Immediate implant placement and restoration in infected sites.

The long-standing assumption that active infection is a contraindication for immediate implant placement has been challenged recently. High implant survival rates have been reported even when implants were placed immediately in infected extraction sockets and provisionalized within 36 hours. To further evaluate the impact of nonocclusal loading on implants placed in cleaned periodontically or endodontically infected extraction sites, this retrospective study examined the results of 77 implants placed in 63 patients and followed for between 3 and 24 months. Initial primary stability was achieved for all implants, and reverse torque testing at 3 and 4 months postoperatively showed 76 of 77 implants (98.7%) to be successfully osseointegrated.

A new implant design for crestal bone preservation: initial observations and case report.

Following the exposure and restoration of two-piece dental implants, some change in the vertical level of the peri-implant crestal bone height has been reported. This change in crestal bone height has not, however, negatively impacted long-term implant success. This article describes how the concept of platform switching is incorporated into a new implant design as a means of reducing or eliminating the occurrence of crestal bone loss. Preliminary observations from clinicians utilizing this new implant design are herein presented.

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.

Immediate occlusal loading of Osseotite implants in the lower edentulous jaw. A multicenter prospective study.

OBJECTIVE: This paper reports the results of a prospective multicenter clinical study on immediately fully occlusally loaded full-arch screw-retained prostheses with distal extensions (hybrid prostheses) supported by Osseotite implants inserted in edentulous lower jaws. METHOD AND MATERIAL: Sixty-two patients were enrolled in four clinical centers. Three hundred and twenty-five Osseotite implants were inserted and occlusally loaded according to an immediate loading protocol. The temporary prosthesis was delivered 4 h from surgery. The final prosthesis was delivered after 6 months. Marginal bone loss was monitored from periapical radiographs using a computerized technique. RESULTS: Two implants failed to integrate within 2 months of occlusal loading. A cumulative implant success rate of 99.4% was achieved for a period of 12-60 months postplacement (mean 28.6+/-14.1 (SD) months). Crestal bone loss around the immediately loaded implants was similar to that reported for standard delayed loading protocols. CONCLUSION: The results of this study suggest that the rehabilitation of the edentulous mandible by an immediate occlusally loaded hybrid prosthesis supported by five to six Osseotite implants represents a viable alternative treatment to classic delayed loading protocols.

A meta-analysis evaluating the risk for implant failure in patients who smoke.

Failure of dental implants to achieve osseointegration is often attributed to patient baseline variables, such as smoking. This meta-analysis examines outcomes of clinical studies that monitored the performance of machined-surfaced and Osseotite, implants; the analysis also isolates the effect of smoking. The implant data for the machined-surfaced implants are derived from three prospective multicenter studies (n = 2,614) and from six prospective studies (n = 2,274) for the Osseotite implants. All implant placement surgeries followed a two-stage surgical approach with an unloaded healing period of 4 to 6 months. An evaluation of the data sets (i.e., smokers vs nonsmokers) was first performed to determine the existence of imbalance in baseline variables, including patient demographics, bone quality, location, dimensions, and types of prostheses. Analysis of the distributions of these baseline variables showed similar proportionalities and therefore qualified the data sets for comparison of the cumulative success rates (CSR) of the implants on the basis of smoking. For the 2,117 nonsmoking, machined-surfaced implants, the 3-year CSR is 92.8%; for the 492 implants in the smoking group, the CSR is 93.5%. The 3-year CSR for 1,877 nonsmoking Osseotite implants is 98.4%; for the 397 smoking implants it is 98.7%. No difference is observed between the smoking groups and the nonsmoking groups in these patient populations. There is, however, a clinically relevant difference observed between the two implant types.