Latest implant research
Maintaining inter-implant crestal bone height via a combined platform-switched, Laser-Lok® implant/abutment system: A proof-of-principle canine study.
M Nevins, ML Nevins, L Gobbato, HJ Lee, CW Wang, DM Kim.
Int J Periodontics Restorative Dent, Volume 33, Number 3, 2013.
Interimplant papillae are critical to achieving esthetic implant-supported restorations in the maxillary esthetic zone. Stable papillary anatomy, however, depends upon a stable volume of underlying crestal bone for support. Multiple studies have documented a critical interimplant distance of 3 mm, under which crestal bone resorption occurs. The current preclinical proof-of-principle canine study examines a novel implant-abutment system design, combining platform switching with precisely configured laser-ablated abutment and implant microgrooves to maintain interimplant crestal bone at interimplant distances of 2 and 4 mm. Results of this initial preclinical study suggest that it is possible through precise implant/abutment design modifications to place adjacent implants at distances of 2 to 4 mm without inducing subpapillary crestal bone loss.
SOFT TISSUE FINDINGS
Peri-implant soft tissues consisted of an epithelial barrier, with the sulcular epithelium merging with the junctional epithelium. The junctional epithelium ended abruptly at the coronal-most position of the abutment Laser-Lok microgrooves, where a zone of CT fibers appeared to enter perpendicularly into the microchanneled 0.7-mm tall band. In addition, CT fibers also appeared to enter into Laser-Lok regions of the implant collar, effectively sealing the IAJ microgap from surrounding tissues. Importantly, no evidence of an inflammatory infiltrate was found in any specimen at the IAJ.
HARD TISSUE FINDINGS
Interimplant crestal bone showed no evidence of bone resorption in any biopsy specimen at the end of 3 months. Significant bone-to-implant contact (BIC) was readily apparent along all aspects of the implant body and collar. In many specimens, regenerated bone was seen immediately proximal to the IAJ microgap. The apposition of both perpendicularly inserting CT fibers and bone onto the laser-ablated microchannels in the region of the IAJ microgap served to anatomically seal the IAJ from surrounding tissues and prevent migration of the junctional epithelium.
The impact of laser microtexturing collar designs on crestal bone level, and clinical parameters under various placement and loading protocols.
M Serra, L Bava, D Farronato, V Iorio Siciliano, M Grande, R Guarnieri.
Submitted for publication, Int J Oral Maxillofac Implants.
A physical attachment of connective tissue fibers to the laser microtexturing (8 and 12μm grooves) surface placed on collar of implant, has been demonstrated using human histology. Related clinical research has suggested that this kind of microtexturing surface may lead to a decreased amount of initial bone loss.
The aim of this retrospective study was to compare crestal bone heights and clinical parameters between implants with laser-microtextured collar and machined collar using different protocols.
MATERIALS AND METHODS
This study evaluates 300 single implants in 300 patients (155 males and 145 females; mean age: 49.3 years; range: 45 to 75 years). 160 implants with laser-microtextured collars (L) and 140 with machined collars (M) were used. Implants were grouped into the treatment categories of immediate placement, delayed placement, immediate non-occlusal loading (INOL), and delayed loading (DL). For all groups, crestal bone level (CBL), attachment level (CAL), plaque index (PI), and bleeding on probing (BOP), were recorded at baseline examinations (BSL) and 6 (T1), 12 (T2), and 24 months (T3) after loading with the final restoration.
Nine implants were lost (four L and five M). The type of implant and time of placement and loading showed no significant influence on the survival rate. A mean CAL loss of 1.12 mm was observed during the first 2 years in the M group, while the mean CAL loss observed in L the group was 0.55 mm. Radiographically, L group implants showed a mean crestal bone loss of 0.58 mm compared to 1.09 mm for the M.
Results suggest that laser microtextured surface on implant collar may mitigate the negative sequelae connected with the peri-implant bone loss regardless of the type of positioning and loading protocol used.
Immediate occlusal loading of tapered internal Laser-Lok implants in partial arch application: A 24-months clinical and radiographic study.
M Grande, A Ceccherini, M Serra, L Bava, D Farronato, V Iorio Siciliano, R Guarnieri.
Accepted for publication, Journal of Osseointegration.
Recently, new implant surfaces have been proposed in an effort to improve hard and soft tissue integration, which may be beneficial in immediate loading situations.
