Implant insertion is an alternative to classical treatment with bridges after tooth extraction or traumatic tooth loss in the anterior and premolar region of the upper and lower jaw. Nevertheless both types of prosthe...Implant insertion is an alternative to classical treatment with bridges after tooth extraction or traumatic tooth loss in the anterior and premolar region of the upper and lower jaw. Nevertheless both types of prosthetic treatment inhere major gingival aesthetic pitfalls by physiological vertical and horizontal resorption. Aim of the study was to investigate if the immediate insertion of root analogue single-stage implants and prosthetic treatment could prevent gingival recessions and bone resorption thus keeping the natural gingival aesthetics untouched. Between 2003 and 2006, 348 root analogue Q1-Implants (TRINON Karlsruhe GmbH/Germany) were inserted in 342 patients’s premolar and molar regions immediately after tooth extraction or traumatic tooth loss and treated with provisional resin crowns. The observation period with recurring 6-month clinical and radiographic check-ups was a minimum of 5 years. Of 348 inserted implants 4 (1.15%) were lost resulting in an overall success rate of 98.85%. In the first 12 weeks after surgery a mean recession of the buccal gingival margin of 0.2 mm (SD 0.34) could be detected, after final prosthetic treatment an overall mean recession of 0.2 mm (SD 0.13) within the survey period. Immediate implant insertion of root analogue single stage implants and immediate prosthetic treatment with provisional resin crowns after minimal invasive tooth extraction seems to be appropriate to prevent bone resorptions of the buccal alveolar crest and the recessions of the gingiva and papillae and thus suggests to be the preferable treatment to keep the natural gingival and papillary aesthetics untouched preventing further traumatic surgical gingival reconstructions.展开更多
Half of altogether 60 cylindrical implant devices made of titanium-aluminum-vanadium alloy （ Ti-6Al-4V） were plusna-sprayed with a hydroxyapatite-couting and the other half had a corundum blasted porous surface. 15...Half of altogether 60 cylindrical implant devices made of titanium-aluminum-vanadium alloy （ Ti-6Al-4V） were plusna-sprayed with a hydroxyapatite-couting and the other half had a corundum blasted porous surface. 15 implants of each group of the titanium test buplants were coated with 230 μg porcine, high-purified BMP- 3-precipitute per implant. In each case a BMP- 3-couted and an uncoated control-device were implanted into the femoral part of the putellofemoral joint of the right and left leg of 30 adult giant rabbits. Histomorphological and histomorphometrical we found in both groups with BMP- 3-coated test devices an improved osteointegrution. Stutistical evaluation using the t-test for matched samples showed 5 weeks after surgery a significant higher volume of tony formed bone of the BMP- 3-coated corundum- blasted or hydroxyapathe- coated Ti- 6Al- 4 V test devices compared to the non-couted controls of the same t）pe （p 〈 0.01, t-test for matched samples）. In both implant groups with BMP-couting a synergetic effect was verifiable although the bone ongrowth in the hydroxyaputite coated implants was more extensive than in the corundum blasted implants. Light microscopy demonstrated osteointegrution without connective tissue membrane around the surface of the implants. Our results indicate that composite metal implants,as used in endoprosthetics and implantology , are suitable carriers for BMP- 3 and im proved fixation of the implants can be achieved. The hydroxyapatite surface is superior to the corundum-blasted surface with regards to the observed parameters because of its pronounced bioactivity and its osteoconductive characteristics.展开更多
