Clipping Literatura Científica - 2012

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Clinical Implant Dentistry and Related Research
Vol. 14 No. 1 (March 2012)
Lindgren C, Mordenfeld A, Hallman M. A prospective 1-year clinical and radiographic study of implants placed after maxillary sinus floor augmentation with synthetic biphasic calcium phosphate or deproteinized bovine bone. Clin Implant Dent Relat Res 2012;14(1):41-50.
Bilateral elevation of the sinus membrane was performed in nine edentulous and two partially edentulous patients. Augmentation was performed with synthetic biphasic calcium phosphate (BCP (Straumann BoneCeramic)) on one side and deproteinized bovine bone (DBB) on the contralateral side. A total of 62 implants were placed after 8 months and evaluated for 1 year. One implant in each biomaterial was lost, giving an implant survival rate of 96.8% for both materials, while the implant success rates were 91.7% and 95.7% in BCP and DBB, respectively. No significant differences in marginal bone loss were found between the materials. Implant success was therefore independent of the augmentation material in sinus augmentation.
Rasmusson L, Thor A, Sennerby L. Stability evaluation of implants integrated in grafted and nongrafted maxillary bone: a clinical study from implant placement to abutment connection. Clin Implant Dent Relat Res 2012;14(1):61-66.
A total of 260 implants were placed in 35 edentulous patients, 25 of whom had severe maxillary atrophy; of these, 19 received lateral onlay block grafts on one side (group A), particulate bone on the other (group B) and sinus augmentation with particulate bone (group C). A LeFort operation with interpositional bone grafts was performed in six patients (group D), while the remaining 10 received implants without bone augmentation (group E; control). Four implants (two each in groups A and D) were removed due to mobility at abutment connection. A slight increase in implant stability was noted from implant placement to abutment connection in all groups, but the difference was not significant. ISQ values were significantly lower in group D compared to all other groups.
Gotfredsen K. A 10-year prospective study of single tooth implants placed in the anterior maxilla. Clin Implant Dent Relat Res 2012;14(1):80-87.
In 20 patients, implants were placed to replace single teeth after either 4 or 12 weeks. Clinical and periodontal parameters were recorded at baseline and annually thereafter, while functional and aesthetic outcomes were evaluated after 3 and 10 years. The implant survival rate was 100% after 10 years, and the crown survival rate was 90%. Mean marginal bone loss was < 1 mm after 10 years in both groups; bone loss was > 1.5 mm in one patient and between 1-1.4 mm in three patients. Patient satisfaction was observed to decrease over time.
Al-Nawas B, Kämmerer PW, Morbach T, Ladwein C, Wegener J, Wagner W. Ten-year retrospective follow- up study of the TiOblast dental implant. Clin Implant Dent Relat Res 2012;14(1):127-134.
A total of 106 edentulous or partially edentulous patients received 516 implants; augmentation was performed prior to placement for 153 implants, while 23 implants were placed post-radiation and 64 implants were irradiated after placement. For a mean follow-up time of 108 months, the implant survival rate was 89.7%; 83 patients with 403 implants were available for follow-up investigation. In 26 patients, implants had been removed due to lack of osseointegration (22 implants), peri-implantitis (18 implants), implant fracture (nine implants), failing of primary stability (two implants) and placement next to tumours (two implants). The success rate was 76% to 89%, depending on the success criteria used.
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Clinical Oral Implants Research
Vol. 23 No. 1 (January 2012)
Vol. 23 No. 2 (February 2012)
Cecchinato D, Bressan EA, Toia M, Araújo MG, Liljenberg B, Lindhe J. Osseointegration in periodontitis susceptible individuals. Clin Oral Implants Res 2012;23(1):1-4.
In 36 patients who had lost teeth due to periodontitis (19 patients) or other reasons (17 patients), a block of hard tissue was removed by trephine and hard tissue lateral to the biopsy site was prepared for the placement of micro implants (5 mm long, 2.2 mm diameter). The implants and surrounding tissue were removed after 3 months and evaluated. Healing was similar in both periodontitis-susceptible and non- susceptible patients, with similar bone-to-implant contact (BIC) and mineralized bone between implant threads. At biopsy sites, there was a weak negative correlation between volume of fibrous tissue and length of BIC, and a weak positive correlation between volume of bone marrow and BIC.

