Implant design is one of the parameters for achieving successful primary stability. This study aims to examine the effect of a self-tapping blades implant design on initial stability in tapered implants. Polyurethane blocks of different densities were used to simulate different bone densities. The two different implant designs included one with self-tapping blades and one without self-tapping blades. Implants were placed at 3 different depths: apical third, middle third, and fully inserted at 3 different densities of polyurethane blocks. A resonance frequency (RF) analyzer was then used to measure stability of the implants. Repeated-measures analysis of variance was used to examine the effect of implant design, insertion depth, and block density on RF. Analysis of covariance was used to examine the strength of association between RF and the aforementioned factors. In both medium-density (P = .017) and high-density (P = .002) blocks, fully inserted non-self-tapping implants showed higher initial stability than self-tapping implants. No differences were noted between the 2 implant designs that were not fully inserted. The highest strength of association was with insertion depth (standardized beta [std beta] = -0.60, P = .0001), followed by block density (std beta = -0.15, P = .0002). Implant design showed a weak association (std beta = -0.07, P = .09). In conclusion, fully inserted implants without self-tapping blades have higher initial stability than implants with self-tapping blades. However, the association strength between implant design and initial stability is less relevant than other factors, such as insertion depth and block density. Thus, if bone quality and quantity are optimal, they may compensate for design inadequacy.
The objective of this systematic review was to perform a comprehensive overview of systematic reviews and meta-analyses pertaining to peri-implantitis in humans, including the prevalence and incidence, the diagnostic findings, microbial findings, effects of systemic diseases, and treatment of peri-implantitis. Electronic databases were searched for systematic reviews and meta-analyses of peri-implantitis. In view of the limitations of the included systematic reviews, the outcome of this overview suggested that (1) occurrence of peri-implantitis was higher in patients with periodontitis, in patients who smoke, and after 5 years of implant function; (2) the microbial profile of peri-implantitis was different from periodontitis; (3) risk for peri-implantitis was higher in patients with uncontrolled diabetes and cardiovascular disease; (4) there was no strong evidence to suggest the most effective treatment intervention for peri-implantitis, although most peri-implantitis treatments can produce successful outcomes; and (5) postimplant maintenance may be crucial in patients with a high risk of peri-implantitis.
A bone-inductive protein, osteogenin, has been isolated from long bones of humans and offers promise as a grafting material. Studies, however, suggest that osteogenin must be combined with a bone-derived matrix in order to initiate bone differentiation. The purpose of this study was to determine if osteogenin combined with demineralized freeze dried bone allograft (DFDBA), a bone-derived matrix, and with a bovine tendon-derived matrix will enhanced regeneration of intrabony defects in humans. The tendon-derived matrix and DFDBA used alone served as controls. The ability of each material to form a new attachment apparatus was evaluated independently in submerged and nonsubmerged environments in 2 patient populations. Lymphocyte testing was performed to assess development of an immune reaction to osteogenin. The most apical level of calculus on the root served as the histologic reference point to measure regeneration. Biopsies were obtained at 6 months and regeneration was measured histomorphometrically by 2 blinded evaluators. Serial sections from 36 submerged defects in 8 patients and 50 nonsubmerged defects in 6 patients were submitted for statistical analysis. Mean results indicate that osteogenin combined with DFDBA significantly enhanced regeneration of a new attachment apparatus and component tissues in a submerged environment. DFDBA plus osteogenin and DFDBA alone formed significantly more new attachment apparatus and component tissues than either the tendon-derived matrix plus osteogenin or the tendon-derived matrix alone in both submerged and nonsubmerged environments. There were no significant differences between the tendon-derived matrix plus osteogenin and the tendon-derived matrix alone in either the submerged or nonsubmerged environment. Osteogenin does not impair normal lymphocyte blastogenesis at 6 months postsurgical challenge.
Background-Previous cross-sectional studies have suggested a link between periodontal disease and osteoporosis. The purpose of the present study is to evaluate the association between changes in bone mineral density (BMD) and clinical signs of periodontal tissue destruction and tooth loss over a 2-year period.
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