recorded  during  the  5-year  follow-up period, and clinical assessments were performed at the end. No implants were lost and the scores for peri- implant inflammation, bleeding and calculus index were similar for both implant types, but mean marginal bone loss was significantly greater around Brånemark implants (1.21 ± 0.1 mm versus 0.73 ± 0.06 mm for Straumann implants). Overdenture survival at 1 and 5 years was similar between the groups, but ball abutment wear was significantly higher in the Brånemark group, and retainer complications and need for occlusal adjustment were significantly higher in the Straumann group.


Van de Velde T, Collaert B, Sennerby L, De Bruyn H.  Effect of implant design on preservation of marginal bone in the mandible. Clin Implant Dent Relat Res 2010;12(2):134-141.

Five implants with a machined surface (Brånemark) or roughened with or without microthreads (TiOblast)

were placed in each of 39 patients and immediately loaded with a provisional glass-fiber or metal-reinforced restoration, replaced by a metal-resin or metal-ceramic cantilever bridge after 3 months. Implant survival rates after 1 year were 98.6%, 100% and 100% for the machined, microthreaded and non-microthreaded implant, respectively, and the mean bone loss values were 1.52 ± 0.66, 0.70 ± 1.01 mm and 0.79 ± 0.79 mm, respectively. The difference between the machined implants from the roughened implants was significant. Bone preservation was therefore influenced by implant design.


Berdougo M, Fortin T, Blanchet E, Isidori M, Bosson J-L.  Flapless implant surgery using an image-guided system. A 1- to 4-year retrospective multicenter comparative clinical study. Clin Implant Dent Relat Res


A total of 552 implants were placed in 169 patients, 271 using image-guided flapless surgery (test) and 281 using a conventional procedure (control). An indication bias initially meant that comparison between the groups could not be made, but propensity scores were used to reduce the bias following logistic regression analysis. Cumulative survival rates were 96.30% and 98.57% in the test and control groups, respectively, and the survival rate for transmucosal implants was 97%. No significant differences were observed, despite initially less favourable conditions for the test group.


Telleman G, Albrektsson T, Hoffman M, Johansson CB, Vissink A, Meijer HJS, Raghoebar GM.  Peri-implant endosseous healing properties of dual acid-etched mini-implants with a nanometer-sized deposition of CaP: a histological and histomorphometric human study. Clin Implant Dent Relat Res 2010;12(2):153-160.

In each of 15 patients, two mini-implants were placed, one with a dual acid-etched surface (DAE) and one with DAE and nanometer-sized calcium phosphate particles (DEA + CaP) to fix an iliac crest bone graft in the maxilla. For each implant, part was in native bone and part was in grafted bone. After 3 months, a trend to greater bone response was observed around the DEA + CaP implants in native bone, but only old bone particles (BIC and bone area percentages) were significant. Peri-implant endosseous healing was therefore increased around DEA + CaP implants in native bone but not in grafted bone.


Clinical Oral Implants Research

Vol. 21 No. 5 (May 2010) Vol. 21 No. 6 (June 2010)

Agliardi E, Panigatti S, Clericò M, Villa C, Malò P.  Immediate rehabilitation of the edentulous jaws with full

fixed prostheses supported by four implants: interim results of a single cohort prospective study. Clin Oral

Implants Res 2010;21(5):459-465.

Two distal tilted implants and two anterior axial implants were placed in the maxilla or mandible of each of

173 patients and immediately loaded with a provisional full-arch fixed prosthesis; definitive restorations were placed after 4-6 months. For this analysis, 154 prostheses had been in function for at least 1 year. There were five implant failures (four axial maxillary implants and one tilted mandibular implant), giving implant survival rates of 98.36% and 99.73% for the maxilla and mandible, respectively. Mean bone loss at 1 year was 0.9 ± 0.7 mm and 1.2 ± 0.9 mm in the maxilla and mandible, respectively. The results suggested that the technique may be a suitable option for immediate rehabilitation.


Vercruyssen M, Quirynen M.  Long-term, retrospective evaluation (implant and patient-centered outcome) of the two-implant-supported overdenture in the mandible. Part 2: marginal bone loss. Clin Oral Implants Res


Data  from  495  patients  with  overdentures  at  least  5  years in function were retrospectively evaluated, including medical history, clinical data and radiographs. Mean bone loss values after 3, 5, 8, 12 and 16 years of loading were 0.08 ± 0.22 mm, 0.07 ± 0.14 mm, 0.06 ± 0.12 mm, 0.04 ± 0.07 mm and 0.05 ± 0.05 mm, respectively. Ongoing bone loss exceeding 0.2 mm was observed at 26 implants, and smoking, GBR, dehiscences and bone quality were seen to have a significant effect. Mean bone loss was therefore < 0.1 mm after the first year of loading.


