Research

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ORIGINAL STUDY
Issue: 01/2013 - E. Esser - C. Schmidt
Frame technique using an allogenic bone matrix for simultaneous implantation and horizontal bone augmentation

Introduction: So far there is no long-term data available which show superiority in the use of a distinctive bone augmentation technique. Therefore, this study reports about first experiences with an allogenic bone matrix for the simultaneous augmentation of horizontal bone deficits in combination with the simultaneous insertion of dental implants.

Material and methods: In 26 patients (14 male, 12 female, average age 57,2 years) with an horizontal bone width of ? 4mm in an area of at least three adjacent teeth, 106 dental implants (Type: NobelActive) were inserted in 38 locations. A demineralized allogenic bone matrix in combination with allogenic cancellous bone was used for the augmentation of the horizontal bone deficit. After a healing time of 4 to 6 months, the implants were expired and loaded with a fixed or removable denture.

Results: 106 implants were inserted, 86 of them were loaded. 5 implants lacked of osseointegration. Healing complications were observed in one patient. The histologic inspection showed a narrow zone of newly formed bone linked to the allogenic transplant. The gain in bone was stable und showed no resorption tendency so far.

Discussion: The use of allogenic bone for the augmentation of horizontal bone deficits shows a favorable healing tendency and a stable gain in bone volume. These results should be evaluated as first experiences in the sense of a pilot study. The procedure should be limited to the therapy of horizontal bone defects

Citation:

Esser E, Schmidt C: Frame technique using an allogenic bone matrix for simultaneous implantation and horizontal bone augmentation. Z Zahnärztl Implantol 2013;29:49?57. DOI 10.3238/ZZI.2013.0049?0057

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Issue: 01/2013 - M. Merli - M. Moscatelli - A. Mazzoni - G. Mariotti - M. Nieri
Lateral bone augmentation applying different biomaterials

Introduction: This paper describes the treatment of horizontal osseous defects around implants in a one-stage split-mouth approach in a middle-aged female patient.

Method and Material: The same identical reconstruction technique was performed in both surgical sites using different biomaterials: a ?-tricalciumphosphate (Ceros TCP granules) grafting material and a porcine, collagen pericardium resorbable membrane (Remotis) were employed on the test side and a deproteinized, bovine bone matrix (Bio-Oss) and a porcine, collagen resorbable membrane (Bio-Gide) on the control side. Bone substitutes were mixed with autologous bone (approximately 10%) harvested during implant insertion procedures.

Results: Substantial bone regrowth was evident in both ridges, although only the test side underwent complete regeneration. Histological examination of the regenerated areas showed the presence of mature bone organized around particles of biomaterial during the incorporation phase.

Conclusion: Both therapeutic approaches have proved favorable in terms of covering the initially exposed implant threads.

Citation:

Merli M, Moscatelli M, Mazzoni A, Merli M, Mariotti G, Nieri M: Lateral bone augmentation applying different biomaterials A clinical and histological evaluation of a case report. Z Zahnärztl Implantol 2013;29:70-79. DOI 10.3238/ZZI.0070-0079

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Issue: 01/2013 - F. Petschelt - M. Millian - T. Kraußeneck
Analysis of the precision of implant templates

Aim: The aim of this study was to evaluate the precision of holes drilled in implant templates, which were analyzed with cone beam computed tomography (CBCT) using suitable planning software.

Material and methods: 40 templates that had been used clinically to enable successful treatment were studied. 17 of the analyzed templates were fabricated with the Med3D program (C. Hafner GmbH, Pforzheim) and 23 templates were made with the ExpertEase software of Dentsply Friadent GmbH. The Scanora Soredex was used for CBCT. Comparative measurements were made on a plaster model with silicone key using an individually fabricated appliance. 3 holes were drilled in each template by 3 different persons. The resulting data were compared to within less than a millimeter.

Results: Maximum deviations of 2.0mm in the horizontal dimension and 1.0 mm in the vertical dimension were found. Much smaller deviations with more precise positions were found with the ExpertEase version compared with the Med3D-assisted procedure.

There were no significant differences in drilling precision between an experienced implantologist and a dental nurse without any practical experience on patients.

Conclusion: With observation of the basic principles of implantology and use of planning software for template-guided surgery, exact implant placement to within less than a millimeter is possible, even in the most demanding situations.

Citation

Petschelt F, Millian M. Kraußeneck: Analysis of the Precision of Implant Templates. Z Zahnärztl Implantol 2013;29:58?69. DOI 10.3238/ZZI.2013.0058?0069

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Issue: 02/2013 - M. Stopper - M. Lorenzoni - - S. Vogl - WA Wegscheider
Immediately and conventionally loaded implants in the edentulous mandible

Objective: The aim of this current investigation was to evaluate clinical outcomes of conventional and immediate loaded implants and Dolder bars in the interforaminal region of the lower jaw after 5 years of clinical function.