Palmer RM, Howe LC, Palmer PJ, Wilson R. A prospective clinical trial of single Astra Tech 4.0 or 5.0 diameter implants used to support two-unit cantilever bridges: results after 3 years. Clin Oral Implants Res 2012;23(1):35-40.
Single implants were placed to support two-unit cantilever prostheses in the premolar/molar regions of 29 patients. High patient satisfaction was noted, and the most important complication was abutment screw loosening (single in four patients and recurrent in six patients). Stable bone levels were observed, with no differences between cantilever and non-cantilever sides. Single implants can therefore be successfully used to support two-unit cantilever prostheses in the premolar region. 

Schneider D, Witt L, Hämmerle CHF. Influence of the crown-to-implant length ratio on the clinical performance of implants supporting single crown restorations: a cross-sectional retrospective 5-year investigation. Clin Oral Implants Res 2012;23(2):169-174.
Clinical and radiographic assessments, including marginal bone level and crown/implant length ratio, were performed in 70 patients with 100 implants supporting single crowns. The mean follow-up period was 6.2 years and the cumulative implant survival rate was 95.8% after 5 years. Mean technical and biological crown/implant ratios were 1.04 ± 0.26 and 1.48 ± 0.42, respectively, and there was no significant influence on implant survival, marginal bone level or the occurrence of complications; only smoking was significantly associated with implant failure and complications.

Schwarz F, Sahm N, Becker J. Impact of the outcome of guided bone regeneration in dehiscence-type defects on the long-term stability of peri-implant health: clinical observations at 4 years. Clin Oral Implants Res 2012;23(2):191-196.
Residual defect height (RDH) for dehiscence-type defects at implants was assessed after 4 months of submerged healing following augmentation with natural bone mineral and either a cross-linked or collagen membrane. RDH vales were 0 mm (control), 1 mm (test 1) and > 1 mm (test 2). Clinical parameters were recorded 4 years after prosthesis placement. Mean probing depth was comparable in all groups, and mean mucosal recession and bleeding on probing were increased in the test groups. A higher risk of developing peri-implant disease was therefore observed for RDH values > 1 mm.


Dierens M, Vandeweghe S, Kisch J, Nilner K, De Bruyn H. Long-term follow-up of turned single implants placed in periodontally healthy patients after 16-22 years: radiographic and peri-implant outcome. Clin Oral Implants Res 2012;23(2):197-204.
From an original 134 patients, implant survival could be assessed after at least 16 years in 101 patients, and 50 were clinically examined. Bone level was assessed at 1-4 years, 5-8 years and 16-22 years, and periodontal parameters were recorded. Of 166 implants, 11 failed, giving a cumulative implant survival rate of 91.5%. Mean bone level was 1.7 ± 0.88 mm after 16-22 years, and changes in bone level were significant between baseline and 1-4  years.  Bone  level  ≤  2nd thread was present at 81.4% of the implants and probing depth > 5 mm was present at 91.5% of implants; 76.3% of implants had both. A steady-state bone level was generally observed, but progressive bone loss was observed at a minority of implants.


Hämmerle CHF, Jung RE, Sanz M, Chen S, Martin WC, Jackowski J; On behalf of the multicenter study group, Ivanoff C-I, Cordaro L, Ganeles J, Weingart D, Wiltfang J, Gahlert M. Submerged and transmucosal healing yield the same clinical outcomes with two-piece implants in the anterior maxilla and mandible: interim 1-year results of a randomized, controlled clinical trial. Clin Oral Implants Res 2012;23(2):211-219.
Implant placement with either submerged or transmucosal healing was performed in the anterior maxilla and/or mandible in 127 patients. Clinical and radiographic measurements were taken at implant placement and after 6 and 12 months. The mean change in crestal bone level from baseline to 6 months was -0.32 mm and -0.29 mm in the submerged and transmucosal groups, respectively, while the change from baseline to 12 months was -0.47 mm and -0.48 mm in the submerged and transmucosal groups, respectively; the differences between the groups were not significant. Good results for soft tissue parameters and patient satisfaction were obtained. The results indicated that submerged and transmucosal healing of implants were equally successful.


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European Journal of Oral Implantology
Vol. 4 No. 4 (January 2012)
Vol. 4 No. 5 (January 2012)
Esposito M, Cannizarro G, Soardi E, Pellegrino G, Pistilli R, Felice P. A 3-year post-loading report of a randomised controlled trial on the rehabilitation of posterior atrophic mandibles: short implants or longer implants in vertically augmented bone? Eur J Oral Implantol 2011;4(4):301-311.
A total of 60 patients with residual crest 7-8  mm  high  and  ≥  5.5  mm  thick  received  one  to  three  short  implants   or longer implants in vertically augmented bone. Provisional acrylic prostheses were placed after 4 months and replaced by definitive metal-ceramic prostheses after another 4 months. Augmentation failed in two patients, so short implants had to be used. No significant differences in prostheses or implant failures were noted between the groups, but there were significantly more complications in the augmented patients. Mean bone loss after 3 years was 1.24 mm in the short implant group and 1.76 mm in the augmented group; the difference was significant. Short implants may therefore be a suitable alternative to vertical augmentation.