Elsyad MA, El Shoukouki AH.  Resilient liner vs. clip attachment effect on peri-implant tissues of bar-implant- retained  mandibular  overdenture:  a  1-year  clinical  and  radiographic  study.  Clin  Oral  Implants  Res


Each of 30 patients received two implants in the canine area of the mandible via a two-stage protocol, and bars were connected to the implants after 3 months, retained with either clips or silicone-resilient liners. Peri- implant tissues were evaluated at baseline and after 6 and 12 months. Peri-implant plaque score, gingival score,  probing  depth  and  horizontal  bone  loss  were  all  significantly  decreased  with  the  resilient  liner compared to the clips. The resilient liner attachment is therefore preferable for peri-implant tissue health.


Zembić A, Glauser R, Khraisat A, Hämmerle CHF.  Immediate vs. early loading of dental implants: 3-year results of a randomized controlled clinical trial. Clin Oral Implants Res 2010;21(5):481-489.

Implants were placed in 11 patients and loaded either early (control) or immediately (test) and evaluated

after 1 and 3 years. The mean observation time was 39.8 months. There were three implant failures in the test group and none in the control groups, giving implant survival rates of 85% and 100%, respectively. There were no differences in implant stability between the groups. Marginal bone level was significantly higher at test implants (0.36 ± 0.5 mm versus 1.08 ± 0.37 mm). There was a significant decrease in bone level from baseline to 3 years in both groups, but the bone loss was not significantly different between the groups.


Roccuzzo M, De Angelis N, Bonino L, Aglietta M.  Ten-year results of a prospective cohort study on implants in periodontally compromised patients. Part 1: implant loss and radiographic bone loss. Clin Oral Implants Res 2010;21(5):490-496.

In 112 patients, who were categorized as periodontally healthy, moderately periodontally compromised or

severely periodontally compromised, implants were placed after completion of periodontal therapy. Patients were asked to perform supportive periodontal therapy at the end of treatment. Clinical and radiographic evaluation  was  performed  after  10  years.  A  total  of  18  implants  were  removed  due  to  biological complications, and 11 patients were lost to follow-up; implant survival rates were 96.6%, 92.8% and 90% for periodontally healthy, moderately periodontally compromised and severely periodontally compromised patients, respectively, and the mean bone loss was 0.75 ± 0.88 mm, 1.14 ± 1.11 mm and 0.98 ± 1.22 mm, respectively; there were no significant differences between the groups. However, the percentage of sites with

3 mm bone loss was significantly greater in the severely compromised versus the healthy group, and was associated with lack of adherence to supportive periodontal therapy.


Tetsch  J,  Tetsch  P,  Lysek  JA.   Long-term  results  after  lateral  and  osteotome  sinus  floor  elevation:  a retrospective  analysis  of  2190  implants  over  a  time  period  of  15  years.  Clin  Oral  Implants  Res


A total of 2190 implants were placed in sinus augmentation sites, 1207 in sites with lateral augmentation(461 patients) and 983 in sites with osteotome sinus floor elevation (522 patients). Most cases of lateral sinus floor elevation used bovine bone mineral (n = 1217), while 126 cases used β-tricalcium phosphate and some used only autogenous bone. Implant survival after a mean of 176 months of loading was 97.1% for both techniques, indicating that both are suitable and show acceptable results.


Thöne-Mülling M, Swierkot K, Nonnenmacher C, Mutters R, Flores-de-Jacoby L, Mengel R.  Comparison of two full-mouth approaches in the treatment of peri-implant mucositis: a pilot study. Clin Oral Implants Res


A total of 13 patients with treated chronic periodontitis and 36 implants with mucositis received full-mouth scaling with or without chlorhexidine and clinical and microbiological examination was performed at baseline and after 1, 2, 4 and 8 months. Probing depth was significantly reduced after 8 months in both groups, with no significant differences between the groups. Samples were also taken 24 h after treatment, which showed a reduction in bacteria, but this reduction was not significant at 8 months.


Mohamed S, Polyzois I, Renvert S, Claffey N.  Effect of surface contamination on osseointegration of dental implants surrounded by circumferential bone defects. Clin Oral Implants Res 2010;21(5):513-519. Mandibular premolars were extracted from four dogs and Nanotite and Osseotite implants partially inserted in  the  left  side-  After  5  weeks,  the  implants  were  removed,  decontaminated  and  placed  fully  in  the contralateral side, with the coronal 5 mm surrounded by a 1 mm circumferential defect. After 12 weeks, direct BIC was observed on the previously contaminated parts of the implants, but the results were superior with Nanotite  compared  to Osseotite. Previously contaminated implant surfaces surrounded by defects can therefore osseointegrate.


Lai HC, Zhuang L-F, Lv X-F, Zhang Z-Y, Zhang Y-X, Zhang Z-Y.  Osteotome sinus floor elevation with or without grafting: a preliminary clinical trial. Clin Oral Implants Res 2010;21(5):520-526.

