The modulation transfer function and signal-to-noise ratio of different digital filters: a technical approach.

OBJECTIVES: The aim of this study was to illustrate the influence of digital filters on the signal-to-noise ratio (SNR) and modulation transfer function (MTF) of digital images. The article will address image pre-processing that may be beneficial for the production of clinically useful digital radiographs with lower radiation dose. METHODS: Three filters, an arithmetic mean filter, a median filter and a Gaussian filter (standard deviation (SD) = 0.4), with kernel sizes of 3 × 3 pixels and 5 × 5 pixels were tested. Synthetic images with exactly increasing amounts of Gaussian noise were created to gather linear regression of SNR before and after application of digital filters. Artificial stripe patterns with defined amounts of line pairs per millimetre were used to calculate MTF before and after the application of the digital filters. RESULTS: The Gaussian filter with a 5 × 5 kernel size caused the highest noise suppression (SNR increased from 2.22, measured in the synthetic image, to 11.31 in the filtered image). The smallest noise reduction was found with the 3 × 3 median filter. The application of the median filters resulted in no changes in MTF at the different resolutions but did result in the deletion of smaller structures. The 5 × 5 Gaussian filter and the 5 × 5 arithmetic mean filter showed the strongest changes of MTF. CONCLUSIONS: The application of digital filters can improve the SNR of a digital sensor; however, MTF can be adversely affected. As such, imaging systems should not be judged solely on their quoted spatial resolutions because pre-processing may influence image quality.

The effect of wavelet and discrete cosine transform compression of digital radiographs on the detection of subtle proximal caries. ROC analysis.

The study compared diagnostic performances of 2 different image compression methods: JPEG (discrete cosine transform; Joint Photographic Experts Group compression standard) versus JPEG2000 (discrete wavelet transform), both at a compression ratio of 12:1, from the original uncompressed TIFF radiograph with respect to the detection of non-cavitated carious lesions. Therefore, 100 approximal surfaces of 50 tooth pairs were evaluated on the radiographs by 10 experienced observers using a 5-point confidence scale. Observations were carried out on a standardized viewing monitor under subdued light conditions. The proportion of diseased surfaces was balanced to approximately 50% to avoid bias. True caries status was assessed by serial ground sectioning and microscopic evaluation. A non-parametric receiver operating characteristic analysis revealed non-significant differences between the 3 image modalities, as computed from the critical ratios z not exceeding +/-2 (JPEG/JPEG2000, z = -0.0339; TIFF/JPEG2000, z = 0.251;TIFF/JPEG, z = 0.914). The mean area beneath the curve was highest for TIFF (0.604) followed by JPEG2000 (0.593) and JPEG (0.591). Both intra-rater and inter-rater agreement were significantly higher for TIFF (kappa(intra) = 0.52; kappa(inter) = 0.40) and JPEG2000 images (kappa(intra) = 0.49; kappa(inter) = 0.38) than for JPEG images (kappa(intra) = 0.33; kappa(inter) = 0.35). Our results indicate that image compression with typical compression algorithms at rates yielding storage sizes of around 50 kB is sufficient even for the challenging task of radiographic detection of non-cavitated carious approximal lesions.

Effect of digital noise filters on diagnostic radiographs for the diagnosis of experimental root fractures.

This article discusses basic concepts of noise suppression for digital radiographs, and shows how false application of algorithms available can lead to a loss of information. Noise suppression realized with low pass convolution filters are designed to decrease strong grey level changes of neighboring pixels. Sixty-two extracted fully intact premolars were selected and treated usingthe crown-down technique to prepare them for experimental fractures. A total of 358 radiographs were taken, of which 312 images were selected with clearly visible root fractures. The selected radiographs were stored as uncompressed images and manipulated with 8 different convolution filters. A total of 2496 raw and filtered images were inspected for visible root fractures. Only the arithmetic mean filter with 5 x 5 kernel size led to a deletion of the visible fracture line in 33.3% of the inspected cases. The other filters proved to be useful for noise reduction without loss of any necessary diagnostic information. None of the filters improved the diagnostic outcome in the 46 remaining radiographs which did not show clearly visible root fractures before application of the filters.