De Angelis N, Felice P, Pellegrino G, Camurati A, Gambini P, Esposito M. Guided bone regeneration with and without a bone substitute at single post-extractive implants: 1-year post-loading results from a pragmatic multicentre randomised controlled trial. Eur J Oral Implantol 2011;4(4):313-325.
Bone augmentation at single immediate post-extractive implants was performed in 80 patients using either resorbable barrier alone or in combination with a bone substitute. Implants were loaded after 4 months. There were seven implant failures (five and two in the membrane and combination groups, respectively). The mean bone level over 1 year changed from -0.21 mm to -1.04 mm in the combination group and from -1.92 mm to - 1.76 mm in the membrane group. Patients were equally satisfied with both treatments. The aesthetic outcomes appeared to be improved by the use of the bone substitute material.


Felice P, Soardi E, Piattelli M, Pistilli R, Jacotti M, Esposito M. Immediate non-occlusal loading of immediate post-extractive versus delayed placement of single implants in preserved sockets of the anterior maxilla: 4- month post-loading results from a pragmatic multicentre randomised controlled trial. Eur J Oral Implantol 2011;4(4):329-344.
A total of 106 patients received single immediate post-extraction implants in the maxilla or socket preservation using anorganic bovine bone and a collagen membrane, with delayed implants placed after 4 months. The implants were restored with provisional non-occlusive crowns, replaced by definitive crowns after 4 months. Immediate loading was not possible for 19 implants in the immediate placement groups and 39 implants in the delayed placement group, due to insertion torque > 35 Ncm not being obtained. There were two implant failures in the immediate group and none in the delayed group, and there were significantly more minor complications in the immediate group. No significant differences were found between the groups for aesthetics, and patients in both groups were equally satisfied.


Perelli M, Abundo R, Corrente G, Saccone C. Short (5 and 7 mm long) porous implant in the posterior atrophic mandible: a 5-year report of a prospective study. Eur J Oral Implantol 2011;4(4):363-368.
A total of 55 short implants (5 or 7 mm in length) were placed in 40 patients and left to heal for 4 months before being loaded with single crowns (21 implants), splinted to adjacent implants (32 implants), or loaded with overdentures (two implants). The follow-up period was 5 years. Nine implants were removed and there were four crown failures, but no complications were noted during the healing period. Severe peri-implantitis occurred at two implants, necessitating implant removal. After 5 years, survival rates were 84% and 80% at the implant and patient levels, respectively.
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International Journal of Oral and Maxillofacial Implants
Vol. 26 No. 6 (November/December 2011)
Roe P, Kan JYK, Rungcharassaeng K, Lozada JL. Immediate loading of unsplinted implants in the anterior mandible for overdentures: 3-year results. Int J Oral Maxillofac Implants 2011;26(6):1296-1302.
Each of eight patients received two unsplinted implants to support a mandibular overdenture. Clinical and radiographic evaluations were performed at implant placement and after 3 months and 1, 2 and 3 years. All implants were in place after 3 years, and the mean marginal bone level change was -0.58 ± 0.39 mm. Plaque index showed an improvement in the first year but some relapse thereafter, and there was a high incidence of complete or partial fracture of the overdentures; however, peri-implant tissue responses were favourable.

Cochran DL, Jackson JM, Bernard J-P, ten Bruggenkate CM, Buser D, Taylor TD, Weingart D, Schoolfield JD, Jones AA, Oates TW Jr. A 5-year prospective multicenter study of early loaded titanium implants with a sandblasted and acid-etched surface. Int J Oral Maxillofac Implants 2011;26(6):1324-1332.
A total of 439 implants were placed in 135 partially and fully edentulous patients, with abutments connected after 6 weeks in type II and III bone and after 12 weeks in type IV bone. Evaluations were performed for up to 5 years, after which the cumulative implant survival and success rates were 99.1% and 98.8%, respectively; al implant failures were between surgery and 1 year. SLA-surfaced implants can therefore be loaded after 6 weeks in type II and III bone and maintain high survival and success over 5 years.