Osteotome sinus floor elevation was performed in 202 patients and 280 implants were placed; in 125

patients, 191 implants were placed without grafting. Residual bone heights were 4.7 ± 2.1 mm and 5.6 ± 2.5 mm in the grafted and non-grafted groups, respectively. The cumulative implant survival rate was 95.71% and was not significantly influenced by residual bone height. Endo-sinus bone gain and crestal bone loss after 9 months were 2.66 ± 0.87 mm and 1.2 ± 0.48 mm, respectively. Predictable osseointegration can therefore be achieved with osteotome sinus floor elevation with or without grafting.


Chang M, Wennström JL.  Peri-implant soft tissue and bone crest alterations at fixed dental prostheses: a 3- year prospective study. Clin Oral Implants Res 2010;21(5):527-534.

Peri-implant assessments were performed at implant placement and after 2, 6, 12, 24 and 36 months in 16

patients with 18 prostheses supported on 43 implants. Soft tissue margin recession of approximately 0.6 mm was noted at facial implants in the first 6 months, but a mean increase of 1.1 mm was seen at proximal sites. Greater loss of proximal bone crest height was observed at inter-implant versus tooth-implant sites at 6 months. No further significant changes were observed from 6 to 36 months. Proximal bone crest level had a significant influence on proximal soft tissue height, and significant predictors of bone loss were horizontal inter-unit distance, type of proximal unit and peri-implant bone level change.


Pelegrine AA, da Costa CES, Correa MEP, Marques JFC Jr.  Clinical and histomorphometric evaluation of extraction sockets treated with an autologous bone marrow graft. Clin Oral Implants Res 2010;21(5):535-


Thirteen patients requiring tooth extraction were split into two groups a total of 15 teeth were extracted from seven patients in the control groups and 15 were extracted from six patients in the test group. Bone marrow was obtained from the iliac crest in the test group prior to the extractions and used to graft the extraction sites; control sites received no grafting. The sites were evaluated after 6 months. Preservation of the alveolar ridge was significantly better in the test group, and the height of bone loss on the buccal plate was also significantly less. Expansion or bone grafting complimentary procedures were necessary at five control sites for implant placement, but none were required in the test group. Alveolar bone repair can therefore be enhanced by autologous bone marrow.


Schmidlin K, Schnell N, Steiner S, Salvi GE, Pjetursson B, Matuliene G, Zwahlen M, Brägger U, Lang NP. Complication and failure rates in patients treated for chronic periodontitis and restored with single crowns on teeth and/or implants. Clin Oral Implants Res 2010;21(5):550-557.

Of 199 patients with chronic periodontitis from an initial total of 392 treated between 1978 and 2002, 64 were treated with single crowns. A total of 168 single crown units were examined. The mean follow-up time was

11.8 years; during this time 19 crowns were lost and there were 22 biological and 11 technical complications. The chance of remaining free of any complication after 10 years was 89.3% for crowns on vital teeth, 85.8% for crowns on endodontically treated teeth without post and core, 75.9% for crowns on endodontically treated teeth with cast post and core, and 66.2% for crowns on implants; the latter were 3.5 times more likely to yield complications or failures, while crowns on vital teeth had the lowest failure/complication rate.


Alsabeeha NHM, de Silva RK, Thomson WM, Payne AGT.  Primary stability measurements of single implants in the midline of the edentulous mandible for overdentures. Clin Oral Implants Res 2010;21(5):563-566. Each of 36 patients received an implant (Southern 8 mm diameter, Southern 3.75 mm diameter or Neoss 4 mm diameter) in the midline symphysis of the edentulous mandible. Primary stability was assessed using the Osstell device and was found to be greatest for the 8 mm implants (mean 84.8) followed by the 4 mm diameter implants (82.3). The primary stability for the 3.75 mm implants (75.3) was significantly lower. Primary stability did not appear to be influenced by host site variables, but there was no clear correlation between ISQ and implant diameter.


Retzepi M, Donos N.  Guided bone regeneration: biologic principle and therapeutic applications. Clin Oral

Implants Res 2010;21(6):567-576.

This review discusses the rationale and concept of GBR and provides an overview focusing on its effectiveness and predictability for regeneration in critical-sized cranio-maxillofacial defects, potential for neo- osteogenesis and reconstruction of the alveolar ridge. Recommendations for future research include investigating the molecular mechanisms of the healing process following GBR, identifying the factors that affect effectiveness and predictability, and evaluating the pathophysiology of the healing process in systemic conditions.



Park J-C, Kim H-D, Kim S-M, Kim M-J, Lee J-H.  A comparison of implant stability quotients measured using magnetic resonance frequency analysis from two directions: a prospective clinical study during the initial healing period. Clin Oral Implants Res 2010;21(6):591-597.

A total of 71 non-submerged implants were placed in 53 patients to replace the loss of mandibular molars. ISQ  was measured at baseline and after 4 and 10 weeks in both the bucco-lingual and mesio-distal directions. No significant differences were observed between ISQs measured in the two different directions, but the higher and lower values at each measurement point were significantly different. For implants with ISQ variation of ≥ 3 or < 3, the pattern of change of the lower value was significantly different from baseline to 10 weeks after surgery. Directional measurements and higher and lower values may therefore allow patterns of changes that may not be otherwise identified.


