Eleven- to fifteen-year outcome for two-piece implants with an internal tube-in-tube connection: a cross-sectional analysis of 245 implants.

PURPOSE: The aim of this retrospective study was to evaluate the outcomes of a two-piece implant system with a tube-in-tube internal connection after up to 15 years of clinical use. MATERIAL AND METHODS: A retrospective follow-up examination of patients treated with internal tube-in-tube implants between 2003 and 2006 was conducted. The implant survival rates, peri-implant conditions (marginal bone loss, bleeding on probing, plaque index, probing depth), and technical complications were determined. RESULTS: In total, 312 dental implants were placed in 152 patients. Of the original 152 patients enrolled, 245 implants in 112 patients were available for a follow-up evaluation after 11 to 15 years (mean observation time, 12.9 ± 1.1 years). The overall implant survival rate was 93.9%. Outcomes for MBL (1.49 ± 1.23 mm), PI (24.3 ± 22.2%), BOP (18.3 ± 28.7%), and PD (2.74 ± 1.21 mm) were observed. Selected parameters (time after implant surgery, smoking habits, bone augmentation (GBR)) showed an influence on MBL and PD. CONCLUSIONS: The internal tube-in-tube implant system showed favorable long-term results. The correlation of MBL and PD with the patient-specific factor smoking habit is in accordance with other studies. CLINICAL RELEVANCE: Camlog Root-Line implants with a tube-in-tube implant-abutment connection and a 1.6-mm polished neck configuration have demonstrated favorable long-term outcomes in daily clinical practice. However, it is important to note that these implants are no longer available on the market.

A randomized clinical trial of phycogenic materials for sinus grafting with hydroxyapatite versus biphasic calcium phosphate: 2 years clinical outcomes.

OBJECTIVES: To assess in a prospective randomized trial two phycogenic bone substitutes-biphasic calcium phosphate (BCP) versus almost pure hydroxyapatite (HA)-for their volume stability and clinical implications after sinus floor elevation (SFE). MATERIALS AND METHODS: Twenty patients requiring lateral-window SFE 6 months prior to implant surgery were randomized to a BCP or HA group. As primary outcome, the grafts were analyzed for volume stability, using four cone-beam computed tomography scans obtained immediately/6/12/24 months after SFE. Secondary outcomes were implant survivval, success, periotest values, oral-health-related quality of life (OHIP-G14), and pain (VAS). RESULTS: Kolmogorov-Smirnov goodness-of-fit test revealed normal distribution of samples (p = .200). At 6/12/24 months, the augmented volumes decreased to 96/92/90% (HA) or 99/96/96% (BCP). Volume changes were significantly a factor of time (p < .001; generalized linear model with repeated measures) and reached significantly lower values in HA group (p = .018). Significant intergroup difference in volume losses was notable at 24 months (p = .021; t-test for independent samples). Periotest values decreased from -3/-4.1 (HA/BCP) after implant placement to -6.3/-4.5 (HA/BCP) after 6 months. OHIP scores diverged at 2 months (HA: 9.5; BCP: 5.2) and largely resolved by 24 months (HA: 1.3; BCP: 1.9). VAS scores were comparable, 2.2 at 1 week after SFE being their highest mean level. CONCLUSIONS: After 2 years, both groups experienced no biological or technical complications, demonstrating a consistent healing trajectory without notable symptoms. Although no significant differences were observed in implant stability and survival, BCP demonstrated higher volume stability than HA.

Two-piece zirconia versus titanium implants after 80 months: Clinical outcomes from a prospective randomized pilot trial.

