Evaluation following functional loading of titanium fixtures placed in ridges augmented by deproteinized bone mineral. A human case study.

The aim of this investigation was to clinically evaluate the periimplant tissues of titanium fixtures, placed in regions augmented using deproteinized bone mineral, after initial functional loading. The original material included 18 individuals (mean age 71+/-9 years) treated using a graft material, Bio-Oss (6 Patients), or Bio-Oss+autogenous bone mixture (12 patients) for alveolar ridge augmentation. 6 titanium fixtures were placed at the time of ridge augmentation. 46 fixtures were placed at a second surgical stage, median 9.5 months after augmentation. Augmentation included crest width (26 fixtures), crest height and width (12 fixtures) and sinus floor lift (14 fixtures) procedures. In addition, 16 fixtures were placed in regions of adequate bone volume. Reconstructions were placed and patients were recalled on a yearly basis. After 4-6.5 years of functional loading, the reconstructions were removed and assessments of fixture stability and periimplant mucosal conditions were made. At this time, 3 patients (13 fixtures) were lost to follow-up (1 deceased, 1 declined to participate, and 1 too ill to attend). In the remaining 15 patients, 7 fixtures were lost due to osseo-disintegration, 2 in one patient in the mandible, and 5 in a second patient in the maxilla. Both individuals were smokers. The remaining 32 fixtures were clinically stable. Periimplant mucosa was healthy with a mean modified sulcular bleeding index of 0.1+/-0.2 and a mean probing depth of 1.5+/-1.1 mm. Radiographic evaluation showed alveolar bone levels at or above the level of the first fixture thread. There were no perifixtural radiolucencies. The survival rate, which coincided with success rate, for fixtures placed in conjunction with ridge augmentation using deproteinized bone mineral was 100% for non-smokers and 43% for smokers after 4-6.5 years of functional loading. No fixture loss occurred in non-augmented areas.

Reconstruction of severely resorbed alveolar ridge crests with dental implants using a bovine bone mineral for augmentation.

This study reviews the outcome of implant placement in 61 patients after augmentation of severely atrophic alveolar bone with a bovine bone mineral, Bio-Oss. Bone augmentation was performed at 4 different sites: alveolar crest width, alveolar crest height, antral cavity, or nasal cavity. After a mean healing time of 11.9 months, 231 implants were placed in Bio-Oss bone. The time of loading of the implants varied between 12 and 113 months. Calculated from the time of implant placement and irrespective of loading time, a survival rate of 80.5% for the individual implants was estimated. In most patients (73%), Bio-Oss was mixed with autogenous bone from the chin. However, the results indicated that autogenous bone may be excluded from the Bio-Oss graft.

A 1-year clinical report of a one-piece implant abutment.

PURPOSE: Solid one-piece standard and conical abutments, which do not involve the external implant hex when seated, have been designed. The present clinical study represents a 1-year follow-up of the use of these abutments for anchorage of implant-supported fixed prostheses for oral rehabilitation of 36 completely and eight partially edentulous patients. MATERIALS AND METHODS: After 1 year of loading, the implant-supported dentures were removed, and the seating of the 214 one-piece abutments was inspected clinically and radiographically. RESULTS: After 1 year of loading, no loose abutments were observed. One complication was reported; it involved fracture of two abutment screws within the same fixed denture. Prosthesis mobility and gold screw loosening accompanied this complication. Ninety-one percent of the patients exhibited healthy gingiva, and 9% showed erythema/edema. No periimplantitis was identified. CONCLUSION: The results of this study--healthy marginal tissue, a mean bone loss of 0.3+/-0.6 mm, and no abutment retightening 1 year after loading--support the use of the one-piece abutment design in implant-supported screw-retained restorations.

A clinical and histologic examination in humans of the osseous response to implanted natural bone mineral.

The purpose of this study was to assess the osseous response to implanted particles of an anorganic xenograft bone mineral. Bio-Oss, in six patients with severely resorbed alveolar ridges. The observation period varied between 9 and 44 months; in five of six patients, long-term bone regeneration around the implants was observed. Histologic examination of biopsy material obtained from the graft area showed Bio-Oss particles still present in all patients after the varying observation periods. This raises the question whether Bio-Oss may be regarded as a resorbable material, as previously reported.