Fast algorithm for real-time detection of root canal orifices in video images.

Real-time image analysis in endodontics opens new options of treatment support in dentistry. Imaging software was developed to detect the root canal orifices in video sequences of trepanated teeth acquired by a digital video microscope, the Motic DM 143. The software developed is capable of communicating with any video camera connected to it and can automatically detect almost all root canal orifices in trepanated teeth. To recognize the root canal orifices we used the so-called Minimum-Distance Classification. The Minimum-Distance Classification provides a color-based pattern recognition algorithm, which is directly implemented in the function accessing the video stream, and is therefore very fast. Processing speed varied between 30 and 64 ms per image with an input image resolution of 352 x 288 pixels on the Pentium 4 computer (2 GHz). The developed software was tested in this study on 78 trepanated teeth. The mean detection sensitivity of the software found for all 78 teeth is 97.01%.

Software for automated application of a reference-based method for a posteriori determination of the effective radiographic imaging geometry.

OBJECTIVES: Presentation and validation of software developed for automated and accurate application of a reference-based algorithm (reference sphere method: RSM) inferring the effective imaging geometry from quantitative radiographic image analysis. METHODS: The software uses modern pattern recognition and computer vision algorithms adapted for the particular application of automated detection of the reference sphere shadows (ellipses) with subpixel accuracy. It applies the RSM algorithm to the shadows detected, thereby providing three-dimensional Cartesian coordinates of the spheres. If the three sphere centres do not lie on one line, they uniquely determine the imaging geometry. Accuracy of the computed coordinates is investigated in a set of 28 charge-coupled device (CCD)-based radiographs of two human mandible segments produced on an optical bench. Each specimen contained three reference spheres (two different radii r1=1.5 mm, r2=2.5 mm). True sphere coordinates were assessed with a manually operated calliper. Software accuracy was investigated for a weighted and unweighted algebraic ellipse-fitting algorithm. RESULTS: The critical depth- (z-) coordinates revealed mean absolute errors ranging between 1.1+/-0.7 mm (unweighted version; r=2.5 mm) and 1.4+/-1.4 mm (weighted version, r=2.5 mm), corresponding to mean relative errors between 5% and 6%. Outliers resulted from complete circular dense structure superimposition and one obviously deformed reference sphere. CONCLUSIONS: The software provides information fundamentally important for the image formation and geometric image registration, which is a crucial step for three-dimensional reconstruction from > or =2 two-dimensional views.

[Root growth after wisdom tooth transposition. Case documentation with proposal for a radiologic method to quantify growth]. / Wurzelwachstum nach Weisheitszahntransposition. Falldokumentation mit Vorschlag einer radiologischen Methode zur Wachstumsquantifizierung.

OBJECTIVES: To introduce a method for assessment of root growth on panoramic radiographs exemplified by a case report on an autotransplanted lower third molar. MATERIAL AND METHODS: A lower left third molar (T) with incomplete root formation was transplanted for replacement of the lower left first molar in an 18-year-old woman. T was monitored clinically and, together with its neighboring lower second molar (37) with constant root length, also radiographically by means of two panoramic radiographs (OPGs) produced 12 days and 20 months postoperatively. A method for calculation of the root length as a multiple of the crown length is introduced, using accurately reproducible landmarks defining the coronal and apical endpoints of the examined tooth in all OPGs of the series. This method minimizes error due to different magnifications within the set of radiographs. RESULTS: Using the method introduced, the root length of the constant tooth 37 varied at 2.7% within the set of OPGs, whereas it revealed a 5.6% variation when the evaluation was based on direct measurement. Based on the described method, T revealed a postoperative root growth of approximately one-third of its final length and showed clinically no pathological findings during the observation period. CONCLUSIONS: Our results indicate that with the described method root growth assessment on panoramic radiographs is more accurate than with direct measurement.