The purpose of the present prospective clinical study was to, during 2 years, clinically and radiographically evaluate an implant with laser microtextured collar surface placed for immediate loading of fixed prostheses in cases of partial posterior maxillary and/or mandibular edentulism.
MATERIALS AND METHODS
Thirty-five partially edentulous patients who needed implant treatment and met inclusion criteria were consecutively enrolled at different study centers in Italy. A total of 107 Tapered Internal Laser-Lok implants (49 maxillary and 58 mandibular) were placed and immediately loaded. All provisional constructions were delivered within 1 hour, and the final constructions placed after 4 months. A total of 32 prosthetic constructions, consisting of 10 two-units, 12 three-units, and 10 four-units restorations, were evaluated. Implants were monitored for clinical and radiographic outcomes at follow-up examinations scheduled for 6, 12, 24 months.
Five implants have been lost after loading (3 implants in a two-unit maxillary restorations, 1 implant in a two-unit mandibular restoration, and 1 implant in three-unit maxillary restoration) giving a survival rate of 95.4% after 24 months. Mean marginal bone loss 6,12, and 24 months after installation was of 0.42mm ± 1.1mm, 0.52mm ± 0.9mm, and 0.66mm ±1.3 mm, respectively.
Although limited to the short follow-up, immediate function with Tapered Internal Laser-Lok ® implants seems to be a viable option to treated partially edentulous patients.
Influence of Laser-Lok® surface on immediate functional loading of implants in single tooth replacement: a 2-years prospective clinical study.
D Farronato, F Mangano, F Briguglio, V Iorio Siciliano, R Guarnieri.
Submitted for publication, Int J Periodontics Restorative Dent.
The purpose of the present clinical study was to evaluate the influence of Laser-Lok ® microtexturing surface on clinical attachment level and crestal bone remodeling around immediate functional loaded implants in single-tooth replacement in the area of 15-25 and 35-45.
MATERIALS AND METHODS
Seventy-seven patients were included in a prospective, randomized study and divided in two groups: in the control group BioHorizons Tapered Internal non-Laser-Lok ®-type (NLL; n=39) implants were used, while in test group BioHorizons Tapered Internal Laser-Lok®-type (LL; n=39) was used. Crestal bone loss (CBL), and clinical parameters including clinical attachment level (CAL), plaque index (PI), and bleeding on probing (BOP), were recorded at baseline examinations (BSL) and 6 (T1), 12 (T2), and 24 months (T3) after loading with the final restoration.
One implants was lost in the control group, and one in the test group, giving a total survival rate of 96,1% after 2 years. PI and BOP outcomes were found similar for both implant types without statistical differences. A mean CAL loss of 1.10mm ± 0.51mm was observed during the first 2 years in the NLL group, while the mean CAL loss observed in LL the group was 0.56mm ± 0.33mm. Radiographically, NLL group implants showed a mean crestal bone loss of 1.07mm ± 0.30mm compared to 0.49mm ± 0.34mm for the LL.
The type of implants did not influence the survival rate, whereas LL resulted in greater CAL and in shallower radiographic peri-implant CBL than NLL.
Soft and hard tissue modifications at immediate transmucosal implants (Laser-Lok® microtextured collar) placed into fresh extraction sites. A six month prospective study with surgical re-entry.
V Iorio Siciliano, G Marzo, A Blasi, C Cafiero, M Mignogna, M Nicolò
Accepted for publication, Int J Periodontics Restorative Dent.
Histological and clinical studies confirm that laser microtexturing of implant collars favors the attachment of connective fibers and reduces probing depth and peri-implant bone loss, when compared to machined collars. This prospective study aimed at assessing the alveolar dimensional changes after immediate transmucosal implants placement (Laser-Lok ® microtextured collar) associated with bone regenerative procedures.
MATERIALS AND METHODS
Thirteen implants (Single-Stage Implant System ®, BioHorizons, IPH. Inc.) were placed immediately into single-rooted extraction sockets. Periimplant defects were treated with bovine-derived xenografts (Laddec®, BioHorizons, IPH. Inc) and resorbable collagen membranes (Mem-Lok®, BioHorizons, IPH. Inc.).
At 6-months surgical re-entry, Laser-Lok ® microtextured collar provides more favorable conditions for the attachment of hard and soft tissues, and reduces the alveolar bone loss.