Sim CPC, Lang NP.  Factors influencing resonance frequency analysis assessed by Osstell mentor during implant tissue integration. I. Instrument positioning, bone structure, and implant length. Clin Oral Implants Res 2010;21(6):598-604.

Implants either 8 mm or 10 mm in length were placed in 32 patients and resonance frequency analysis

(RFA) using the Osstell mentor performed at baseline and after 1, 2, 3, 4, 5, 6, 8 and 12 weeks; clinical parameters were also assessed. ISQ increased continuously from baseline to weeks 6, 8 and 12, and was not found to be affected by the position of the Osstell device. Lower ISQ values up to week 8 were observed in lower bone density and higher ISQ values were observed with shorter implants; a significant increase in ISQ was observed with 8 mm implants but not with 10 mm implants. Reproducible ISQ values can be obtained with the Osstell mentor that are affected by implant length and bone quality.


Han J, Lulic M, Lang NP. Factors influencing resonance frequency analysis assessed by Osstell mentor during implant tissue integration. II. Implant surface modifications and implant diameter. Clin Oral Implants Res 2010;21(6):605-611.

A total of 25 implants were placed (12 SLA RN, eight SLActive RN and five SLA WN) and ISQ measured

with the Osstell mentor device at baseline and after 4 days and 1, 2, 3, 4, 6, 8, and 12 weeks. ISQ decreased from baseline to 3 weeks and then increased steadily up to 12 weeks. There were no significant differences between the implant types at each of the time points and patterns of change in ISQ were similar. The authors recommended that implant stability should therefore be monitored by ISQ after implant placement at 3 and 8 weeks.


Merheb J, Van Assche N, Coucke W, Jacobs R, Naert I, Quirynen M.  Relationship between cortical bone thickness or computerized tomography-derived bone density values and implant stability. Clin Oral Implants Res 2010;21(6):612-617.

RFA and Periotest was performed for 136 implants placed in 24 patients at implant placement and loading,

and bone density and thickness was elucidated from pre-operative CT scans. The results showed that mean RFA at implant placement was not significantly influenced by implant length or diameter or the presence of bony dehiscence. There were significant linear relationships between RFA/Periotest values and bone density or bone thickness at both implant placement and loading.


Araújo MVF, Mendes VC, Chattopadhyay P, Davies JE.  Low-temperature particulate calcium phosphates for bone regeneration. Clin Oral Implants Res 2010;21(6):632-641.

A low temperature calcium phosphate (LTCP) particulate was prepared using a machine-based process and

compared with anorganic bovine bone, bioactive glass and demineralised bone matrix in defects in rat femurs. Histological and μCT analyses were carried out at 2, 6, 12 and 16 weeks. An early increase in bone formation, complete degradation and reparative bone remodelling was observed with LTCP, whereas the other materials were not resorbed after 16 weeks. The marrow cavity and tissue were therefore reconstituted with LTCP.



Klein  MO,  Bijelic  A,  Toyoshima  T,  Götz  H,  van  Koppenfels RL, Al-Nawas B,  Duschner H.  Long-term response of osteogenic cells on micron and submicron-scale-structured hydrophilic titanium surfaces: sequence of cell proliferation and cell differentiation. Clin Oral Implants Res 2010;21(6):642-649.

Titanium disks with smooth, SLA or modSLA surfaces were analyzed for surface topography and surface elemental composition. Human osteogenic cells were then cultivated on the disks; tissue culture polystyrene served as a control. Cell counts were performed and osteogenic differentiation assessed after 24, 48 and 72 hours and 7, 14 and 21 days. Low surface carbon contamination was found on the modSLA disks. The maturation of osteogenic precursors into osteoblasts was promoted by SLA and especially by modSLA, whereas an immature phenotype remained on the smooth and control disks. The highest osteocalcin expression was found on the modSLA disks. The results indicate that cell maturation is influenced by surface topography and hydrophilicity.


Nisapakultorn K, Suphanantachat S, Silkosessak O, Rattanamongkolgul S.  Factors affecting soft tissue level around anterior maxillary single-tooth implants. Clin Oral Implants Res 2010;21(6):662-670.

Variables associated with soft tissue level were elucidated for 40 implants in anterior maxillae and the

influence of each was analyzed. Most implants replaced upper central incisors. Papilla fill of 50% was observed for 89% of the sites. The mean facial mucosal margin was 0.5 ± 0.9 mm more apical than the adjacent teeth, and this was influenced by thin peri-implant biotype, proclined implant angle, more apical facial bone crest, increased distance from contact point to bone crest, contact point to platform and contact point to implant bone; the most significant factor was thin biotype.


