The aim of the study was to evaluate the use of narrow implants (3.25 mm) to replace upper lateral and lower incisors according to an established immediate function protocol.A total of 49 narrow implants (Neoss Proactive 3.25 mm implants, Neoss Ltd, Harrogate, UK) in 35 patients were evaluated.Thirty-one implants were placed in the mandible and 18 in the maxilla.The mean insertion torque was measured in Ncm.Thirty-six implants were placed in fresh extraction sockets.Implant stability measurements were performed at baseline, after 2, 4, 6 weeks and 3, 6 months using resonance frequency analysis (RFA) measurements (Osstell ISQ™, Osstell AB, Gothenburg, Sweden) expressed in ISQ units (Implant Stability Quotient).The patients were followed with clinical and radiographic examinations for 18 months.One implant failed after 4 weeks giving a cumulative survival rate of 98.0 % and the marginal bone loss amounted to 0.7 + 1.0 mm after 18 months.The mean insertion torque was 36 + 9.1 Ncm.The mean ISQ values indicated firm stability at baseline in both mesial-distal and buccal-lingual directions (i.e.above 65 ISQ).The ISQ curve presented a significant drop after 2-4 weeks where after the stability recovered progressively up to 6 months.It is concluded that upper lateral and lower incisors can be replaced with 3.25 mm implants according to an immediate loading protocol with high survival rate and minimal marginal bone loss.Moreover, the immediately loaded implants showed an initial dip of stability during the first 4 weeks followed by an an increase with time.

Background. Hydrophilic and moderately rough implant surfaces have been proposed to enhance the osseointegration response. Aim. The aim of this study was to compare early changes of stability for two implants with identical macrodesign but with different surface topographies. Materials and Methods. In 11 patients, a total of 22 implants (11 bimodal (minimally rough, control) and 11 proactive (moderately rough and hydrophilic, test), Neoss Ltd., Harrogate, UK) were immediately placed into fresh extraction sockets and immediately loaded. The peak insertion torque (IT) was measured in Ncm at placement. Resonance Frequency Analysis (RFA) measurements were made at baseline and 2, 4, 6, and 12 weeks after surgery. Results. The two implant types showed similar IT and RFA values at placement (NS). A dip of RFA values after 2 weeks followed by an increase was observed, where the test implant showed a less pronounced decrease and a more rapid recovery than the control implant. The test implants were significantly more stable than the control ones after 12 weeks. Conclusions. The results from the present study indicated that the hydrophilic and rougher test implant was more resistant to immediate loading and showed a significantly higher stability than the smoother control implant after 12 weeks.

Purpose: To study the clinical/radiographic outcomes and stability of a tapered implant design with a hydrophilic surface when placed in the maxilla using various protocols and followed for one year. Methods: Ninety-seven consecutive patients treated as part of daily routine in two clinics with 163 tapered implants in healed sites, in extraction sockets and together with bone augmentation procedures in the maxilla were evaluated after one year in function. Individual healing periods varying from 0 to 6 months had been used. Insertion torque (IT) and resonance frequency analysis (RFA) measurements were made at baseline. Follow-up RFA registrations were made after 6 and 12 months of loading. The marginal bone levels were measured in intraoral radiographs from baseline and after 12 months. A reference group consisting of 163 consecutive straight maxillary implants was used for the comparison of baseline IT and RFA measurements. Results: Five implants failed before loading, giving an implant survival rate of 96.9% and a prosthesis survival rate of 99.4% after one year. The mean marginal bone loss after one year was 0.5 mm (SD 0.4). The mean IT was statistically significantly higher for tapered than for straight reference implants (41.3 ± 12.0 Ncm vs 33.6 ± 12.5 Ncm, p < 0.001). The tapered implants showed a statistically insignificantly higher mean ISQ value than the straight references implants (73.7 ± 6.4 ISQ vs 72.2 ± 8.0 ISQ, p=0.119). There was no correlation between IT and marginal bone loss. There was a correlation between IT and RFA measurements (p < 0.001). Conclusion: The tapered implant showed a high survival rate and minimal marginal bone loss after one year in function when using various protocols for placement. The tapered implant showed significantly higher insertion torque values than straight reference implants.

n Primary Stability. This term refers to the mechanical stability of a dental implant immediately after placement. It depends on a number of factors, such as • the surgical technique. The surgical site can be underprepared to obtain greater bone engagement upon insertion(6), • implant geometry. A tapered implant design will considerably increase its stability, particularly in soft bone (7), • sufficient quantity and quality of bone. A sufficient amount of bone is required both in the horizontal and vertical dimensions. The presence of cortical bone is associated with higher implant stability, with a corresponding increase in RFA ISQ values (8). In case of partial

This work sought to investigate the clinical efficacy of esterified hyaluronic acid for treating deep periodontal defects. Nineteen defects, 18 infrabony and one mandibular molar furcation, were treated. Defects with probing pocket depths (PPDs) of at least 6 mm were consecutively included in the study. The PPD, gingival recession, and clinical attachment level (CAL) were evaluated at each defect before treatment and 1 year after surgery. A full-thickness flap was raised and the roots were accurately planed; hyaluronic acid in the form of fibers was then packed into the defect to completely fill the space. One year after treatment, the mean PPD was reduced by 5.8 mm (range, 0 to 10 mm), gingival recession had increased by 2.0 mm (range, 0 to 6 mm), and attachment gain was 3.8 mm (range, 0 to 7 mm).