Materials and methods: 160 implants were inserted in the interforaminal region. 20 patients of the control group were treated after a healing period of 3 months and 20 patients of test group were loaded within one week with Dolder bars and overdentures. Annual radiographic bone resorption, Periotest values and survival rates were recorded and evaluated.

Results: All implants (160 implants) were placed with an insertion torque of more than 20Ncm. The evaluated mean coronal bone loss increased from 0.56mm to 1.91mm after five years of clinical function in the control group and from 0.55mm to 1.98 mm in the test group. The median Periotest value was between –4 and –5 for the immediately loaded and the conventionally restored implants. After an observation period of 5 years the survival rate was 100% in both groups.

Conclusion: These results after 5 years of loading suggest that interforaminal implants can be treated conventionally and immediately and restored with Dolder bars with clinically predictable outcomes with stable coronal bone levels.

Citation:

Lorenzoni M, Stopper M, Vogl S, Wegscheider WA: Immediately and conventionally loaded implants in the edentulous mandible. Z Zahnärtzl Implantol 2013;29:130?138

DOI 10.3238/ZZI.2013.0130?0138

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Issue: 02/2013 - M. Stopper - M. Lorenzoni - - S. Vogl - WA Wegscheider
test Immediately and conventionally loaded implants in the edentulous mandible

Objective: The aim of this current investigation was to evaluate clinical outcomes of conventional and immediate loaded implants and Dolder bars in the interforaminal region of the lower jaw after 5 years of clinical function.

Materials and methods: 160 implants were inserted in the interforaminal region. 20 patients of the control group were treated after a healing period of 3 months and 20 patients of test group were loaded within one week with Dolder bars and overden

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Issue: 03/2013 - R. Schneider - R. Hinkle - D. Galasso - P. Zeman
Clinical report on a follow-up of 415 implants with two designs: a multicenter retrospective analysis and a case report

Introduction: The purpose of this report is to evaluate survival rates of 2 implants with slightly different machined collar height and body design (1.0mm vs. 1.5mm, cylindrical vs. cylindric-conical) but with the same enossal surface. The implants were placed in partially and fully edentulous patients in three centers. A retrospective chart review study was undertaken to evaluate the performance of implant based restorations. Mesial and distal alveolar bone heights were evaluated radiographically.

Material and Methods: Data were collected by 3 practitioners on 2 different design implants. Implant survival was calculated. Change in alveolar bone level was measured from periapical radiographs.

Results: 154 treated patients were followed up for 1.8 years. Included were 18 patients with 64 implants that had a minimum of 60 Gy radiation to the area due to treatment for their previous malignant disease. Failure to obtain osseointegration was seen in 3 patients who received 4 implants. The overall implant survival rate was 99.0%, implant failure rate 0.7% prior to and 0.2% after the restoration.

Discussion: Both implant types appear to be a satisfactory choice for treatment of either the totally or partially edentulous patients in both simple and complex situations. This conclusion is supported by the outcome obtained in a patient edentulous both in the upper and lower jaw. Eight years after surgery both overdentures were intact and stable with normal function. No difference was observed in the previously irradiated patients.

Citation:

Schneider R, Hinkle R, Galasso D, Zeman P: Clinical Report on a Follow-up of 415 Implants With Two Designs: a Multicenter Retrospective Analysis and a Case Report. Z Zahnärztl Implantol 2013;29:214–229

DOI 10.3238/ZZI.2013.0214–0229

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Issue: 04/2013 - E. Schneider - G. Wahl
Radiographic detection of artificial bone lesions adjacent to dental implants in human jaw – an in-vitro study model

Introduction: The aim of this study was to evaluate the diagnostic efficacy of conventional intraoral radiographs for detection of bone lesions adjacent to dental implants in an ex-vivo model. Furthermore, the authors aimed to characterize additional factors influencing their detectability.

Materials and Methods: In 19 human cadaver bloc sections from upper and lower jaws provided with implants, artificial defects with progressively increasing size (n=9) were created. Two analogue intraoral radiographs were taken of each defect (orthoradial and oblique technique). Six investigators were asked to decide on the presence of a bony lesion on 380 randomly presented radiographs. Linear regression analysis was performed to evaluate data.

Results: The minimum size of a defect, which was detected by almost 50 percent of the observers, was 1.8mm in diameter. The radiographic detection correlated with an increasing size of the defect and was more frequent when the intraoral radiograph was taken with the oblique technique. In addition, the defect's location (oral or buccal side of the implant) and the bone structure (maxilla or mandible) were of major concern. There was a significantly higher rate of detection for bone lesions in the maxilla and if the defect was near to the intraoral x-ray film.

Discussion: If there is a reasonable suspicion for bone lesions near implants, which are not visible in standard periapical films, an additional x-ray taken with the oblique technique can provide further information. For the visualization of very small defects different imaging methods may be considered.

Citation:

Schneider E, Wahl G: Radiographic detection of artificial bone lesions adjacent to dental implants in human jaw – an in-vitro study model. Z Zahnärztl Implantol 2013;29:308–320

DOI 10.3238/ZZI.2013.0308–0320

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