European Journal of Oral Implantology

Vol. 3 No. 1 (April 2010)

Esposito  M,  Grusovin  MG,  Rees  J,  Karasoulos  D,  Felice  P,  Allisa  R,  Worthington  H,  Coulthard  P.

Effectiveness of sinus lift procedures for dental implant rehabilitation: a Cochrane systematic review. Eur J Oral Implantol 2010;3(1):7-26.

A literature and database search was performed, and implant companies were contacted, for studies on

augmentation techniques in the maxillary sinus for implant-supported prostheses. A total of 29 trials were considered eligible for inclusion, of which 10 were randomized controlled trials. One trial with 15 patients suggested that short implants may be an alternative to sinus lift in suitable patients, while nine trials, with 235 patients, compared different sinus lift techniques, four of which evaluated platelet-rich plasma. There were few  trials,  with  short  follow-up  times  and  often  a  high  risk  of  bias.  However,  short  implants  can  be successfully used in 1-5 mm residual bone height, but long-term prognosis is unknown. Bone substitute material can be used instead of autogenous bone, and a crestal approach and 8 mm implants may have fewer complications than a lateral window approach and 10 mm implants if the residual bone height is 3-6 mm. Outcomes may also be improved by the use of PRP.


Wiesner G, Esposito M, Worthington H, Schlee M.  Connective tissue grafts for thickening peri-implant tissues  at  implant  placement.  One-year  results  from  an  explanatory  split-mouth  randomised  controlled clinical trial. Eur J Oral Implantol 2010;3(1):27-35.

Ten patients requiring bilateral implant placement in the premolar or molar regions were randomised to have autogenous connective tissue graft on one side and no augmentation on the contralateral side. Abutments were placed after 3 months and definitive crowns placed after another month. There were no implant failures or complications after 1 year of loading, but both groups lost significant peri-implant bone, with no significant difference between the groups However, soft tissue was significantly thicker  and the pink esthetic score was significantly better in the augmented group. Patients were satisfied with both treatments, but the esthetics of the augmented sites were significantly preferred, although five patients indicated they would not undergo the procedure again.



Bonde  MJ,  Stokholm  R,  Isidor  F,  Schou  S.   Outcome  of  implant-supported  single-tooth  replacements performed by dental students. A 10-year clinical and radiographic retrospective study. Eur J Oral Implantol


A total of 55 implant supporting single crowns were placed in 51 patients by dental students, under the supervision of experienced dentists and surgeons. Survival, clinical parameters and complications were assessed during the follow-up period. At the end of the study, 49 implants in 45 patients were available for analysis. The implant survival rate was 94%, the mean probing depth was 4.8 mm and the mean change in bone level was -0.14 mm in the first year and 0.16 mm after 10 years. Absence of bleeding around the implant sites was rarely seen, and the mean bleeding on probing score was 0.57. Peri-implantitis was observed in five patients due to excess cement, fistula was observed at two implants in two patients, and five technical complications were observed in five patients. The high survival rates and low complications suggested that implant therapy is suitable for inclusion in the undergraduate dental curriculum.


Todisco M. Early loading of implants in vertically augmented bone with non-resorbable membranes and deproteinised anorganic bovine bone. An uncontrolled prospective cohort study. Eur J Oral Implantol


Vertical GBR with anorganic bovine bone and ePTFE titanium-reinforced membranes was performed at 25 sites in 20 patients; the membranes were removed after 1 year and 64 implants placed, which were loaded after a further 30 days. Early membrane exposure occurred at two sites but healing was uneventful in the remaining 23 sites. Mean vertical bone defect was 5.6 ± 1.7 mm, and the mean vertical bone gain was 5.2 ±

1.5 mm. Histological analysis showed 52.6% xenograft and new bone. Implant survival was 100% and significant peri-implant bone loss (mean 0.95 ± 0.21 mm) was observed from implant placement to the 1-year follow-up. The results showed that vertical bone gain can be achieved with this GBR technique, with good stability.


Cannullo L, Sisti A. Early implant loading after vertical ridge augmentation (VRA) using e-PTFE titanium- reinforced membrane and nano-structured hydroxyapatite: 2-year prospective study. Eur J Oral Implantol


Vertical ridge augmentation was performed with nano-structured Mg-enriched hydroxyapatite and an ePTFE membrane in 20 patients; 42 implants were simultaneously placed. Second surgery was performed after 3 months and definitive restorations were placed within a further 2 weeks. After 2 years, there were no implant or prosthesis failures and complete bone filling was obtained in 19 out of the 20 cases, with a mean gain in bone height of 5.6 mm. Inter-implant bone levels were maintained over the 2-year period but significant peri- implant bone loss was observed (mean bone levels of 0.3 mm at loading, 0.90 mm after 1 year and 0.98 after 2 years). Significant increases in ISQ were noted, from 49.3 at implant placement to 63.9 at final restoration placement and 73.6 after 2 years.


Lambrecht JT, Cardone E, Kühl S. Status report on dental implantology in Switzerland in 2006. A cross- sectional survey. Eur J Oral Implantol 2010;3(1):71-74.

