Preliminary report of immediately loaded Altiva Natural Tooth Replacement dental implants.

BACKGROUND: Osseointegration may be described as a direct contact between living bone and an alloplastic implant. It is thought that a period of undisturbed healing is required to ensure osseointegration. The length of the healing period is dependent on a number of factors, such as implant material, surface configuration, site preparation technique, bone quality, healing capacity of the osteotomy, and implant design. Elimination of the healing period offers distinct advantages in terms of cost of therapy and convenience to patients. Recently, a new one-piece implant design was proposed that provides improved stability of the implant to allow immediate support of an interim prosthesis. PURPOSE: This article presents the initial clinical experiences when the Altiva Natural Tooth Replacement one-piece implant was used in a human clinical trial. MATERIALS AND METHODS: This was a prospective multicenter study of the placement and immediate loading of the one-piece implant. A total of 142 implants were placed in the jaws of 93 patients. Implants were placed consecutively and were followed at specified intervals in three private clinical practices. Clinical performance was recorded relative to implant survival and prosthesis support. RESULTS: The implant survival rate was 93.7%, with similar responses in the maxilla (95.0%) and the mandible (92.7%). When implant failure occurred, it was observed as mobility without infection within 3 to 5 weeks of implant insertion. CONCLUSIONS: On the basis of this trial, there is promising evidence that this implant design can succeed at rates similar to other designs that require conventional healing times.

Interim clinical study report: a threaded, hydroxylapatite-coated implant--five-year post-restoration safety and efficacy.

An ongoing prospective clinical trial is being conducted at three study sites to evaluate the safety and efficacy of a threaded, hydroxylapatite-coated implant (Steri-Oss Inc., Yorba Linda, CA) in a patient population reflective of the investigators' overall population of implant candidates. The 2062 implants placed and restored among 720 patients over the five-year period up to the study interim analysis cut-off date (November, 1994) include over 600 implants and 200 patients at each study site. Mean age and sex distribution of patients were comparable among the study sites. Study design attributes included well-defined patient selection criteria, standardized study procedures, standardized measurement and observation methodology, complete data accountability, and rigorously applied implant success/failure criteria. Thirty-five implants were considered failures at exposure, and the surgical success rate was 98.3%. Of 65 implants that failed post-restoration, three were removed, while 62 remained functional and in service. The five-year post-restoration follow-up success rate, determined by means of life table methodology, was 96.0%. By region, the five-year life table success rates post-restoration were 94.3% in the anterior maxilla, 96.6% in the posterior maxilla, 97.2% in the anterior mandible, and 95.6% in the posterior mandible. Adverse events occurred in association with less than 1% of the implants placed.

Success through astute preplanning.

This article discusses the "implant team" concept as it is actually carried out in an implantology practice. The restorative dentist is designated to function as the head of the team, directing each stage of the treatment. He is the first one the patient consults, he refers the patient to the surgeon, and he consults other specialists, if necessary. Excellent communication between the members of the team is stressed throughout.

A retrospective analysis of one implant system in an oral surgery practice. Phase I: Patient satisfaction.

A questionnaire was used to rate patients' satisfaction, expectations, and level of discomfort associated with implant treatment. The questionnaire was sent to 262 patients who had been treated with Core-Vent implants between 1984 and 1988. Over 60% of the patients contacted completed the questionnaire. The distribution of the respondents was evaluated according to age, sex, occupation, and marital status. Statistical interpretation of the data revealed that (1) measures of the level of satisfaction and expectation were significantly less for housewives when compared with other occupations; (2) satisfaction significantly correlated with measures of expectations and lack of discomfort; and (3) expectations correlated with lack of discomfort. In general, most subjects were extremely satisfied with the treatment they received.

Efficacy of threaded hydroxyapatite-coated implants placed in the anterior mandible.

