Clinical results and guidelines on Steri-Oss endosseous implants.

A statistical study of the Steri-Oss implant system, concerning 673 implants placed in 280 patients in the course of a 5-year period, allows a therapeutic proposal to be made that will optimize the success rate of osseointegration. The study revealed indications specific to each type of implant, according to the depth and density of available bone. The use of titanium screws is recommended whenever bone quality is type I. In all other cases, where the density of bone decreases and approaches type IV, especially in the posterior maxilla, cylindrical hydroxyapatite-coated implants are recommended.

An 8-year compilation of clinical results obtained with Steri-Oss endosseous implants.

This 8-year study shows an increased success rate for Steri-Oss' osseointegrated implants in full, partial, and single-tooth edentation, compared to previous 5- and 6-year studies. A total of 1,499 implants placed in 389 women and 216 men had an average success rate of 96.1%. Of the 716 implants placed in the maxilla, 697 were exposed and only 31 failed-a success rate of 95.6%. Of 783 placed in the mandible, 750 were exposed and 25 failed-a success rate of 96.7%. Performance comparisons of Steri-Oss titanium threaded, hydroxyapatite-coated, cylindrical implants and titanium plasma-sprayed cylindrical implants showed, as in previous reports, a higher success rate for the coated and sprayed implants, especially for short implants placed in soft maxillary bone.

A single-step GTR treatment for gingival recession with a bioresorbable membrane: a case report.

Creating a single-step surgical treatment for coverage of gingival recession has long been the objective in the development of guided tissue regeneration. A single-step procedure would avoid the trauma of a second surgery and eliminate the limitations associated with soft tissue grafts and nonresorbable barriers. It would also ensure the predictable integration of the bioresorbable membrane in the periodontal tissue and the clinical repair of gingival recession. The learning objective of this article is to present the clinical application of a bioresorbable matrix along with the indications and advantages of the procedure. Three case reports are used to illustrate the clinical technique.

Periimplant tissue considerations for optimal implant results.

A healthy soft tissue is one of the prerequisites for long-term success in implantology. The periimplant tissue health must be either preserved during the surgical procedure or reinstated. This article presents a surgical technique that is less traumatic in its approach and can be used for single or multiple implant procedures. The learning objective of this article is to review this surgical technique for the clinician. The flap design is discussed along with the primary and subsequent incisions during the first stage surgery. The need for preservation of the interdental tissues is outlined to limit excessive bleeding, necrosis of the flap, and to provide anatomic reference for implant placement. Emergence profile and placement of healing abutments during the second stage surgery are reviewed along with the condition of the periimplant tissues, which is one of the key factors for long-term success.

Implant positioning for periodontal, functional, and aesthetic results.

Implant positioning requires the adherence to a very precise protocol in order to achieve the best periodontal, functional, and aesthetic results. In this article, the authors discuss the step-by-step procedure, including pre-implant study, transfer techniques, implant positioning, gingiva grafts, and post-implant hygiene.

Treatment classifications and sequencing for postextraction implant therapy: a review.

Dental implantology has become an acceptable and effective treatment modality for totally and partially edentate alveolar arches. When teeth are extracted due to pathology or trauma, bone and soft tissue resorption often occurs. Either an immediate implant placement must be performed or a more traditional treatment plan must be determined; teeth for extraction or incorporation into the overall treatment scheme must also be selected. Selection of the implant site must reflect the mesiodistal, buccolingual, and apicocoronal dimensions. The responsibility of the implant team is to establish a correct diagnosis, evaluate clinical parameters, and design a comprehensive treatment plan, selecting the optimal time for implant placement. The learning objective of this article is to review three classifications of extraction sites and the time sequences of surgical protocols to implant placement following extraction.

Implant site preparation with osteotomes: principles and clinical application.

The use of implant-supported restorations is a well-accepted and predictable treatment modality. Drilling has been the traditional method for cylindrical implant site preparation. This procedure, however, removes a considerable amount of bone. This article presents an alternative site preparation method--the use of osteotomes--which preserves, expands, and condenses alveolar bone. Indications, advantages, and the clinical procedure are presented, with extensive details on bone preservation, expansion, condensation, and sinus floor elevation. The learning objective of this article is to familiarize the reader with the principles of this alternative method and the clinical application of osteotomes.

Periodontal implications in implant treatment planning for aesthetic results.

Insufficient hard and soft tissue height and width can be a repercussion of tooth loss or a result of postoperative healing following implant surgery. Insufficient bone can preclude proper implant positioning, while inadequately treated soft tissue will not exhibit a gingival appearance similar to that of the adjacent teeth. If hard and soft tissue discrepancies are not corrected by regenerative techniques, the replaced tooth appears long or overbulked gingivally. In order to create hard and soft tissue harmony, an understanding of the biological variables and periodontal implications is necessary.

Microbial infections and occlusal overload: causes of failure in osseointegrated implants.

Microbial infections and occlusal overload are the two primary causes of failure in osseointegrated implants. This paper reviews the roles of pathogenic bacteria and occlusal overload, summarizes the types of microbes, outlines the diagnosis, and discusses how these conditions may be avoided and/or corrected. The learning objective of this article is an enhanced and updated understanding of the etiology, prevention, and correction of these two conditions.

Selection and ideal tridimensional implant position for soft tissue aesthetics.

While single-tooth replacement can be accomplished with predictability using implant therapy, this procedure is challenging in the anterior region where numerous criteria must be evaluated by the restorative team. The available height of bone, soft tissue volume, and three-dimensional position of the anticipated implant restoration are among the numerous concerns that must be addressed prior to the initiation of treatment. This article provides a comprehensive review for the selection and placement of implants in the aesthetic region and illustrates these principles with a case presentation.

Mastication forces and implant-bearing surface.

This article discusses the shift of emphasis in implantology from the phenomenon of osseointegration of implants to the accurate fabrication of the prosthesis, recognizing the implant/prosthesis unit as an actual replica rather than a replacement of the missing tooth. The study of kinetics with its succession of mandibular cycles is used to discuss the integration of mastication and occlusion. The importance of periimplant ligament in natural teeth is discussed, along with the impact of its absence on implant mobility. The impact of the bone types and the root surface architecture on the implant-bearing surface is presented along with the stress of the mastication forces. All these factors have to be considered in the treatment planning and effectively communicated to the laboratory. The learning objective of this article is to provide updated information in those areas for the reader.

Single tooth implant--management for success.

Implant positioning in a mesio-distal, bucco-lingual, and apical-occlusal direction is a prerequisite in developing a good emergence profile and creating optimum aesthetics. The use of a healing abutment and the following healing and maturation of soft periimplant tissue develop a subgingival dimension that allows an emergence profile of the final restoration that is consistent with the size of the tooth to be replaced and the adjacent teeth. The learning objective of this article is to review and update the knowledge of single tooth implants and their management.