Norton MR. The influence of insertion torque on the survival of immediately placed and restored single-tooth implants. Int J Oral Maxillofac Implants 2011;26(6):1333-1343.
Failing teeth were extracted and 68 implants immediately placed using  a  low  insertion  torque  protocol  (≤  25   Ncm) in 61 patients. The 5-year implant survival rate was 95.5% and the mean marginal bone loss for 54 implants followed for 24 months was 0.23 ± 0.60 mm and 0.20 ± 0.72 mm mesially and distally, respectively. No significant correlations were observed between insertion torque, age, gender, implant size, tooth position and marginal bone loss. A low insertion torque protocol can therefore result in high survival rates. 
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International Journal of Periodontics and Restorative Dentistry
Vol. 31 No. 6 (November/December 2011)
Vol. 32 No. 1 (February 2012)

Gruender U, Wenz B, Schupbach P. Guided bone regeneration around single-tooth implants in the esthetic zone: case series. Int J Periodontics Restorative Dent 2011;31(6):613-620.
Implants were placed 8 weeks after tooth extraction and sites augmented using bone substitute and a non- resorbable titanium-reinforced membrane. After 6 months, histological analysis showed ongoing bone formation and an adequate amount of hard and soft tissue.


Froum SJ, Froum SH, Rosen PS. Successful management of peri-implantitis with a regenerative approach: a consecutive series of 51 treated implants with a 3- to 7.5-year follow-up. Int J Periodontics Restorative Dent 2011;32(1):11-20.
This was a case series  of  51  implants  in  38  patients;;  implants  had  bleeding  on  probing,  probing  depth  ≥  6  mm   and   bone   loss   ≥   4   mm   prior   to   surgery,   and   a   regenerative   approach   was   employed.   Patients   were   in   two   groups: those in which the greatest defect depth was radiographically visible (group 1), and those where the greatest bone loss was on the facial or oral aspect of the implant (group 2). Mean probing depth reductions were 5.4 mm and 5.1 mm in groups 1 and 2, respectively, and concomitant bone level gain was 3.75 mm and 3.0 mm, respectively. Encouraging results were therefore observed with this approach.


Antoun H, Belmon P, Cherfane P, Sitbon JM. Immediate loading of four to six implants in completely edentulous patients. Int J Periodontics Restorative Dent 2011;32(1):e1-e9.
A total of 44 patients received four or six implants to support full-arch acrylic resin prostheses. Of 205 implants, three were lost after a mean follow-up period of 17.6 months. Cosmetic fractures were observed in six patients, and prosthetic fracture was observed in one patient. Marginal bone loss between two and five threads was apparent at 6.4% of implants. Immediate loading on for or six implants was therefore considered a reliable technique.


Crespi R, Capparè P, Gherlone E, Romanos G. Immediate provisionalization of dental implants placed in fresh extraction sockets using a flapless technique. Int J Periodontics Restorative Dent 2011;32(1):29-37. Ion 15 patients, 20 implants were placed immediately after tooth extraction using a flapless technique and immediately provisionalised. All implants survived up to 24 months and periodontal parameters remained stable for up to 24 months. The mean bone loss after 24 months was 0.83 ± 0.52 mm. Flapless immediate implant placement and immediate provisionalisation was therefore a suitable treatment.


Levine RA, Sendi P, Bornstein MM. Immediate restoration of nonsubmerged titanium implants with a sandblasted and acid-etched surface: five-year results of a prospective case series study using clinical and radiographic data. Int J Periodontics Restorative Dent 2011;32(1):39-47.
Mandibular first molar sites in 20 patients were treated with 21 implants, with provisional restorations placed on the day of surgery and definitive restorations after 8 weeks. The distance from implant shoulder to first BIC (DIB) and the Community Periodontal Index of Treatment Needs (CPITN) were evaluated over 5 years. The mean CPITN decreased from 3.24 to 1.43 and the mean DIB increased from 1.41 mm to 1.99 mm. Implant survival and success were 100%.

Cordaro L, Di Torresanto VM, Torsello F. Split-mouth comparison of a coronally advanced flap with or without enamel matrix derivative for coverage of multiple gingival recession defects: 6- and 24-month follow-up. Int J Periodontics Restorative Dent 2011;32(1):e10-e20.
Buccal gingival recession defects in 10 patients were treated by coronally advanced flap with or without the addition of EMD. Clinical measurements were assessed at baseline and after 6 and 24 months. Significant root coverage was obtained by both procedures after 6 months, and there was a similar amount of relapse in both procedures by 24 months.