A data subset from an ongoing prospective multicenter clinical study of threaded hydroxyapatite-coated implants was evaluated to assess safety and efficacy of the implants in anterior maxillary regions when used to support fixed prostheses. Observations were recorded before surgery, at first-stage surgery, at second-stage surgery, at loading, and at quarterly post-restoration prophylactic exams and annual comprehensive patient visits. Of 2,062 implants restored in 720 patients in the parent study, a total of 95 implants in 54 patients met the criteria for inclusion into this portion. Implant failure criteria included mobility, radiographic evidence of bone loss greater than one-third the length of the implant or peri-implant radiolucency, fracture, exfoliation, removal for any reason, and patient reported pain upon palpation. Soft tissue indices were monitored as part of the study. Post-restoration implant performance was analyzed using life-table methodology. No failures were observed before prosthodontic rehabilitation. Three implants failed during an observation period of up to 5 years after completion of prosthodontic treatment. The Cutler-Ederer life table success rate after 5 years was 93.4 percent. Results of this investigation suggest that threaded hydroxyapatite-coated implants are safe and effective when placed in anterior maxillary regions to support fixed prostheses.

Extravasation cyst diagnostic curettement: a treatment. Report of 15 cases and suggested treatment.

Fifteen cases of extravasation lesions of the mandible have been treated. In six cases, the lesions were entered surgically, explored, and directly curetted following preliminary diagnosis by needle aspiration. Healing was uneventful in all cases, and bone regeneration occurred rapidly. Hemorrhage was easily controlled, and the surgery was considered a minor procedure. Nine cases were treated by a combined diagnostic-curettement technique. The entire procedure was quickly performed under local anesthesia. There was little chance of injury to surrounding structures, and there were few postoperative sequelae. The resolution of the lesion and bone regeneration occurred in a time span similar to that of the surgical treatment of lesions.

Efficacy of threaded hydroxyapatite-coated implants placed in the posterior mandible in support of fixed prostheses.

A data subset from an ongoing prospective multicenter clinical study of threaded hydroxyapatite-coated implants was evaluated to assess safety and efficacy of the implants when used to support fixed prostheses in the posterior mandible. Observations were recorded before surgery, at first-stage surgery, at second-stage surgery, at loading, and at quarterly postrestoration prophylactic exams and annual comprehensive patient visits. Implant failure criteria included mobility, radiographic evidence of bone loss greater than one-third the length of the implant or peri-implant radiolucency, fracture, exfoliation, removal for any reason, and patient reported pain upon palpation. Soft tissue indices were monitored as part of the study. Postrestoration implant performance was analyzed using life-table methodology. From the 2,062 implants restored in 720 patients in the parent study, a total of 423 implants in 195 patients were included in the posterior mandibular data subset. Thirteen implants failed at or before second-stage surgery for a surgical success rate of 96.9 percent. Prosthodontics was completed, and one or more postrestoration annual follow-up visits occurred for 314 implants as of the interim analysis cutoff date. Fourteen implants failed during an observation period extending up to 62 months after completion of prosthodontic treatment. One failed implant was removed, whereas the 13 remaining implants are functional despite having been identified as failures under the protocol criteria. The Cutler-Ederer life table success rate after 5 years was 92.2 percent. Results of this investigation suggest that threaded hydroxyapatite-coated implants are effective when placed in posterior mandibular regions in support of fixed prostheses.

Efficacy of threaded hydroxyapatite-coated implants in the anterior mandible supporting overdentures.

A data subset from an ongoing prospective multicenter clinical study of threaded hydroxyapatite-coated implants was evaluated to assess safety and efficacy of the implants when placed in the anterior mandible to support overdentures. Observations were recorded before surgery, at first-stage surgery, at second-stage surgery, at loading, and at quarterly postrestoration prophylactic exams and annual comprehensive patient visits. Implant failure criteria included mobility, radiographic evidence of bone loss greater than one-third the length of the implant or peri-implant radiolucency, fracture, exfoliation, removal for any reason, and patient reported pain upon palpation. Soft tissue indices were monitored as part of the study. Postrestoration implant performance was analyzed using life-table methodology. From the 2,062 implants restored in 720 patients in the parent study, a total of 660 implants in 174 patients were included in the anterior mandibular overdenture data subset. Twelve implants in 8 patients failed at or before second-stage surgery for a surgical success rate of 98.2 percent. Five implants failed during an observation period extending up to 72 months after completion of prosthodontic treatment. The Cutler-Ederer life table success rate after 5 years was 97.8 percent. No significant adverse events were reported during the observation period. Results of this investigation suggest that threaded hydroxyapatite-coated implants are effective when placed in anterior mandibular regions in support of overdentures.