Low-level 809 nm GaAlAs laser irradiation increases the proliferation rate of human laryngeal carcinoma cells in vitro.

The aim of the study was to investigate the effect of low-level 809 nm laser irradiation on the proliferation rate of human larynx carcinoma cells in vitro. Epithelial tumor cells were obtained from a laryngeal carcinoma and cultured under standard conditions. For laser treatment the cells were spread on 96-well tissue culture plates. Sixty-six cell cultures were irradiated with an 809 nm GaAlAs laser. Another 66 served as controls. Power output was 10 mW(cw) and the time of exposure 75-300 s per well, corresponding to an energy fluence of 1.96-7.84 J/cm2. Subsequent to laser treatment, the cultures were incubated for 72 h. The proliferation rate was determined by means of fluorescence activity of a redox indicator (Alamar Blue Assay) added to the cultures immediately after the respective treatment. The indicator is reduced by metabolic activity related to cellular growth. Proliferation was determined up to 72 h after laser application. The irradiated cells revealed a considerably higher proliferation activity. The differences were highly significant up to 72 h after irradiation (Mann-Whitney U test, p < 0.001). A cellular responsiveness of human laryngeal carcinoma cells to low-level laser irradiation is obvious. The cell line is therefore suitable for basic research investigations concerning the biological mechanisms of LLLT on cells.

Efficacy of NaOCl/H2O2 irrigation and GaAlAs laser in decontamination of root canals in vitro.

BACKGROUND AND OBJECTIVES: To investigate the bactericidal effect of an 809 nm semiconductor laser alone, and in combination with NaOCl/H(2)O(2) irrigation in root canals in vitro. STUDY DESIGN/MATERIALS AND METHODS: A total of 72 human single-rooted teeth extracted for periodontal reasons were included. The crowns were removed, the roots shortened to a length of 12 mm, and the canals enlarged up to an apical size of #50 file. The specimens were autoclaved and incubated with a suspension of Streptococcus sanguinis (ATCC 10556). Laser irradiation was performed on a PC-controlled XY translation stage. A 200 micron optic fiber was used. Twelve specimens were irradiated at a power output of 1.5, 3.0, and 4.5 W in the cw-mode. The total irradiation time was 60 seconds per canal. Twelve specimens were rinsed with NaOCl and H(2)O(2) only, 12 were rinsed and laser treated, and 12 served as untreated controls. After laser treatment, the specimens were sonicated and the bacterial growth was examined by counting colony forming units on blood agar plates. Temperature changes at the outer root surface during irradiation were registered by means of thermocouples. Treated and control specimens were investigated by means of scanning electron microscopy. RESULTS: Mean bacterial reductions of 0.35 log steps at a power output of 1.5 W, 1.44 at 3.0 W, and 2.84 at 4.5 W were calculated. Bacterial reduction by the NaOCl/H(2)O(2) solution alone was 1.48 and comparable to that achieved by irradiation at 3.0 W. With a log kill 2.85, the combination of rinsing and laser irradiation at 3.0 W resulted in a further significant bacterial reduction as compared to rinsing alone (P = 0.004). Irradiation did not result in excessive heat generation at the root surface. Carbonization of the root canal wall was observed in single teeth at 3.0 and 4.5 W and no controlled sealing of the dentinal tubules could be achieved in the root canal. CONCLUSIONS: The application of the diode laser might be an adjunct to conventional endodontic treatment when used in combination with a NaOCl/H(2)O(2) solution.

Effect of diode laser irradiation on root surfaces in vitro.

