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.

The modified osteotome technique.

Patients who have been partially edentulous in the posterior segments for many years frequently present with reduced alveolar bone and/or enlarged sinuses. The choice of treatment for these patients will depend on the volume of residual bone, morphology of the alveolar crest, and amount of space available for the prosthesis. A new, minimally invasive surgical procedure using Summers osteotomes is described for the treatment of the edentulous posterior maxilla in which the bone thickness below the sinus is limited (> or = 5 mm). This suggested modified treatment is based on the use of a combination of osteotomes, drills, and screw-type implants with a rough surface texture.

Three-stage approach to aesthetic implant restoration: emergence profile concept.

Proper treatment planning and precise evaluation of various parameters (e.g., bone volume, soft tissues, dental anatomy, surgical and prosthetic components) are crucial for an aesthetic implant restoration. The three-stage approach of the emergence profile concept guides the selection of implant, healing abutment, and provisional prosthesis. Adaptation of the implant, provisional prosthesis, and crown restoration stages and their harmonious integration with the soft tissues enable the development of an optimal aesthetic result. This article demonstrates the incorporation of the emergence profile concept for aesthetic implant placement.

Wide-diameter implants: new concepts.

At the end of the 1980s, it was suggested that wide-diameter implants be used to better the prognosis in cases in which the condition of the supporting bone is unfavorable. Technical improvements associated with different shapes and materials used for implants have led to an evolution of our concepts of surgical and prosthetic treatments. The aim of these new suggestions is to optimize the functional and esthetic result while respecting the fundamental principles of osseointegration. Up to the present time, very few studies have been published on wide-diameter implants. However, the short- and medium-term results that have been reported have been very satisfactory.

Apical-coronal implant position: recent surgical proposals. Technical note.

The conventional placement protocol for submerged and non-submerged implants was proposed in the 1960s and 1970s. Multicenter studies have reported satisfactory success rates for both protocols and a similar loss of crestal peri-implant bone after implant loading (0.5 to 1.5 mm). In recent years, placement of submerged implants using a single surgical procedure was introduced, with the immediate placement of a healing abutment. Some studies reported good short-term results using this approach. Recently, a supracrestal apical-coronal positioning of the implant collar has been proposed for posterior sectors using submerged implants. This positioning facilitates the second surgical phase, as well as fabrication of the prosthetic restoration, and limits the amount of crestal bone loss.

To conserve or implant: which choice of therapy?

The longevity of teeth depends directly on the state of the periodontal tissues. Many etiologic factors can lead to the loss of a tooth. Tooth loss is frequently associated with bone resorption. The diagnosis of a condition and knowledge of its etiology are essential to assess the prognosis of the remaining teeth and to formulate the correct treatment plan. Many parameters must be investigated to ascertain an accurate diagnosis. An understanding of the patient's needs and the length and likely success of treatment guides the decision of whether to preserve teeth or extract them and place implants. Advanced periodontitis poses a major therapeutic dilemma. Judicious, strategic extractions may permit the placement of long implants in ideal positions.

Small-diameter implants: indications and contraindications.

The choice of implant diameter depends on the type of edentulousness, the volume of the residual bone, the amount of space available for the prosthetic reconstruction, the emergence profile, and the type of occlusion. Small-diameter implants are indicated in specific clinical situations, for example, where there is reduced interradicular bone or a thin alveolar crest, and for the replacement of teeth with small cervical diameter. Before using a small-diameter implant, the biomechanical risk factors must be carefully analyzed. Preliminary reports of this type of implant show good short- and medium-term results.

Guided tissue regeneration around dental implants in immediate extraction sockets: comparison of e-PTFE and a new titanium membrane.

To evaluate the efficacy of guided tissue regeneration around exposed implant threads, 16 implants were placed into fresh extraction sockets in beagle dogs. Polytetrafluoroethylene (e-PTFE) membranes and titanium membranes were used to cover the defects around implants. A control group did not receive any membranes. Results were evaluated histologically. The average gain in bone height was 2.1 mm for e-PTFE sites, 0.8 mm for titanium membranes, and 2.9 mm for control sites. The greatest gain in bone levels was seen for two sites that received e-PTFE membranes and remained covered for the entire evaluation interval. Within the limits of this study, clinical and histologic evidence demonstrated that, when primary coverage is maintained, the use of e-PTFE membranes can significantly enhance bone regeneration around implants.

[Periodontal diseases. Clinical forms, epidemiology, etiology, prevention]. / Les parodontopathies. Formes cliniques, épidémiologie, étiologie, prévention.

Periodontal diseases affect the teeth-supporting tissues and are the main causes of tooth loss in subjects older than 40 years. They are characterized by gingival bleeding, bone destruction and dental mobility and are due to bacterial proliferation on dental plaque and tartar. Several forms have been described according to the severity of alveolar bone destruction and to the patient's age. These diseases can be prevented by a strict bucco-dental hygiene applied jointly by the patient and the practitioner.

[Bone regeneration in implantology. The use of Gore-Tex membranes: GTAM]. / Regeneration osseuse en implantologie. Utilisation des membranes Gore-Tex: GTAM.

The use of expanded polytetrafluorethylene membranes to attain bone regeneration around dental implants is described. Membranes discourage "non-desirable" cells form colonizing the healing site. These cells are essentially derived from gingival epithelium and gingival connective tissue. It is suggested that this procedure could be employed directly after tooth extraction.

[An x-ray computed tomography study with radiographic splints in implant evaluation]. / Examen tomodensitométrique avec gouttière radiographique dans le bilan implantaire.

CT-Scan provide a powerful diagnostic tool in the presurgical evaluation for endosseous implants. This article overviews a computer assisted system combined with a "marked radiographic stent" and a "surgical stent". The technique evaluates the ideal number, location and direction of the implants for a successful treatment.

Periodontal and prosthodontic treatment for patients with advanced periodontal disease.

This article describes prosthetic management of advanced periodontally involved dentitions. Overall prognosis and means of assessing scores to prospective abutment teeth are presented. Esthetic treatment and prognosis of surgically elongated dentitions is discussed, and a method to determine what the patient will look like after completion of treatment is presented. A specific approach using ceramometal restorations with modified long bevel and minimum gold collar and the use of electrosurgery for subgingival access is covered.

[Muco-gingival procedures (author's transl)]. / Les techniques muco-gingivales.

The gingival marginal region, in which the inflammatory processes of parodontal disease commence, needs to be protected by a sufficient height and thickness of attached gum. Surgical procedures for these lesions must, therefore, involve the attached gum. A variety of muco-gingival procedures have recently replaced the classical vestibular deepening operation which was always followed by a relapse.

[A classification of parodontal surgical procedures (author's transl)]. / Classification des techniques de chirurgie parodontale.

Parodontal surgery is a dynamic entity, which has evolved in a continuous manner since the beginning of the century, because of the increasing interest in parodontology itself, the growing importance of surgical treatment for parodontal diseases, and improved knowledge of biological processes involved in cicatrization. A new classification is suggested which should allow a more specific selection of indications for surgical treatment and thus to obtain a stable and long-lasting result.