Immediate loading of Brånemark system TiUnite and machined-surface implants in the posterior mandible, part II: a randomized open-ended 9-year follow-up clinical trial.

PURPOSE: To present clinical results with 9 years of follow-up of a protocol of immediately loaded implants with two different surfaces. MATERIALS AND METHODS: A total of 44 patients received 66 Brånemark System TiUnite and 55 Brånemark machined implants, all immediately loaded. Control examinations were performed on the day of surgery and at 1-, 3-, and 9-year follow-up visits. RESULTS: All implant sites had intact buccal and lingual bone walls. The prefabricated provisional restorations showed an excellent fit. Three TiUnite and 8 machined implants failed within 7 weeks of loading, resulting in a cumulative survival rate of 95.5% and 85.5% respectively after 9 years of load. The survival rate for implants in a partial prosthesis was 98.8% and 92.2% for single restorations in the TiUnite group, and 87.8% and 83.2%, respectively, for partial and single resorations in the control group. The marginal bone resorption in the first year was on average 0.9 mm in the TiUnite group and 1.0 mm in the machined group; at the third year it was 0.4 and 0.5 mm, respectively. On examination at 9 years, there was a general settlement of the bone, with a negligible further loss in height. CONCLUSIONS: The unchanged survival rate and the low bone loss after 9 years confirm the feasibility of an immediate loading protocol in the mandible, which included flapless surgery. TiUnite implants obtained a 10% higher success rate compared with machined fixtures .

Immediate loading of maxillary prostheses using flapless surgery, implant placement in predetermined positions, and prefabricated provisional restorations. Part 2: a retrospective 10-year clinical study.

PURPOSE: Immediate loading has become a widely reported practice in implant dentistry. The aim of this study is to report on the 10-year clinical and radiographic outcomes of an immediate-loading treatment protocol that included flapless surgery. MATERIALS AND METHODS: Forty-six patients were treated with 97 immediately loaded Mk IV implants (Nobel Biocare) with machined surface in the maxilla. Presurgically, a three-dimensional model of each patient's soft tissue and underlying alveolar bone anatomy was created and a surgical template was fabricated. A circular mucotome was used to punch out a 5-mm hole in the mucosa to avoid flap elevation. Control examinations were performed on the day of surgery and at 1, 2, 3, 6, 8, and 10 years after surgery. RESULTS: All prepared implant sites had intact buccal and lingual bone walls. The prefabricated provisional restorations showed excellent fit. Nine implants failed within 8 weeks of loading, resulting in a cumulative survival rate of 91% after 10 years of loading. The survival rates were 94% for implants supporting partial prostheses and 81% for implants supporting single restorations. Average marginal bone resorption was 1 mm during the first year, 0.4 mm during the second year, and 0.1 mm during the third year and after 10 years. CONCLUSIONS: The unchanged survival rate and the low average bone loss after 10 years confirm the feasibility of an immediate loading treatment protocol in the maxilla that included flapless surgery.

New laser-treated implant surfaces: a histologic and histomorphometric pilot study in rabbits.

PURPOSE: The purpose of this study was to confirm the validity of laser treated implant surfaces, with regard to high superficial purity preservation and to extremely regular and uniform roughness surfaces. METHODS: In this in vivo study, seven different laser treated implant surfaces were analyzed. A diode-pumped solid state source laser, in a Q-Switch output mode, was used at various wavelengths, which were chosen to generate surface irregularities of varying diameter, depth and pitch. Twenty one implants were placed in 11 New Zealand rabbits. Eight weeks after surgery, implants were harvested for histometric analysis: total, threads and body bone-to-implant, and bone-to-implant contacts were measured. The morphologic analysis of the surface was carried out using a Scanning Electron Microscope. RESULTS: Average bone-implant contact values were approximately 50% for all tested surfaces. Both total and threads values, within the same processing pattern group, had a high variance. Bone-implant contact thread and body variances were different, so that is possible that laser beam angle is able to modify the superficial roughness and thus the histological response. CONCLUSIONS: Implants provided with pores of 20 and 25 µm achieved more than satisfactory bone-implant contact partial peaks. Further statistically significant experiments are needed in order to study, in depth, these surfaces.