Faculty Bibliography

A prospective clinical research study of various graft materials used for the augmentation of human maxillary sinuses is currently in progress at New York University Department of Implant Dentistry. This interim case report describes the healing response after a sinus augmentation procedure using a new mineralized cancellous bone allograft. The results after 9 months of healing demonstrated a vital bone content of 25.2% in the grafted sinus, as ascertained from a trephine core taken from the superior aspect of the lateral window area. Although the vital bone requirement for implant survival in an augmented sinus is unknown, the 25.2% vital bone demonstrated in this case compares favorably with that reported in the literature for other augmentation materials, including xenografts, alloplasts, and autogenous bone

PURPOSE: This study compares implant survival and patterns of implant failure in periodontally compromised and periodontally healthy patients. MATERIALS AND METHODS: In a private periodontal practice, over a 13-year period, implants were placed in both periodontally compromised and periodontally healthy patients. Implants were classified in 5 different groups according to surface texture. Survival rates in each group were compared according to implant location, diameter, length, and phase of treatment. RESULTS: A total of 1,511 implants were placed in 334 patients. One hundred fifty-one of these patients, classified as periodontally compromised patients (PCP), received 923 implants. The remaining 183 patients, classified as periodontally healthy patients (PHP), received 588 implants. The overall survival rate for implants placed in the PHP group was 93.7%, compared to 90.6% in the PCP group. The survival rate of hydroxyapatite-coated implants was 92.6% in the PHP group and 81% in the PCP group. The survival rate of the turned-surface implants was similar in both groups. DISCUSSION: Two types of implant failure were identified. The first was failure of the implant to osseointegrate. This type of failure occurred early in treatment and appeared to be related to smooth-surface implants placed in bone of low density. Failures of this type were distributed equally between the PHP and PCP groups. The second type of failure was related to peri-implantitis. It was observed most often with implants with hydroxyapatite surfaces, occurred as the result of a progressive condition, and was most prevalent in the PCP group. CONCLUSION: Further long-term controlled investigations are needed to determine the influences of implant suface and host susceptibility on implant failure in both PHP and PCP

A predictable, aesthetic result is sometimes difficult to achieve when two or more adjacent implants are placed in the anterior maxilla. Maintenance of the distance from the interproximal crest of bone to the contact point influences the presence or absence of the interdental papilla. The design of the coronal portion of implants currently in the market and the contour of the implant-abutment junction may further affect the biology and reformation of the papilla between two adjacent implants. Through a series of case reports, parameters influencing implant placement are presented

PURPOSE: The purpose of this study was to compare bone-to-implant contact (BIC) of the one-stage sandblasted surface EVL implant (SERF, Decines, France) with that of the two-stage turned (machined) Branemark Nobel BioCare implant in a dog model system. MATERIALS AND METHODS: Three 1-year old female beagle dogs (canine) were acquired, examined, and quarantined. In dog no. 1, three test implants were placed on one side of the jaw, and four control implants were placed on the other side. In dog no. 2, two test implants were placed in alternation with two control implants on the left and right sides (total 4 tests, 4 controls). In dog no. 3, three test implants were placed on one side and three control implants on the other. After a 3-month period of healing, the dogs were killed and the jaws sectioned for histological preparation. Eleven implants, six tests, and five controls were available for histological evaluation. RESULTS: The percent of BIC for the test implants varied from 24.9% to 61.6%, with an average of 42.7%. The percent of BIC for the control implants varied from 22.1% to 42.6%, with an average of 27.4%. CONCLUSION: The degree of BIC of the EVL implants was on average greater than that of the turned surface of the Branemark implant. However, because of the limited number of implants placed in this pilot study, the results should be interpreted with caution

The high success rate of dental implants has changed the quality of life for many patients. Immediate loading finds its application in some clinical cases and certainly adds another modality of treatment for the implant patient. Starting with a couple of implants placed in the mandible and immediately loaded within 72 hours after surgical placement with an overdenture, this concept evolved to immediately loading multiple implants in both the maxilla and the mandible. In this investigation, 11 consecutive patients were treated with 87 screw-shaped endosteal acid-etched, Osseotite implants (3i, Implant Innovations, Inc., Palm Beach Gardens, FL) between June 1998 and June 1999. Two mandibular and two maxillary cases received screw-retained provisional prostheses the day of surgery. Three mandibular and four maxillary cases were loaded 48 hours after surgery with the final screw-retained, porcelain-fused-to-metal prostheses. All implants were followed for 2 to 3 years. Follow-up consisted of clinical as well as radiographic examination. All implants were successful. There was no implant mobility or periimplant radiolucency. The bone level was measured at the 12th and 24th months. The average radiographic bone level from the implant platform to the first bone-to-implant contact was 0.654 mm at the 12th month and 0.946 mm at the 24th month. We conclude that a high success rate can be achieved when implants with a hybrid surface, machined/acid-etched, are immediately loaded within 48 hours after surgical placement in the maxilla and the mandible

This case report concerns the loss of osseous tissue around two hydroxyapatite (HA) Biovent implants, placed in 1993, at sites #30 and #31. The implant in site #31 was positioned with a distal angle, resulting in an ill-fitting prosthesis. This permitted bacterial colonization to set up a periimplantitis. The rough HA coating on the implants further exacerbated the resultant bone loss. In an attempt to rectify the pathology, surgical debridement, antibiotic therapy, bone grafting, and guided tissue regeneration with a barrier membrane were utilized. This case report documents a successful partial repair of osseous housing around these implants

Postoperative complications have been identified with implant failure in conjunction with the increased use of root-type implant restorations. The failure of osseointegrated dental implants primarily occurs as a result of peri-implantitis and occlusal overload. Less frequently reported failures, however, have been attributed to implant periapical lesions. The etiology and treatment modalities for such lesions have been speculated throughout the literature. This article discusses possible etiologies of and treatment for implant periapical lesions based on the existing literature and four case reports