OBJECTIVE: The objective of this study was to evaluate possible morphological alterations of root surfaces after GaAlAs-diode laser (809 nm) irradiation under standardized in vitro conditions. MATERIALS AND METHODS: Root specimens obtained from extracted periodontally diseased teeth were scaled and root planed with curettes followed by air-powder abrasive treatment prior to lasing. The variable parameters were power output (0.5-2.5 W) and exposure time (10-30 sec per specimen). Additionally, the effect of a saline solution and a human blood film on the root surface was investigated. The root segments were analyzed by means of a reflected light microscope. Photographs before and after irradiation were taken and evaluated. The scale of carbonization was quantified using a grid laid over the photographs. Specimens with distinct morphological changes were analyzed with a scanning electron microscope. RESULTS: Lasing dry specimens and specimens moistened with saline resulted in no detectable alterations, irrespective of irradiation time and power output applied. Depending on different settings, irradiation caused severe damages to the root surface when segments were covered by a thin blood film. Irradiation at a power output of 1 Watt and below had barely any negative effect on the root surface, whereas lasing at 1.5, 2.0, and 2.5 Watt resulted in partial or total carbonizations of the root samples. The angle of irradiation had a significant effect on the scale of the root surface damage (Mann-Whitney U test,p < 0.05). CONCLUSION: The diode laser may cause damage to periodontal hard tissues if irradiation parameters are not adequate.

A method to calculate angular disparities between object and receptor in "paralleling technique".

OBJECTIVE: To develop an image analysis method for calculation of angular disparities between an object, temporarily equipped with a reference system, and a radiographic receptor. MATERIALS AND METHODS: A mathematical method based on a reference system containing two metallic spheres is developed, allowing calculation of inclination between the inter-spherical axis and the digital image receptor using image features. Experimental evaluation was done in standardized projection geometry for two sphere sizes at four randomly chosen inclinations per size, with each radiograph assessed three times. Truth was assessed threefold from photographs obtained at each inclination. RESULTS: Mean standard deviation between single assessments was 2.6 degrees. Significant differences (P Maloney/Rastogy=0.00) were found between absolute values of truth and calculated values (mean: -0.9 degrees; range: -6.0 degrees; 3.6 degrees), indicating a significant lack of accuracy. CONCLUSIONS: Although so far not sufficiently accurate, the method yields information relevant for correction of distortion in intra-oral radiology.

Effect of diode laser irradiation on the attachment rate of periodontal ligament cells: an in vitro study.

BACKGROUND: The present study is part of a basic research program investigating the cellular effects of an 810 nm GaAlAs-diode laser on human periodontal tissues. The aim of the investigation was to evaluate the effects of laser treatment of root surface specimens on the attachment of periodontal ligament (PDL) cells in vitro. METHODS: Root specimens were prepared from periodontally diseased teeth. PDL cells were obtained from human third molar ligaments. Cells were cultured under simple, standardized, and reproducible experimental conditions. One hundred fifty root specimens were scaled and root planed with curets followed by air-powder abrasive treatment; 75 were then lased and 75 served as controls. The irradiation time was 20 seconds at a power output of 1 W. The root segments were placed into culture dishes, covered with a solution of PDL cells, and incubated for 72 hours. The specimens were then washed with phosphate buffer to remove cells not attached to the surface, and the adherent cells were stained with methylene blue. Cells were counted using a reflected light microscope and the cell density per mm2 was calculated. RESULTS: The analysis of 150 specimens revealed no significant differences between the groups (P = 0.347, Wilcoxon test). The cell numbers, however, were slightly higher on laser specimens. The mean was 66 cells/mm2 in the laser group and 63.7 cells/mm2 in the control group. CONCLUSIONS: The application of the diode laser at the parameters used did not have a substantially positive effect on the new attachment of PDL cells on the tooth specimens. It remains to be investigated whether the difference detected is really clinically relevant.

Mathematical analysis of projection errors in "paralleling technique" with respect to implant geometry.