A total of 3,315 questionnaires were sent to all members of the Swiss Dental Society for background data

and implantology concepts. The response rate was 47.3%. The implant systems most frequently used were Straumann, Nobel Biocare, SPI and Frialit and most of the respondents (63.8%) placed more than 20 implants per year. The indication of choice was the edentulous mandible, and the most important factor was long-term prognosis. The majority of dentists also followed active education programs. The n umber of dentists  using  implantology  had  almost  doubled  from  a  similar  survey  12  years  previously,  and  the willingness to extend the therapeutic range was greatly increased.


Implant Dentistry

Vol. 19 No. 2 (April 2010)

Cortes ARG, Cortes DN.  Nontraumatic bone expansion for immediate dental implant placement: an analysis

of 21 cases. Implant Dent 2010;19(2):92-97.

Harvesting of autologous bone to reconstruct the resorbed alveolar ridge can be beneficial but carries the risk of certain complications. The use of bone expansion with screws, followed by immediate implant placement, to try to prevent such problems was therefore analyzed. Management solutions were based on an analysis of 21 cases of bone expansion in poor bone width.



Koh  RU,  Rudek  I,  Wang  H-L.   Immediate  implant  placement:  positives  and  negatives.  Implant  Dent


Immediate implant placement is defined as immediately following tooth extraction – this allows shorter treatment and fewer surgical procedures, but may increase the risk of implant failure. A literature search was therefore performed on this topic to investigate the pros and cons of the approach. The most important factor for successful treatment outcomes appeared to be careful case selection. The review presents suitable indications, contraindications and indications where delayed placement would be better suited, and proper case selection is discussed.


Arora NS, Ramanayake T, Ren Y-F, Romanos GE.  Platelet-rich plasma in sinus augmentation procedures: a systematic literature review: Part II. Implant Dent 2010;19(2):145-157.

A literature review was conducted to determine whether bone regeneration is more rapid or effective with the

addition of PRP to bone or bone substitutes in sinus augmentation. There are few human studies on PRP in conjunction with graft materials, although early regeneration and reduction of soft and hard tissue healing times has been shown. However, no significant benefit could be found from these studies that fulfilled the inclusion criteria. The benefit of PRP in sinus augmentation was therefore not supported.


International Journal of Oral and Maxillofacial Implants

Vol. 25 No. 2 (March/April 2010)

Neugebauer J, Ritter L, Mischkowski RA, Dreiseidler T, Scherer P, Ketterle M, Rothamel D, Zöller JE.

Evaluation of maxillary sinus anatomy by cone-beam CT prior to sinus elevation. Int J Oral Maxillofac

Implants 2010;25(2):258-265.

Cone-beam CT scans from 1,029 patients were examined, taking note of the number of septa and locations. Septa were observed in 33.2% of sinuses and 47% of patients, with 13.7% showing a septum in each sinus and 8.7% with up to three septa per sinus. There was no difference in prevalence according to age, sex or location. The most common locations, in order, were the first, second and third molar regions, respectively, the second and first premolar regions, respectively, and the canine region. Mean septa height was 11.7 ±

6.08 mm and 7.3 ± 5.08 mm for sagittal and transverse orientations, respectively.


Çehreli MC, Karasoy D, kat AM, Akca K, Eckert S. A systematic review of marginal bone loss around implants retaining or supporting overdentures. Int J Oral Maxillofac Implants 2010;25(2):266-277.

A literature review of bone loss in connection with implant-supported overdentures was performed. A total of

46 articles were included in the analysis, and a meta-analysis was possible for eight of these, but statistical analysis was not possible for maxillary overdentures. Implant design and attachment did not appear to influence bone loss for mandibular implants, and no significant differences in implant types of attachment systems were detected by meta-analysis.


Chowdhary R, Mankani N, Chandraker NK.  Awareness of dental implants as a treatment choice in urban

Indian populations. Int J Oral Maxillofac Implants 2010;25(2):305-308.

A questionnaire on dental implant awareness was administered to 10,000 Indian urban dwellers through private clinics and dental hospitals. The results showed that 23.24% had heard of dental implants, and the majority (96.23%) thought that dental insurance coverage would be required for dental implant treatment. Dentists were seen as the main source of information about treatment options.


Bergkvist G, Koh K-J, Sahlholm S, Klintström E, Lindh C.  Bone density at implant sites and its relationship to assessment of bone quality and treatment outcome. Int J Oral Maxillofac Implants 2010;25(2):321-328.

A total of 21 patients received 137 implants (87 maxillary and 50 mandibular), which were immediately

loaded with fixed provisional prostheses. Mean bone mineral density was significantly correlated with bone quality classification and stability values. Mean bone loss was not significantly different after 1 year, regardless of bone mineral density and stability at implant placement. CT can therefore be used preoperatively to assess bone density before implant placement, since these seem to correlate with implant stability.


