Osseotite implant: 3-year prospective multicenter evaluation.

PURPOSE: This prospective multicenter study evaluates the cumulative success rate of the Osseotite implant after 3 years of prosthetic loading. MATERIALS AND METHODS: A total of 413 Osseotite implants (Implant Innovations) were placed in 142 patients (completely or partially edentulous) in five dental offices exclusively devoted to implants. The average age of the patients was 58.3 years. Of the 413 implants, 191 were placed in the maxilla and 222 in the mandible; 271 (65.6%) were posterior implants and 142 (34.4%) were anterior implants. Clinical and radiographic evaluations were made after completion of the prosthetic restoration, after 6 months of loading, at 1 year, and at 3 years. RESULTS: A cumulative success rate of 95.3% was obtained after 3 years of prosthetic loading. The success rate was similar in both arches: 95.1% in the maxilla and 96.8% in the mandible. Early failures (before prosthetic loading) were greater (n = 12) than late failures (n = 2). After 3 years of prosthetic loading, the marginal bone level of 385 (93.2%) implants were evaluated radiographically. Bone level was at the first thread for 91.4% of the implants. A slightly increased loss was observed around 26 implants (6.7%). Including survival implants, the cumulative implant success rate after 3 years was 96%. A success rate of 98.4% was obtained with 187 short implants (8, 5 and 10 mm) reported in this multicenter evaluation. CONCLUSION: This multicenter evaluation demonstrates excellent predictability for Osseotite implants.

The self-tapping and ICE 3i implants: a prospective 3-year multicenter evaluation.

This multicenter prospective clinical evaluation was undertaken to determine the therapeutic success and marginal bone level stability of 3i's self-tapping and ICE implants after 3 years of prosthetic loading. Between July 1995 and June 1996, 189 completely or partially edentulous patients were treated with 614 machined-surface screw-type commercially pure titanium implants (self-tapping or ICE). Two hundred seventy-seven self-tapping implants were placed in 85 patients (average age of 56 years), and 337 ICE implants were placed in 104 patients (average age of 61 years). A total of 360 implants (58.6%) were placed in posterior segments. Easier placement was reported with the ICE implant in normal or dense bone. For the self-tapping implants, survival rates of 92.9% and 91.6% were noted after 1 and 3 years of prosthetic loading, respectively. Survival rates of 95.4% and 93.8% were obtained with the ICE implant for the same periods. Late failures (after loading) were more common than early failures (before loading) for both types of implants. The marginal bone level of 238 self-tapping implants (85.9%) and of 307 ICE implants (91%) was radiographically evaluated at 3 years. Marginal bone level was at the first thread for 95.1% of implants. A loss of marginal bone level of 2 to 4 threads was noted for 4.9% of the evaluated implants. No implant showed bone loss greater than the fourth thread. Overall survival rates of 94.3% and 92.9% were obtained after 1 and 3 years of prosthetic loading, respectively, for 596 and 588 implants.

Comparison of the benzoyl-DL-arginine-naphthylamide (BANA) test, DNA probes, and immunological reagents for ability to detect anaerobic periodontal infections due to Porphyromonas gingivalis, Treponema denticola, and Bacteroides forsythus.

Most forms of periodontal disease are associated with the presence or overgrowth of anaerobic species that could include Treponema denticola, Porphyromonas gingivalis, and Bacteroides forsythus among others. These three organisms are among the few cultivable plaque species that can hydrolyze the synthetic trypsin substrate benzoyl-DL-arginine-naphthylamide (BANA). In turn, BANA hydrolysis by the plaque can be associated with periodontal morbidity and with the presence of these three BANA-positive organisms in the plaque. In this investigation, the results of the BANA test, which simultaneously detects one or more of these organisms, were compared with the detection of these organisms by (i) highly specific antibodies to P. gingivalis, T. denticola, and B. forsythus; (ii) whole genomic DNA probes to P. gingivalis and T. denticola; and (iii) culturing or microscopic procedures. The BANA test, the DNA probes, and an enzyme-linked immunosorbent assay or an indirect immunofluorescence assay procedure exhibited high sensitivities, i.e., 90 ot 96%, and high accuracies, i.e., 83 to 92%, in their ability to detect combinations of these organisms in over 200 subgingival plaque samples taken from the most periodontally diseased sites in 67 patients. This indicated that if P. gingivalis, T. denticola, and B. forsythus are appropriate marker organisms for an anaerobic periodontal infection, then the three detection methods are equally accurate in their ability to diagnose this infection. The same statement could not be made for the culturing approach, where accuracies of 50 to 62% were observed.

Microbial aspects of failing osseointegrated dental implants in humans.

The subgingival microflora of 18 failing implants were examined for pathogenic periodontal microorganisms. Peptostreptococcus micros was recovered from 6 failing implants, Wolinella recta from 6, Fusobacterium species from 5, Candida albicans from 5, and Bacteroides intermedius from 4. Enteric rods or pseudomonads constituted a significant part of the microflora in 5 failing implants. Actinobacillus actinomycetemcomitans, nonpigmented Bacteroides species, Capnocytophage species, and staphylococci were detected in a few implant failures. The present study showed that a complex microflora comprising oral as well as primarily non oral organisms, and bacteria as well as yeasts, can be associated with failing implants. This great diversity in microbial composition and antimicrobial susceptibility among "peri-implantitis" isolates suggest that antimicrobial therapies for implant failures should not be implemented without a prior comprehensive microbiological analysis.

The composition of gingival inflammatory cell infiltrates in children studied by enzyme histochemistry.

Gingival biopsies were obtained from 23 children, aged 5-11 years (8.6 +/- 1.8 years). Specimens were taken from areas of the gingiva adjacent to the teeth which were to be extracted because of caries or its sequelae and which clinically had a gingival index score of at least 1. Staining for alpha-naphthyl acetate esterase with unspecific esterase at pH 5.8 (ANAE) permitted identification of T lymphocytes, monocytes/macrophages, plasma cells and non-reactive (ANAE-negative) cells. Cells which tentatively were identified as "natural killer" (NK) cells were also observed. Differential cell counting was performed for 10 specimens, selected on the basis of the presence of a well-defined inflammatory infiltrate, clear morphology throughout and good ANAE staining. Cell counts confirmed earlier studies showing that lymphocytes predominate in the inflammatory infiltrates in childrens' gingivitis. T lymphocytes dominated particularly in the periphery of the most densely infiltrated areas. Relatively few plasma cells were seen. It was concluded that T lymphocytes dominate in the inflammatory infiltrate in childrens' gingivitis.

Prevalence and microbiology of localized prepubertal periodontitis.

Loss of crestal alveolar bone at primary teeth was ascertained radiographically in a dental school clinical population of 2264 children. 19 patients (0.84%) demonstrated distinct periodontal bone destruction around one or more primary teeth; in only 2 of these patients had periodontal disease been identified in previous clinical examinations. A microbiological study of 35 subgingival samples from 9 available patients revealed a high prevalence of black-pigmented Bacteroides spp., mainly Bacteroides intermedius. Actinobacillus actinomycetemcomitans and Capnocytophaga spp. were predominant organisms in some samples. The present data indicate that localized prepubertal periodontitis is more common than previously realized and is associated with bacteria generally regarded as major periodontal pathogens.