Introduction: The current discussion about the use of short implants to avoid bone-augmentation (“sinus lift”) in the lateral maxilla remains a controversial topic and is increasingly at odds with the reality of evo...Introduction: The current discussion about the use of short implants to avoid bone-augmentation (“sinus lift”) in the lateral maxilla remains a controversial topic and is increasingly at odds with the reality of evolutionary biology. Aim of the study was to determine the percentage of cases from a large routine patient-sample in which short implants might be suitable to avoid sinus lift procedures. Materials and Methods: From January 2012 to June 2015, all patients in three general dental practices in Austria with at least one subantral edentulous area were subjected to routine panoramic X-ray screening. The subantral alveolar ridge heights and the mesial extension of the maxillary sinus towards the canine fossa were measured. Statistics were performed by Excel data analysis (mean value, standard deviation). Results: 2837 patients were screened with 2837 panoramic radiographs presenting 3528 edentulous subantral regions and the subantral bone heights of 5674 maxillary sinuses were surveyed. 57.43% revealed subantral alveolar ridge heights of 4 mm or less;24.43% of all measure-points indicated a maximum alveolar ridge height of 6 mm. In 39.32% of cases, the pneumatisation of the maxillary sinuses with a subantral residual ridge height of 6 mm or less extended as far as the anatomical position of the second premolars, in 20.51% as far as the position of the first premolar and in 10.84% as far as the canine fossa. Discussion: The sinus lift procedure will continue to be one of the basic standard surgical procedures carried out by practice-based dental surgeons who perform implant surgery since in at least two thirds of the cases short implants with lengths of less than 6 mm cannot be applied. Preference should be given to sinus lift-procedures, which can be learned safely with a minimum of time-effort, least risk of failure and lowest possible level of patient morbidity. Transcrestal hydrodynamic ultrasonic sinus lift-procedures with piezotomes seem to fulfill these basic demands.展开更多
Alveolar crest-splitting and horizontal distraction is an established surgical technique to enable implant insertion into the narrow, lateral atrophic alveolar crest. This surgical technique is challenging for the ora...Alveolar crest-splitting and horizontal distraction is an established surgical technique to enable implant insertion into the narrow, lateral atrophic alveolar crest. This surgical technique is challenging for the oral surgeon and restricted to crest-widths of 3 - 5 mm: significant procedural bone loss at osteotomy, the need to prepare a full thickness mucoperiostal flap and milling a baseline-osteotomy to weaken the bone for distraction inhere significant risks of accidental fractures. Aim of the study was to investigate if the recently developed novel Flapless Piezotome enhanced Crest-Splitting and Widening Technique (FPeCSWT) could safely narrow down the indication for this procedure to narrow alveolar crests of widths of even less than 2 mm in a three-year survey-period. 239 patients underwent 261 FPeCSWT-surgeries and 488 implants were inserted simultaneously in the upper and the lower jaw and clinical parameters such as intrasurgical complications, patient morbidity, implant loss and vertical bone loss (VBL) in the first three years after surgeries were recorded comparing sites with less than 2 mm width with sites of more than 2 mm. After three years a significant difference (p = 0.24) of VBL could be observed between the group with less than 2 mm crest-width (mean: 0.97 mm, max: 2.0 mm/min: 0.0 mm;SD: 0.41) compared with the group with more than 2 mm crest-width (mean: 0.69 mm, max: 1.5 mm/min: 0.0 mm;SD: 0.36) but was still significant lower when compared with the results of similar studies published with a mucoperiostal-flap approach and baseline bone-cut. The cumulative 3-year-implant-survival-rate was 98.8%, no accidental fracture of the distracted buccal bone-plate occurred. The re-sults of the study suggest that the FPeCSWT narrows safely down the indication for crest-splitting to also crest-widths of only 1 mm. The procedure is highly predictable and significantly reduces the challenge of surgical skills and leads to negligible patient-morbidity. The higher VBL in crest-widths of less than 2 mm can easily be compensated by subcrestal placement of implants.展开更多