Artzi Z, Kohen J, Carmeli G, Karmon B, Lor A, Ormianer Z.  The efficacy of full-arch immediately restored implant-supported reconstructions in extraction and healed sites: a 36-month retrospective evaluation. Int J Oral Maxillofac Implants 2010;25(2):329-335.

A total of 676 implants (367 in immediate extraction sites and 309 in healed alveoli) were placed in 54

patients to support provisional full-arch prostheses, with definitive restorations placed after 3-6 months. A total of 21 implants failed (3.1%), 13 of which were placed immediately after extraction; all failures occurred within 2 months of placement. Short and narrow implants were significantly associated with greater risk of failure. Mean crestal bone resorption after 6, 18 and 36 months was significantly less for implants in extraction sockets (0.18 mm, 0.55 mm and 0.79 mm, respectively, versus 0.31 mm, 0.78 mm and 1.1 mm, respectively for implants placed in healed sites). A correlation was also observed between crestal bone resorption and simultaneous bone augmentation and implant placement.


Oliva J, Oliva X, Oliva JD.  Five-year success rate of 831 consecutively placed zirconia dental implants in humans: a comparison of three different rough surfaces. Int J Oral Maxillofac Implants 2010;25(2):336-


A total of 831 coated, uncoated and acid-etched ZrO2  implants with five different implant designs were placed in 378 patients, using standard or flapless surgical procedures and simultaneous bone augmentation or sinus elevation, and followed for up to five years. Implant success rates for coated, uncoated and acid- etched implants were 92.77%, 93.57% and 97.60%, respectively; the difference for the acid-etched group was significant. Rough surface zirconia dental implants may therefore be a suitable alternative treatment for tooth replacement.


Tortamano P, Camargo LOA, Bello-Silva MS, Kanashiro LH.  Immediate implant placement and restoration in the  esthetic  zone:  a  prospective  study  with  18  months  of  follow-up.  Int  J  Oral  Maxillofac  Implants


In each of 12 patients, a hopeless maxillary incisor was removed and immediately replaced with an implant, and a provisional restoration was immediately placed. Clinical peri-implant measurements were recorded at implant placement and restoration and after 6 weeks and 3, 6, 12 and 18 months. There were no implant failures up to 18 months, and there were no significant differences in the distances between the incisal edge of  the  adjacent  teeth  and  tips  of  the  mesial/distal  papillae  at  any  time,  and  no  alterations  in  crown dimensions. Immediate implantation and restoration may therefore be a suitable option in certain patients.


Jofré J, Conrady Y, Carrasco C.  Survival of splinted mini-implants after contamination with stainless steel. Int

J Oral Maxillofac Implants 2010;25(2):351-356.

In the anterior mandibles of 45 patients a total of 90 implants were inserted using a flapless protocol (44 placed without a guide (ball group) and 46 using a stainless steel guide (bar group)), and mandibular overdentures were immediately placed. In an in vitro analysis, five implants were contaminated with a stainless steel guide and observed to identify surface contaminants and chemical composition, compared to implants from their original containers. One implant failure occurred in the bar group, giving an implant survival rate of 97.8%, while four failed in the ball group, giving an implant survival rate of 90.9%. Carbon and oxygen was observed on all implants in the in vitro analysis, and silica, calcium, iron and chromium were found on those in contact with stainless steel. Stainless steel contamination did not appear to generate contamination that jeopardized implant survival.


Krennmair G, Seemann R, Schmidinger S, Ewers R, Piehslinger E.  Clinical outcome of root-shaped dental implants of various diameters: 5-year results. Int J Oral Maxillofac Implants 2010;25(2):357-366.

A total of 541 implants placed in 216 patients were retrospectively evaluated; 198 of the patients were

available for a 5-7-year follow-up evaluation. Survival and success rates after 5 years were 98.3% and

97.3%, respectively, and the failure rate was slightly greater for 3.8 mm diameter implants (3.7%) compared to 4.3 mm and 5.0/6.0 mm implants (1.4% and 1.0%, respectively). Mean peri-implant bone resorption was

1.8 ± 0.4 mm. All prostheses remained in function, and the most frequent prosthodontic maintenance requirements were abutment screw loosening (4.5%) and isolated crown loosening (9.8%).



Stanford CM, Wagner W, Rodriguez y Baena R, Norton M, McGlumphy EA, Schmidt J.  Evaluation of the effectiveness  of  dental  implant  therapy  in  a  practice-based  network  (FOCUS).  Int  J  Oral  Maxillofac Implants 2010;25(2):367-373.

A total of 549 subjects requiring a minimum of two dental implants were recruited and a total of 1,893

implants were placed. At the 1-year recall, 340 patients with 1,246 implants (779 maxillary and 467 mandibular) were available for analysis. A total of 17 implants in 15 patients were lost after 1 year, giving a cumulative a survival rate of 98.6%. The risk of implant loss was greater at sites with advanced resorption and for wider diameter implants, but there was no relationship between implant loss and implant length or anatomic location.


