Influence of a nanometer-scale surface enhancement on de novo bone formation on titanium implants: a histomorphometric study in human maxillae.

In this prospective randomized controlled clinical study, small titanium implants were placed in posterior maxillae for the purpose of assessing the rate and extent of new bone development. Nine pairs of site evaluation implants were placed in posterior areas of maxillae and retrieved with trephine drills after 4 or 8 weeks of unloaded healing. The amount of bone in linear contact (%) with the implant surface was used to determine the osteoconductive potential of the implant surface. Implant surfaces were dual acid etched (n = 9) (controls) or dual acid etched and further conditioned with nanometer-scale crystals of calcium phosphate (n = 9) (test implants), and the surfaces were compared. The implants and surrounding tissues were processed for histologic analysis. The mean bone-to-implant contact value for the test surface was significantly increased over that of the control implants at both time intervals (P <.01). For the implants/patients included in this study, the addition of a nanometer-scale calcium phosphate treatment to a dual acid-etched implant surface appeared to increase the extent of bone development after 4 and 8 weeks of healing.

Immediate Occlusal Loading (IOL) of dental implants: predictable results through DIEM guidelines.

For years, dental implants have been loaded immediately upon implant placement with varying degrees of success. As clinicians' understanding of the biological and mechanical factors involved in immediate occlusal loading (IOL) has evolved, the success of these procedures has increased--particularly as a treatment option for the restoration of the edentulous mandible or the mandible that will be rendered edentulous during treatment. Due to increasing interest in this treatment alternative, the authors have provided a clear definition of the terminology associated with IOL and have demonstrated the DIEM Guidelines used to increase the success and predictability of such treatment. This presentation also introduces new implant components that simplify the clinical application of the immediate loading concept, enhancing its benefits and acceptance among dental patients and practices alike.