Aim:The bone particles harvested during osteotomy could be used as autogenous bone graft materials to correct a bony defect prior to implant placement.Methods:A simple surgical procedure was described in which autogen...Aim:The bone particles harvested during osteotomy could be used as autogenous bone graft materials to correct a bony defect prior to implant placement.Methods:A simple surgical procedure was described in which autogenous bone was harvested from the drills during the preparation of implant sites.Eleven samples were obtained from bone drilling duringfixture installation in 11 patients(5 men and 6 women)with an average age of 57 years.These samples were subjected to histological preparation,in order to evaluate for the presence of viable osteoblasts.Results:Histological evaluation of the samples suggested that the viability of the bone tissue was maintained.Conclusion:The results show that this method of harvesting autogenous bone may be useful in situations where small amounts of bone are required.展开更多
文摘Implant insertion is an alternative to classical treatment with bridges after tooth extraction or traumatic tooth loss in the anterior and premolar region of the upper and lower jaw. Nevertheless both types of prosthetic treatment inhere major gingival aesthetic pitfalls by physiological vertical and horizontal resorption. Aim of the study was to investigate if the immediate insertion of root analogue single-stage implants and prosthetic treatment could prevent gingival recessions and bone resorption thus keeping the natural gingival aesthetics untouched. Between 2003 and 2006, 348 root analogue Q1-Implants (TRINON Karlsruhe GmbH/Germany) were inserted in 342 patients’s premolar and molar regions immediately after tooth extraction or traumatic tooth loss and treated with provisional resin crowns. The observation period with recurring 6-month clinical and radiographic check-ups was a minimum of 5 years. Of 348 inserted implants 4 (1.15%) were lost resulting in an overall success rate of 98.85%. In the first 12 weeks after surgery a mean recession of the buccal gingival margin of 0.2 mm (SD 0.34) could be detected, after final prosthetic treatment an overall mean recession of 0.2 mm (SD 0.13) within the survey period. Immediate implant insertion of root analogue single stage implants and immediate prosthetic treatment with provisional resin crowns after minimal invasive tooth extraction seems to be appropriate to prevent bone resorptions of the buccal alveolar crest and the recessions of the gingiva and papillae and thus suggests to be the preferable treatment to keep the natural gingival and papillary aesthetics untouched preventing further traumatic surgical gingival reconstructions.
文摘Half of altogether 60 cylindrical implant devices made of titanium-aluminum-vanadium alloy （ Ti-6Al-4V） were plusna-sprayed with a hydroxyapatite-couting and the other half had a corundum blasted porous surface. 15 implants of each group of the titanium test buplants were coated with 230 μg porcine, high-purified BMP- 3-precipitute per implant. In each case a BMP- 3-couted and an uncoated control-device were implanted into the femoral part of the putellofemoral joint of the right and left leg of 30 adult giant rabbits. Histomorphological and histomorphometrical we found in both groups with BMP- 3-coated test devices an improved osteointegrution. Stutistical evaluation using the t-test for matched samples showed 5 weeks after surgery a significant higher volume of tony formed bone of the BMP- 3-coated corundum- blasted or hydroxyapathe- coated Ti- 6Al- 4 V test devices compared to the non-couted controls of the same t）pe （p 〈 0.01, t-test for matched samples）. In both implant groups with BMP-couting a synergetic effect was verifiable although the bone ongrowth in the hydroxyaputite coated implants was more extensive than in the corundum blasted implants. Light microscopy demonstrated osteointegrution without connective tissue membrane around the surface of the implants. Our results indicate that composite metal implants,as used in endoprosthetics and implantology , are suitable carriers for BMP- 3 and im proved fixation of the implants can be achieved. The hydroxyapatite surface is superior to the corundum-blasted surface with regards to the observed parameters because of its pronounced bioactivity and its osteoconductive characteristics.