"Standardized" radiographs acquired in paralleling technique serve for monitoring of marginal bone levels around endosseous implants. Under clinical conditions, parallel adjustment of the film to the implant is beset with great difficulties. A mathematical model matching clinical conditions was developed to evaluate projection geometry within an interval of clinically relevant angulations (+/- 10 degrees from parallel position). Radiographs of two implants (Frialit 2, Friadent AG, Mannheim, Germany; Implant No. 1: 3.8 mm, length 10 mm; Implant No. 2: 6.5 mm, length 13 mm) were separately produced per angulation (2 degrees increments) at one focus-object distance (FO=322.9 mm). Implant images were repeatedly measured along their midline/vertical edge, local magnification (MF) was calculated and the values were compared to the computed ones. Projected dimensions of the implants were calculated for a second distance (232.3 mm). The experimentally acquired data were in agreement with the mathematical calculation. MF calculated for assessment along the vertical edge varied less (+/-1.94% from mean value) than along the midline (+/-2.74%), with a range of 1.037-1.068 (FO=322.9 mm) and 1.061-1.099 (FO=232.3 mm) for implant No.1, and 1.060-1.101 (FO=232.3 mm) and 1.037-1.069 (FO=322.9 mm) for Implant No. 2. Magnification revealed a mean variation of 4%. Radiographic evaluation of periimplant bone level should not exceed a precision of 0.5 mm, when parallelism between film and implant is not guaranteed and FO is less than 380 mm.

Effect of diode laser irradiation on the survival rate of gingival fibroblast cell cultures.

BACKGROUND AND OBJECTIVE: The present study is part of a basic research program investigating the cellular effects of the GaAlAs-diode laser with a wavelength of 810 nm on human periodontal tissues. The aim of the investigation was to evaluate the effects of the laser treatment on the survival rate of human gingival fibroblasts (HGF) in monolayer cell culture at different power settings and durations. STUDY DESIGN/MATERIALS AND METHODS: HGF were obtained from a human gingival connective tissue explant. Cells were cultured on 24-well tissue culture plates. One hundred and thirty multi well cell cultures were laser treated. The variable parameters were power output (0.5-2.5 W) and exposure time (60-240 seconds per well). The cultures were analyzed by means of trypan blue staining, and the cell numbers counted under a light microscope. Photographs before and after irradiation were taken and evaluated. RESULTS: Depending on different settings, the laser irradiation caused significant (P < 0.05, t-test) reductions of cell numbers. Exposure time was more relevant to this phenomenon than the power output. Linear regression analysis revealed no unambiguous correlation between power output and cell death, when exposure time was kept constant. CONCLUSIONS: When used for periodontal pocket decontamination, the laser beam may cause damage to collateral periodontal tissues, if the power setting and the duration of the treatment are not adequate. Further investigation, especially with regard to the effects on hard tissue and microorganisms, are needed to give a secure recommendation for irradiation parameters at pocket decontamination.

A new method for the radiological investigation of residual ridge resorption in the maxilla.

OBJECTIVES: To develop a new method for assessing residual ridge resorption in the edentulous maxilla. METHODS: Defined experimental and reference areas in the maxilla were drawn on transparent film laid over a panoramic radiograph and digitized. Bone areas were measured with an integrated planimetry program and expressed as a ratio R. The effect of positioning errors on reliability of the method was investigated on dry skulls. The correlation between the change in ratio and actual bone loss was examined by progressively reducing the height of an artificial residual ridge on one skull. RESULTS: The coefficient of variation for the absolute ratio in different head positions was < 0.05 and its correlation coefficient of the change in R and the degree of resorption was r2 > or = 98.3%, P = 0.0001. CONCLUSIONS: Comparison of the experimental area with the reference area on serial panoramic radiographs appears suitable for the assessment of residual resorption in the maxilla.

The longitudinal clinical effectiveness of ITI solid-screw implants in partially edentulous patients: a 5-year follow-up report.

