There are two ways of looking at secondary failures of osseointegration; one is to reflect on possible causes for the failure, the other focuses on the pathology per se. In the first case, background factors such as mechanical trauma (adverse loading) or inflammations/infections are being discussed as the cause of failure. Then peri-implantitis is a term reserved for implant disturbance due to inflammation/infections only. However, irrespective of the original reason for the failure being adverse loading or inflammation/infection, the end result with bone resorption and inflammation may be very similar. Hence, in the present article, an alternative outlook has been chosen. Trigerring factors for peri-implantitis are generally gathered under four categories: lesions of peri-implant attachment, presence of aggressive bacteria, excessive mechanical stress, and corrosion. If only one of these factors would start a chain reaction leading to lesions, then the other factors may combine to worsen the condition. With other words, peri-implantitis is a general term dependent on a synergy of several factors, irrespective of the precise reason for first triggering off symptoms.

The Peri-Implantitis: Implant Surfaces, Microstructure, and Physicochemical Aspects

Objectives The aim of the present study was to compare the delayed-immediate (Im) and the delayed (De) protocols for placement of single-tooth implants. Material and methods After allocation to the Im and De groups by random, 46 patients were treated with a single-tooth implant with acid etched surfaces (Osseotite) in the anterior or pre-molar region of the maxilla or the mandible on average 10 days (Im) or 3 months (De) following tooth extraction, respectively. Forty-one patients attended a follow-up visit 2 years after implant placement corresponding to 1(1/2) years of loading of the implant restorations. Peri-implant and prosthetic parameters were evaluated clinically and marginal bone levels measured on radiographs. Results Three implants were lost, all before mounting of the crown. None of the implant restorations had failed after 1(1/2) years of function. Probing pocket depths were reduced by up to 1.4 mm on average from the time of loading to the 2-year follow-up and at that time, no significant difference between the Im and De groups was found (4.2 versus 4.1 mm). A statistically significant radiographic marginal bone loss had occurred in the Im group (mean=0.8 mm) as well as in the De group (mean=0.7 mm) in the follow-up period. However, a mean marginal bone level of approx. 1.5 mm in both groups measured from the implant-abutment junction was found to be acceptable. It was demonstrated that probing pocket depths and marginal bone levels after 1(1/2) years of loading of the implant-retained crowns were not influenced by the presence of peri-implant bone defects immediately after implant placement. Furthermore, no severe prosthodontic complications, such as screw loosening or porcelain fractures, arose in this study material. Conclusion High success rates of single-tooth implants after 1(1/2) years of function were achieved using the delayed-immediate and delayed implant placement techniques.

Clinical and radiographic performance of delayed-immediate single-tooth implant placement associated with peri-implant bone defects. A 2-year prospective, controlled, randomized follow-up report.

Background: The aims of this pilot study were to evaluate the efficacy of treatment consisting of the immediate loading of implants placed immediately after tooth extraction in full-arch restorations and to compare the clinical and radiographic outcomes of implants placed in healed versus postextraction sites in the same group of patients.Methods: Twenty-three patients who needed full-arch restorations were treated. One hundred forty-four implants were placed: 59 after tooth extraction (test group) and 85 in healed sites (control group). Within 48 to 72 hours of implant placement, nine maxillary and 15 mandibular arches received screw-retained fixed prostheses, consisting of a titanium framework fabricated with a computer-aided design and manufacturing techniques and composite resin teeth. The insertion torque for implants was ≥30 Ncm. Implant stability measurements (ISQ) and radiographs of the marginal bone level (MBL) change were performed at prosthesis delivery and after 1 year.Results: One implant in ...

Immediate Occlusal Loading of Immediately Placed Implants Supporting Fixed Restorations in Completely Edentulous Arches: A 1-Year Prospective Pilot Study

The present study comprises an investigation of 7 different probe types, representing currently-marketed major designs (WHO-CPITN, Williams, Michigan), as well as available calibration systems (engraved, etched and painted markings). Width of markings, accuracy of calibration from probe tip, and tine diameter at the tip and at specified points along the tine were assessed, using a stereomicroscope at a magnification of x 40. Blind duplicate measurements of these probe tine characteristics were 100% reproducible to within 0.01 mm. There was an overall range in marking width from 0.00-1.13 mm. The best marking, in that it had no appreciable width and the highest accuracy, was the discrete transition between normal and engraved parts of probes with engraved bands. Mean inaccuracies of different probe sets varied from 0.06 to 0.22 mm. Probes from the same batch from the same production line could differ by more than 0.5 mm in calibration. Mean tip diameter ranged from 0.28 to 0.70 mm. It was concluded that probe tine diameter and calibration should be considered in addition to other variables of periodontal probing. Standardisation of tine characteristics and avoidance of the use of different types or batches in a single study should enhance the accuracy and reproducibility of periodontal probe-dependent measurements.

