Vasak C.,Medical University of Vienna |
Kohal R.J.,University Hospital Freiburg |
Lettner S.,Medical University of Vienna |
Rohner D.,Cfc Hirslanden Medical Center |
Zechner W.,Medical University of Vienna
Clinical Oral Implants Research | Year: 2014
Objectives: The study was designed to evaluate the clinical use of the NobelGuide™ concept over a follow-up period of 12 months with respect to implant success and survival rates, development of soft tissue condition and recording of potential surgical and prosthetic complications. In addition, radiological assessment of peri-implant bone levels was performed at the 1-year follow-up post-implant placement. Material and methods: Thirty patients (male/female = 15/15) with partially dentate and edentulous mandibles and maxillae were included. All patients were planned and operated on using the computer-aided, template-guided treatment concept NobelGuide™. Overall, 163 implants (NobelReplace® Tapered Groovy) were placed (mandible/maxilla = 107/56 implants). Recall appointments were performed after 1-2 weeks, 1, 3, 6 and 12 months after implant placement. Clinical parameters of the soft tissue conditions [e.g. bleeding on probing (BoP), pocket probing depth ≥3 mm (PPD), marginal plaque index (mPI)] and the dentist's esthetic and functional evaluation using a visual analogue scale (VAS) were documented. Marginal bone level was evaluated on radiographs made at implant insertion and at the 1-year follow-up. Results: All 30 patients with 161 implants completed the 1-year follow-up resulting in a cumulative survival rate of 98.8% (two implant losses). Clinical parameters improved in a majority of the implants. The mean marginal bone level at implant insertion and at 1-year follow-up was reported with 0.17 mm (SD 1.24; n = 125) and -1.39 mm (SD 1.27; n = 110), respectively. The mean change in bone level from implant insertion to 1 year was -1.44 mm (SD 1.35; n = 98). Conclusions: The 1-year follow-up showed a cumulative survival rate and success rate of 98.8% and 96.3%, respectively. Immediate or delayed loading of implants using a flapless, guided surgery approach (NobelGuide™) appears to be a viable concept demonstrating good clinical and radiographic outcomes at the 1-year time point. © 2012 John Wiley & Sons A/S.
Held U.,Cfc Hirslanden Medical Center |
Rohner D.,Cfc Hirslanden Medical Center |
Rothamel D.,University of Cologne
Head and Face Medicine | Year: 2013
Introduction: Pure titanium is the material of choice for contemporary dental implants. However, superficial reaction of the moderately rough titanium surface with atmospheric components decreases its hydrophilicity. INICELL® represents a chemical alteration and hydrophilization of a moderately rough i. e. sand-blasted and acid-etched titanium surface. The hydrophilicity leads to a more homogenous adsorption of proteins on the implant surface in-vitro, supporting the activation of a higher number of platelets and the generation of a homogenous, complete fibrin matrix in the early phases of osseointegration. This in turn helps to reduce the healing time and enhances the predictability of osseointegration in compromised bony situations.The objective of this case series trial was therefore to investigate if early loading (after 8 weeks) of hydrophilic INICELL implants is feasible in patients with reduced bone quality.Methods: In 10 patients, 35 hydrophilic implants were placed in sites revealing bone quality class 3 and 4, and uncovered after 4 weeks. Eight weeks later implants were released for loading if the tactile resistance was ≥35 Ncm. Lower resistances resulted in 12 weeks initial healing period. Insertion torque, ISQ, tactile resistance and vertical bone level were evaluated at implant installation, after 4 weeks (uncovering), 8 or 12 weeks (loading), and 12 weeks and one year after loading.Results: Mean implant insertion torque was 21 Ncm. 31 (88.6%) showed a tactile resistance of >35 Ncm after eight weeks and were released for prosthetic loading. Eight weeks after insertion, one implant (2.9%) had to be removed following a soft tissue complication. One implant had to be removed after 4 weeks due to a technical complication (fractured Osstell-abutment), it was therefore excluded from the analysis.33 of 34 implants (97%) were loaded to occlusion and were in situ/functional one year after implantation. ISQs increased from 43 at baseline to 63 at eight weeks, and 72 at three months after loading. Then, ISQ remained constant until one year after loading.Conclusions: Within the limitations of this prospective case series, hydrophilic implants may allow for shortening of the initial healing period even in bone with compromised density. © 2013 Held et al.; licensee BioMed Central Ltd.