A total of 114 ITI solid-screw implants was consecutively placed in 55 partially edentulous patients and restored with 68 fixed prostheses. The patients were followed for at least 5 years in a prospective study that focused on implant success and longitudinal reactions of the peri-implant hard and soft tissues. During the study period, 5 implants failed and 15 implants were lost to follow-up, resulting in a cumulative survival rate of 95.3% after 5 years of loading. The success analysis included additional strictly defined events ("first occurrence of marginal bone loss > or = 4 mm," "first occurrence of pocket depth > or = 4 mm," and "first occurrence of crevicular fluid volume > or = 2.5 mm") and resulted in a cumulative 5-year success rate of 89.0%. Median loss of marginal bone, as observed on radiographs, was 0.7 mm between implant placement and prosthetic treatment and 0.5 mm between prosthesis placement and the 5-year evaluation. Compared to the previous year's value, the annual increase in marginal bone loss did not reach a level of statistical significance between 1 and 5 years of function, so that a steady state prevailed. The incidence of lingual-palatal surfaces affected with remarkable plaque deposits increased from 13% after prosthesis placement to 23% after 5 years. Sulcus Bleeding index, probing depth, attachment level, and crevicular fluid volume were used to describe the health of the peri-implant soft tissues. The research parameters remained almost unchanged and indicated a soft tissue response within physiologic levels. Most mechanical complications were experienced during the first year of loading and were related to loosening of occlusal screws, which occurred in 8 (12%) of 68 restorations.

[Effect of positioning errors on magnification factors in the mandible in digital panorama imaging]. / Auswirkung von Positionierungsfehlern auf Vergrösserungsfaktoren im Unterkiefer bei der digitalen Panoramaschichtaufnahme.

Magnification factors (VF) in relation to various head positions were evaluated for a digital panoramic radiography machine (Orthophos DS, Sirona) by means of a dry skull phantom. Six metallic objects were attached to the facial layer of the mandible. A set of 170 digital radiographs (program 1) was produced, with defined positioning errors within the vertical and horizontal plane. Repeated digital measurements of the object images were performed by one reader, applying the mouse-driven measurement tool integrated in the proprietary software. In addition, the central layer of the radiographic device was experimentally determined and its location compared to that of the accurately positioned dry mandible. All objects were located on the outside of the central layer of minimum distortion and therefore placed towards the sensor. One- and two-way analysis of variance was applied for the statistical evaluation of the data, with VF as dependent variable and the positions as factors, respectively. Vertical inclinations of the skull affected horizontal VF only in the premolar region (p = 0.0069). However, when the skull was rotated within the horizontal plane, VF was significantly influenced in all anatomical regions of the mandible (p = 0.0001). This was particularly obvious in the premolar region, with a maximum variation of 10.3%. Fluctuations of VF were more pronounced in the premolar region than at the mandibular angle. We conclude from this study that, as expected, digital panoramic radiographs exhibit identical distortion effects as compared to conventional panoramic x-rays. Exact quantification of regional magnification requires (spherical) reference objects with known dimensions. Horizontal magnification is quite unreliable and far less reproducible than vertical magnification. Whenever several panoramic radiographs of one patient are to be compared quantitatively, accurate positioning of the patients' head is a necessary prerequisite.

Treatment of peri-implantitis defects with autogenous bone grafts: six-month to 3-year results of a prospective study in 17 patients.