Marking width calibration from tip and tine diameter of periodontal probes

espanolLa literatura cientifica parece indicar que la conexion/desconexion del pilar protesico puede provocar alteraciones en la insercion epitelial, causando sangrado y ulceracion en el mismo. Esta ruptura mecanica se puede considerar como una herida abierta con la exposicion del tejido conjuntivo, lo cual puede resultar en una respuesta inflamatoria y consecuentemente en migracion apical epitelial. Esta tesis resume un trabajo de investigacion experimental “in vivo” disenado con el objetivo principal de evaluar histologicamente el comportamiento del tejido oseo marginal, cuando se manipula, repetidamente, el pilar de conexion en implantes “switching-platform” colocados en perros Beagle. El objetivo secundario del estudio fue evaluar el comportamiento marginal de tejido blando tanto histologicamente (anchura bilogica) como clinicamente (cambios en el margen de la encia), y radiograficamente el comportamiento marginal de tejido duro (nivel oseo marginal), variando solo la estabilidad de la conexion del pilar durante el procedimiento estandar de colocacion de implantes Straumann® Bone Level la y su rehabilitacion protesica. Se seleccionaron seis perros Beagle adultos fueron seleccionados, y se extrajeron los premolares en las posiciones Pm3 y Pm4 del ambos lados izquierdo y derecho, dejando un periodo de cicatrizacion de 3 meses. En este momento, se colocaron 24 implantes (BL) (Straumann®, Basilea, Suiza) O 3.3 / 8 mm, dos en cada lado y en las regiones Pm3 y Pm4. En uno de los lados (grupo control), se colocaron 12 pilares de cicatrizacion conicos O 3,6 mm, y en el otro lado (grupo teste) lado, se conectaron 12 pilares multibase Narrow CrossFitTM (NC) (Straumann®, Basilea, Suiza) en el momento de la cirugia de colocacion de los implantes. En el grupo test, todos los procedimientos de protesis se realizaron directamente al pilar multibase pilar sin desconectarlo, y en el grupo control, el pilar multibase se conecto / desconecto cinco veces (en las semanas 6/8/10/12/14) durante los procedimientos protesicos. Posteriormente se confeccionaron 12 puentes fijos metalicos y se atornillaron 14 semanas despues de la colocacion de los implantes. Una visita de higiene / control fue realizada seis meses despues de la colocacion de los implantes. Los animales fueran sacrificados a los 9 meses del estudio. Los parametros clinicos y radiograficos (peri-apicales) se registraron en cada visita. El analisis histometrico se realizo para los 24 implantes. La distancia desde el hombro del pilar multibase al primero contacto del implante con hueso (S-BIC) se definio como variable principal. Se utilizo para el analisis estadistico el test de Wilcoxon (n = 6). No se encontraron diferencias estadisticamente significativas (p = 0,917 bucal, lingual p = 0,463) entre los grupos teste y control tanto en lingual como en bucal, para la distancia S-BIC. Solo el parametro aBE-BC (distancia desde el extremo apical del epitelio de union hasta el primer contacto oseo con el implante) en bucal del Pm3 (p = 0,046) presento diferencias estadisticamente significativas entre los grupos test y control. El grupo control presento 0.57 mm mas de recesion que el grupo test, siendo esta diferencia estadisticamente significativa entre los dos grupos (p Asi y dentro de los limites de este estudio los animales, se puede concluir que la conexion/ desconexion de pilares proteticos “switching-platform” durante la fase protesica del tratamiento con implantes, no induce la reabsorcion osea marginal. Sin embargo, puede presentar una influencia negativa en la insercion conectiva bucal, haciendola mas corta, especialmente en los biotipos finos. En cualquier caso en este estudio, este efecto no supuso mayor reabsorcion osea. EnglishBackground: The influence of dental implants on the surrounding soft and hard tissue is crucial in defining the implantâ€™s functional and esthetics success. Some previous investigations have evaluated the effects of the microgap between the roughened and smooth titanium surfaces on crestal bone levels. Greater crestal bone resorption occurs if the interface is placed below the level of the crestal bone (1). A recent dog study (2) showed that the soft tissue attachment around titanium implants is adequately established soon after surgery. Fibroblasts predominated in the connective tissue interface after 2 weeks, decreasing in density by 4 weeks. The organization of collagen fibers was seen after 4-6 weeks, and epithelial proliferation was evident after 1-3 weeks, with mature epithelial tissue after 6-8 weeks. In addition, preliminary results from ongoing clinical field trial have indicated that the soft tissue around SLActive implants is ready 3 weeks after implant placement. In the new Straumann® Bone Level implant (BL), the microgap of the prosthetic connection between implant and restoration is shifted inwards. This means that the biological distance is taken into consideration and that more space is left for the â€œinsertionâ€ of the epithelium and the connective tissue of the peri-implant soft tissue in order to preserve crestal bone. Cochran has developed an animal study placing delayed restorations in 60 BL implants and evaluating the bone preservation with submerged and non-submerged implants placed at different heights and Tarnow in another animal study, has placed immediate restorations in 72 BL implants to evaluate the interproximal bone preservation with adjacently placed implants. Additional marginal bone resorption following abutment manipulation was found in a dog study concerning 10 Branemark implants with no restoration done by Abrahamsson. Hypothesis: It was suggested that healing abutment disconnection as a part of prosthetic treatment results in disruption of the epithelial seal, causing bleeding and ulceration of the site. This mechanical disruption may be considered as an open wound or exposure of connective tissue which may result in inflammatory responses and epithelial migration. The reestablishment of biological width in a more apical position may be one of the factors that could explain initial crestal bone loss (5). Aim: The objective of this study is to evaluate radiographically (bone level), histologically (biological width components) and clinically (soft tissue level changes) varying only the stability of abutment connection during the standard Bone Level Straumann® implant and prosthesis placement.

/pdf/marginal-bone-and-soft-tissue-behavior-following-platform-2y7cuwizhl.pdf

Marginal bone and soft tissue behavior following platform switching abutment connection/disconnection– a dog model study

Periodontium in normal dentition is not as it is surrounding an implant area. Thus, periodontal probing with normal dentition is not similar to periimplant probing. The periimplant probing protocol should be different from periodontal probing because of inherent anatomical differences. The aim of this paper is to review the topics related to periimplant probing and to draw inferences to develop a periimplant probing protocol.

Periimplant probing: positives and negatives

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Periimplant probing: positives and negatives