OBJECTIVES: To prospectively evaluate, as part of an ongoing randomized pilot trial, the clinical outcomes of two-piece zirconia implants in comparison with titanium implants 80 months after delivery of all-ceramic (lithium disilicate) single-tooth restorations. MATERIAL AND METHODS: The original sample included 31 (16 zirconia and 15 titanium) implants in 22 healthy patients. In addition to evaluating implant survival and success, a number of clinical or radiographic parameters were statistically analyzed: plaque index (PI), bleeding on probing (BOP), pink esthetic score (PES), and marginal bone loss (MBL). Both implant groups were compared using a Mann-Whitney U test. RESULTS: Three implants (2 zirconia and 1 titanium) had been lost, so that 28 implants (14 zirconia and 14 titanium) in 21 patients could be evaluated after a mean of 80.9 (SD: 5.5) months. All surviving implants had remained stable, in the absence of any fixture or abutment fractures and without any chipping, fracture, or debonding of crowns. The zirconia implants were associated with PI values of 11.07% (SD: 8.11) and the titanium implants with 15.20% (SD: 15.58), the respective figures for the other parameters being 16.43% (SD: 6.16) or 12.60% (SD: 7.66) for BOP; 11.11 (SD: 1.27) or 11.56 (SD: 1.01) for PES; and 1.38 mm (SD: 0.81) or 1.17 mm (SD: 0.73) for MBL. CONCLUSIONS: No significant differences were found between the clinical outcomes of two-piece zirconia and titanium implants based on the aforementioned parameters after 80 months of clinical service. Our results should be interpreted with the limited sample size in mind.

Phycogenic bone substitutes for sinus floor augmentation: Histomorphometric comparison of hydroxyapatite and biphasic calcium phosphate in a randomised clinical pilot study.

Aims: While numerous materials are available for sinus floor elevation, plant-based alternatives still hold promise of overcoming concerns about allogeneic or xenogeneic materials. Thus, the present authors designed a randomised clinical trial to histologically compare an almost pure hydroxyapatite (HA) to a biphasic calcium phosphate comprising 80% ß-tricalcium phosphate (ß-TCP) and 20% hydroxyapatite (ß-TCP/HA), all of phycogenic origin. Materials and methods: Twenty patients scheduled for lateral window sinus floor elevation were randomised to either an HA or a ß-TCP/HA group. Biopsy specimens were taken 3 months after sinus floor elevation and during implant surgery after 6 months. One ground section per biopsy specimen (N = 40) was stained, scanned and histomorphometrically analysed for new bone, old bone, soft tissue, graft, bone infiltration of graft, bone-to-graft contact and penetration depth. Results: At 6 months, more new bone was seen in the ß-TCP/HA group (P = 0.011), whereas more residual graft was present and in more extensive contact with new bone in the HA group. More pronounced alterations, and smaller particle sizes, of graft surrounded and infiltrated by bone were seen in the ß-TCP/HA group. The less extensive bone-to-graft contact in the ß-TCP/ HA group reflected a more advanced state of resorption, while infiltration of residual graft material by bone was also increased in this group. Conclusions: Proper healing was seen in both groups, with the graft materials guiding the formation of new bone, which grew especially well through the particles of the highly osteoconductive and resorptive ß-TCP/HA material. HA was very stable, without significant resorption, but was extensively in contact with new bone after 6 months.

Immediate occlusal vs nonocclusal loading of implants: A randomized prospective clinical pilot study and patient centered outcome after 36 months.

BACKGROUND: Immediate provisionalization reduces chair time and improves patient comfort. PURPOSE: To analyze immediate functional loading vs nonfunctional loading with restorations in the posterior mandible for marginal bone defects, implant success/survival, and patient satisfaction. MATERIALS AND METHODS: A randomized controlled clinical trial was designed to assess these parameters based on 20 adult patients who underwent implant surgery, followed by immediate delivery of screw-retained or cemented single or splinted restorations in full occlusal contact or in infraocclusion (test and control group). A questionnaire with visual analog scales was used to assess patient satisfaction. RESULTS: Following 36-month data were evaluable for 9 patients (21 implants) in the study group (immediate functional loading) and for 10 patients (31 implants) in the control group (immediate nonfunctional loading). One implant in the control group was lost, hence the overall implant survival and success rate was 98.2%. Marginal bone defects were consistent with previous studies and comparable in both groups. Periotest values did not significantly change from baseline and the 12-month follow-up (Friedmann test). Patient satisfaction was high and did not involve any significant intergroup differences (Mann-Whitney U-test). CONCLUSIONS: Both types of immediate provisional restorations are viable in selected patients. Larger randomized controlled trials are needed to establish immediate functional loading as a standard treatment for partially edentulous jaws.