Semper W, Heberer S, Nelson K.  Retrospective analysis of bar-retained dentures with cantilever extension:

marginal  bone  level  changes  around  dental  implants  over  time.  Int  J  Oral  Maxillofac  Implants


Data were obtained from 48 patients with implant-supported bar-retained cantilevered (up to 12 mm) prostheses, on a total of 313 implants (172 in the maxilla supporting 30 prostheses and 141 in the mandible supporting 36 prostheses). Changes in bone level at mesial and distal implant sites were measured on panoramic radiographs. Mean mesial and distal bone loss after 4 years was 2.20 ± 0.91 mm and 2.31 ±

1.05 mm, respectively. There was no correlation between implant length, number of implants placed or cantilever length and bone loss, but there was a significant correlation between jaw (maxilla or mandible), implant system and bone loss. Bar-retained prostheses with cantilever extensions up to 12 mm are therefore a suitable treatment option.


Mangano C, Mangano F, Piattelli A, Iezzi G, Mangano A, La Colla L.  Prospective clinical evaluation of 307 single-tooth  Morse  taper-connection  implants:  a  multicenter  study.  Int  J  Oral  Maxillofac  Implants


A total of 307 Morse taper connection implants (162 maxillary, 145 mandibular) were placed in 295 patients over a 4-year period, with evaluations planned after 12, 24, 36 and 48m months. The mean follow-up time was 30.79 months. The rate of abutment loosening was very low (0.66%); only two cases of abutment loosening were noted. The implant survival rate and implant/crown success rate was 98.4% and 97.07%, respectively, and the mean distance from implant shoulder to first BIC was 1.14 mm. Morse taper connection implants are therefore a good option for single-tooth restoration.


Atieh  MA,  Payne  AGT,  Duncan  WJ,  de  Silva  RK,  Cullinan  MP.  Immediate  placement  or  immediate restoration/loading of single implants for molar tooth replacement: a systematic review and meta-analysis. Int J Oral Maxillofac Implants 2010;25(2):401-415.

An  electronic  database  search  was  performed  and  a  meta-analysis  carried  out,  on  data  relating  to

immediately placed single implants in molar sites. For implants placed immediately in molar extraction sockets, nine studies with 1,013 implants were identified; the implant survival rate was 99.0%, and no differences were observed between immediate or delayed restoration/loading. For implants placed in healed molar sites, four studies with 188 implants were identified; the implant survival rate was 97.9%, and no differences were observed between immediate and delayed loading.


Journal of Clinical Periodontology

Vol. 37 No. 5 (May 2010) Vol. 37 No. 6 (May 2010)

Leininger M, Tenenbaum H, Davideau J-L.  Modified periodontal risk assessment score: long-term predictive

value of treatment outcomes. A retrospective study. J Clin Periodontol 2010;37(5):427-435.

Re-examination of 30 patients was performed 6-12 years after the initial diagnosis and treatment of periodontitis. Periodontal risk assessment diagram surface (PRAS) score was elucidated and the patients classified into low-to-moderate, high risk or non-compliant (if no supportive periodontal therapy was not attended) groups. Tooth loss was significantly higher in the high-risk group, probing depth reduction was lower and bleeding on probing reduction was greater. Probing depth reduction was significantly greater in the compliant versus the non-compliant group. PRAS was therefore reliable in evaluating long-term tooth loss and susceptibility to periodontal disease.



Fransson C, Tomasi C, Pikner SS, Gröndahl K, Wennström JL, Leyland AH, Berglundh T. Severity and pattern of peri-implantitis-associated bone loss. J Clin Periodontol 2010;37(5):442-448.

Bone level measurements from intra-oral radiographs taken after the 1-year follow-up were obtained for 419

implants with a history of bone loss in 182 subjects. Mean bone loss after the first year was 1.68 mm; bone loss 2 mm was observed at 32% of implants. The pattern of bone loss was non-linear and the rate increased over time. The pattern of bone loss varies between subjects but was similar within the same subject.


Schwarz F, Sahm N, Schwarz K, Becker J.  Impact of defect configuration on the clinical outcome following surgical regenerative therapy of peri-implantitis. J Clin Periodontol 2010;37(5):449-455.

Access flap surgery and application of natural bone mineral and a collagen membrane was used for surgical

therapy of periodontitis in 27 patients with Class Ib, Class Ic or Class Ie intrabony defects. Higher changes in probing depth and clinical attachment level were observed in Class Ie defects at 6 and 12 months, but differences were significant only at 6 months. The lowest changes in probing depth and clinical attachment level were observed in Class Ib and Class Ic defects at the mid-buccal aspect. The outcome of surgical regenerative therapy may therefore be influenced by the defect configuration.


Chao Y-L, Chen H-H, Mei C-C, Tu Y-K, Lu H-K.  Meta-regression analysis of the initial bone height for predicting implant survival rates of two sinus elevation procedures. J Clin Periodontol 2010;37(5):456-465. Associations