文摘Introduction: The current discussion about the use of short implants to avoid bone-augmentation (“sinus lift”) in the lateral maxilla remains a controversial topic and is increasingly at odds with the reality of evolutionary biology. Aim of the study was to determine the percentage of cases from a large routine patient-sample in which short implants might be suitable to avoid sinus lift procedures. Materials and Methods: From January 2012 to June 2015, all patients in three general dental practices in Austria with at least one subantral edentulous area were subjected to routine panoramic X-ray screening. The subantral alveolar ridge heights and the mesial extension of the maxillary sinus towards the canine fossa were measured. Statistics were performed by Excel data analysis (mean value, standard deviation). Results: 2837 patients were screened with 2837 panoramic radiographs presenting 3528 edentulous subantral regions and the subantral bone heights of 5674 maxillary sinuses were surveyed. 57.43% revealed subantral alveolar ridge heights of 4 mm or less;24.43% of all measure-points indicated a maximum alveolar ridge height of 6 mm. In 39.32% of cases, the pneumatisation of the maxillary sinuses with a subantral residual ridge height of 6 mm or less extended as far as the anatomical position of the second premolars, in 20.51% as far as the position of the first premolar and in 10.84% as far as the canine fossa. Discussion: The sinus lift procedure will continue to be one of the basic standard surgical procedures carried out by practice-based dental surgeons who perform implant surgery since in at least two thirds of the cases short implants with lengths of less than 6 mm cannot be applied. Preference should be given to sinus lift-procedures, which can be learned safely with a minimum of time-effort, least risk of failure and lowest possible level of patient morbidity. Transcrestal hydrodynamic ultrasonic sinus lift-procedures with piezotomes seem to fulfill these basic demands.
文摘Alveolar crest-splitting and horizontal distraction is an established surgical technique to enable implant insertion into the narrow, lateral atrophic alveolar crest. This surgical technique is challenging for the oral surgeon and restricted to crest-widths of 3 - 5 mm: significant procedural bone loss at osteotomy, the need to prepare a full thickness mucoperiostal flap and milling a baseline-osteotomy to weaken the bone for distraction inhere significant risks of accidental fractures. Aim of the study was to investigate if the recently developed novel Flapless Piezotome enhanced Crest-Splitting and Widening Technique (FPeCSWT) could safely narrow down the indication for this procedure to narrow alveolar crests of widths of even less than 2 mm in a three-year survey-period. 239 patients underwent 261 FPeCSWT-surgeries and 488 implants were inserted simultaneously in the upper and the lower jaw and clinical parameters such as intrasurgical complications, patient morbidity, implant loss and vertical bone loss (VBL) in the first three years after surgeries were recorded comparing sites with less than 2 mm width with sites of more than 2 mm. After three years a significant difference (p = 0.24) of VBL could be observed between the group with less than 2 mm crest-width (mean: 0.97 mm, max: 2.0 mm/min: 0.0 mm;SD: 0.41) compared with the group with more than 2 mm crest-width (mean: 0.69 mm, max: 1.5 mm/min: 0.0 mm;SD: 0.36) but was still significant lower when compared with the results of similar studies published with a mucoperiostal-flap approach and baseline bone-cut. The cumulative 3-year-implant-survival-rate was 98.8%, no accidental fracture of the distracted buccal bone-plate occurred. The re-sults of the study suggest that the FPeCSWT narrows safely down the indication for crest-splitting to also crest-widths of only 1 mm. The procedure is highly predictable and significantly reduces the challenge of surgical skills and leads to negligible patient-morbidity. The higher VBL in crest-widths of less than 2 mm can easily be compensated by subcrestal placement of implants.
文摘Aim:The bone particles harvested during osteotomy could be used as autogenous bone graft materials to correct a bony defect prior to implant placement.Methods:A simple surgical procedure was described in which autogenous bone was harvested from the drills during the preparation of implant sites.Eleven samples were obtained from bone drilling duringfixture installation in 11 patients(5 men and 6 women)with an average age of 57 years.These samples were subjected to histological preparation,in order to evaluate for the presence of viable osteoblasts.Results:Histological evaluation of the samples suggested that the viability of the bone tissue was maintained.Conclusion:The results show that this method of harvesting autogenous bone may be useful in situations where small amounts of bone are required.