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Journal of Clinical Periodontology
Vol. 39 No. 1 (January 2012)
Vol. 39 No. 2 (February 2012)
Costa FO, Takenaka-Martinez F, Cota LOM, Ferreira SD, Silva GLM, Costa JE. Peri-implant disease in subjects with and without preventive maintenance: a 5-year follow-up. J Clin Periodontol 2012;39(2):173- 181.
Periodontal and peri-implant examinations were carried out in 212 patients with implants at baseline, and 80 patients diagnosed with mucositis at baseline were re-examined after 5 years, One group had preventive maintenance during the study period, while a second group did not. The incidence of peri-implantitis in those who received preventive maintenance was 18.0%, while in those who did not it was 43.9%; the overall incidence was 31.2%. Clinical parameters were also associated with a greater risk of developing peri- implantitis.


Schliephake H, Rödiger M, Phillips K, McGlumphy EA, Chacon GE, Larsen P. Early loading of surface modified implants in the posterior mandible – 5 year results of an open prospective non-controlled study. J Clin Periodontol 2012;39(2):188-195.
In the posterior mandibles of 44 patients, 134 TiO2 blasted, fluoride-modified surface implants were placed and loaded after 7 weeks. Implant stability, bone level and clinical parameters were recorded for up to 5 years. A total of 41 patients with 123 implants completed the study. Implant stability significantly decreased from placement to 2 weeks and then increased significantly up to 1 year, while plaque accumulation increased from loading to the end of the study. Mean marginal bone level changed from 0.59 mm at placement to 0.80 mm at loading, with only slight variations thereafter. Early loading is therefore a viable treatment option for posterior edentulism.


Merli M, Moscatelli M, Mariotta G, Piemontese M, Nieri P. Immediate versus early non-occlusal loading of dental implants placed flapless in partially edentulous patients: a 3-year randomized clinical trial. J Clin Periodontol 2012;39(2):196-202.
Implants were placed in 60 partially edentulous patients to support fixed partial dentures; loading was non- occlusal and either early (control) or immediate (test). Implant failure, complications and bone level were evaluated for up to 3 years. No implant failures were noted and three complications were noted, two in the control group and one in the test group. The mean bone level after 3 years was 1.91 mm and 1.59 mm in the test and control groups, respectively. The null hypothesis of no difference between the treatment groups could not be rejected.
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Journal of Oral Implantology
Vol. 37 No. 6 (December 2011)
Bilhan H, Geckili O, Mumcu E, Bilmenoglu C. Maintenance requirements associated with mandibular implant overdentures: clinical results after first year of service. J Oral Implantol 2011;37(6):697-704.
Patients were treated with implants to support mandibular overdentures; patients received two or three single interforaminal implants, or three or four splinted interforaminal implants. A total of 59 patients appearing at the 12-month recall visit were included in the study, which examined prosthetic parameters and the condition of the tissues. There was no significant relationship between attachment type, bite force values, implant number and complications with the exception of relining, which was significantly greater in the ball attachment group.

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Quintessence International
Vol. 43 No. 1 (January 2012)
Vol. 43 No. 2 (February 2012)
Drew HJ, Alnassar T, Gluck K, Rynar JE. Considerations for a staged approach in implant dentistry. Quintessence Int 2012;43(1):29-36.
The transition from fixed dentition to a removable prosthesis, often supplied during implant osseointegration, can be difficult for the patient and can generate several challenges. Reconstruction of the dentition through a staged approach with strategic extractions and the placement of implants, using selected abutment teeth for a fixed prosthesis, may be an alternative option. In this way, the provisional tooth-supported prosthesis can later be converted to an implant-supported prosthesis, so that the patient has a fixed prosthesis throughout treatment. This approach requires good communication between periodontist, surgeon, restorative dentist, laboratory and patient, and needs a team approach. The advantages and disadvantages of the protocol are discussed.


Furze D, Byrne A, Donos N, Mardas N. Clinical and esthetic outcomes of single-tooth implants in the anterior maxilla. Quintessence Int 2012;43(2):127-134.
Implants were placed with simultaneous guided bone regeneration 6 to 8 weeks after extraction of 10 single failing teeth and provisionally loaded after 2-3 months. Definitive loading was performed after a further 6 months. Aesthetic outcomes were evaluated after 1 year using the pink and white esthetic scores. All implants survived, and good aesthetic outcomes were observed; the mean PES and WES scores were 7.9 ± 1.7 and 7.0 ± 1.5, respectively.