As part of an ongoing prospective study, the treatment of peri-implantitis defects using autogenous bone grafts was evaluated. This present report is based on data from 25 ITI screw implants in 17 patients with progressive peri-implant tissue destruction during the maintenance phase. Treatment of these lesions included raising flaps, removal of the surrounding granulation tissue, and air-polishing of the implant surface. Subsequently, corticocancellous bone grafts or particulate bone were placed into the peri-implant osseous defects, and the flaps were sutured around the cervical segment of the implants, allowing for transmucosal healing. Two of the 25 cases resulted in a negative outcome of the procedure. One of the transplants had to be removed 40 days after augmentation because of flap dehiscence and graft mobility. In another patient, the healing period was uneventful until the re-entry surgery, but when the site was reopened, the total graft volume was resorbed. The primary therapeutic success at re-entry surgery evaluated by intraoperative measurements resulted in a median defect depth reduction of 6.9 to 0.7 mm (P = .001), corresponding to a bone repair of 90%. The change in defect width was 1.9 mm (P = .002, repair 100%). A positive result of the reconstructive therapy has been observed during a re-evaluation time of up to 3 years. Median marginal bone loss was reduced from 6.2 to 2.3 mm after 2 and 3 years, respectively. The median vertical bone resorption of 4.5 mm was completely repaired. The crevicular fluid volume, a parameter of the level of marginal inflammation, along with probing depths and attachment levels, were reduced to a physiologic rate. The implant observation period until the first appearance of the lesion seems to be crucial to the effectiveness of the therapy. Early failures appearing within the first 2 years after implant placement showed a more stable therapeutic result over time.

Precision and accuracy of measurements in digital panoramic radiography.

OBJECTIVES: To evaluate the precision and accuracy of digital measurements in digital panoramic radiography. METHODS: A series of 70 digital panoramic radiographs were obtained of a dry skull in seven different positions with metallic pins and spheres fixed to the mandible. Three replicate measurements were performed with the mouse-driven cursor by one reader at 1:1 and 2:1 magnification. Precision was assessed with the reliability index (R) and Malony/Rastogi test and the effect of magnification on accuracy by paired Wilcoxon test. RESULTS: Vertical measurements were less reproducible than horizontal measurements. There were significant differences in assessments between images at 1:1 and 2:1 magnification (P < 0.05). The maximum variation in mean difference was 0.4% of actual object length for pins and 1.2% for spheres. The difference did not exceed 0.1 mm. R was lower for 2:1 magnification and consistently lower for spheres compared with pins. CONCLUSION: The most reliable measurements were obtained of linear objects in the horizontal plane. Digital measurements are sufficiently accurate for clinical use.

The Frialit-2 implant system: five-year clinical experience in single-tooth and immediately postextraction applications.

In an observational study of 696 Frialit-2 implants in 376 patients that was carried out between 1990 and 1995, implants of varying diameters and lengths were delivered for a range of indications in the maxilla and mandible. Single-tooth replacement was performed in 42% of cases; of these, 22.4% were placed immediately following extraction. Study parameters (Plaque Index, Gingival Index, probing depth, Periotest value, and peri-implant bone loss) are reported in detail. Statistical analysis is based on a 97.6% rate of recall. The overall success rate was found to be 96% using the Kaplan-Meier statistical analysis. No difference was apparent between single-tooth applications and prosthesis restorations.

Study of interface phenomena between bone and titanium and alumina surfaces in the case of monolithic and composite dental implants.

The interface between mandibular bone and dental implants was examined with the in vivo dog model. Implant/bone interfaces were investigated for three types of materials: Ti-30 wt% Ta/Al2O3, titanium and Al2O3 using microscopy techniques covering a large magnification range: scanning electron microscopy, transmission electron microscopy, energy dispersive X-ray analysis and Auger spectroscopy. During the interaction of the Al2O3 ceramic with bone, an interfacial layer about 15 microm thick is formed. The same phenomenon was observed at the titanium bone interface, where the thickness of the layer was about 10 microm. In all cases, interface layers were sharp with well-defined borders between bone tissue and implant materials. No calcification took place inside the interface layer. A chemical analysis performed on this layer shows the presence of titanium, calcium and phosphorus in the case of titanium implants, and aluminium, calcium and phosphorus in the case of alumina implants. A rapid decrease in metal composition with increasing distances from the implant surface is correlated to a slow increase in calcium and phosphorus in the direction of the bone. Direct contact between implant and bone was observed. No biocorrosive effects were detected at the Ti-30 wt% Ta/Al2O3 metal-ceramic interface.