BACKGROUND:An increasing number of studies show that immediate/early function of dental implants can be as successful as two-stage procedures. However, the results may not be universal for all implant types and it is important that new implants are tested for this treatment modality.PURPOSE:The aim was to evaluate an immediate/early function protocol in the maxilla and in the posterior mandible using Neoss implants (Neoss Ltd., Harrogate, UK).MATERIALS AND METHODS:A total of 21 patients were provided with 69 Neoss implants (4 mm in diameter and 9-15 mm in length) and a provisional bridge within 7 days (mean 4.6 days). Sixteen implants were placed in immediate extraction sites where seven were treated with autologous bone grafts (n = 6) or bone grafts + resorbable membrane (n = 1). A final fixed prosthesis was made 3 to 6 months later. The patients were followed-up with clinical examinations for 18 months. In addition, the implants were monitored with resonance frequency analysis (RFA) measurements at surgery and after 1, 2, and 6 months. Intraoral radiographs were taken after surgery and after 1, 6, and 18 months.RESULTS:One implant in an extraction site in the maxilla failed after 1 month, giving a survival rate of 98.5% after 18 months. The mean marginal bone loss was 0.7 mm (SD 0.7) after 18 months. RFA showed a mean implant stability quotient (ISQ) value of 68.1 (SD 8.8) at surgery, which increased to 73.7 (SD 5.7) after 6 months. The primary stability for maxillary and mandibular implants was similar, although mandibular implants showed slightly higher values with time. Implants in extraction sockets showed a lower initial stability than in healed sites, ISQ 65.8 (SD 7.5), which increased to ISQ 67.5 (SD 6.9) after 6 months. The failed implant showed an ISQ of 74 at placement, which decreased to 42 1 month after surgery.CONCLUSION:Within the limitations of the present study, it is concluded that immediate/early function with Neoss implants is a reliable method with an implant survival rate comparable to that of the traditional two-stage protocol.

ABSTRACT Background: The advantages of placing implants in fresh extraction sockets and putting them in immediate/early function are many. A predicable protocol opens the possibility of performing a single surgical procedure, giving the patient a temporary prosthesis immediately, and minimizing the shrinkage of hard tissue and soft tissue recession. Purpose: The aim of the present study was to develop a strict protocol for and to evaluate the feasibility of immediate/early function on implants placed in fresh extraction sockets located in maxillae and posterior mandibles, including defects around the implants treated according to a regenerative procedure. Materials and Methods: Nineteen patients were treated after tooth extraction according to an immediate function protocol and were observed for 18 months. Fifty Mk IV TiUnite™ (Nobel Biocare AB, Göteborg, Sweden) implants were installed in partially edentulous areas in maxillae ( n = 17) and posterior mandibles ( n = 5). Implants were installed directly into the alveoli, and the temporary prostheses were connected immediately after surgery ( n = 11) or within 7 days, that is, an “early function” procedure ( n = 11). Thirteen implants did not require any type of regenerative procedure, whereas the remaining 37 implants had filling with autogenous bone, 4 of which also had a resorbable membrane. Standardized intraoral radiographs were taken for evaluation of marginal bone level, and 38 of the implants were systematically checked by resonance frequency analysis. Results: All patients were followed for 18 months, and none of the 50 implants failed. However, one implant showed signs of failure after 6 weeks, but once the occlusal load was removed, the implant regained its stability completely, no longer demonstrated symptoms, and could be used successfully for prosthetic rehabilitation. The mean value of the implant stability quotient was 60 at baseline (range 45–75) and 63 after 6 months (range 46–75). The marginal bone resorption was 0.9 mm (SD 1.1 mm; n = 48) 18 months after implant insertion (1 year after final prosthesis). Conclusion: The immediate placement of implants into fresh extraction sockets combined with immediate/early function procedures seems to be a safe and reliable procedure when using a strict protocol.

BACKGROUND Immediate or early loading of implants placed in maxillas and posterior mandibles has been a concern as bone density is often low in these areas, making it difficult to establish good initial implant stability. By adapting implant design and insertion protocols, however, high initial implant stability may be achieved in these regions. Further, a modified implant surface texture has been proved to help in maintaining stability during the initial healing period. PURPOSE The aim of the present study was to investigate the clinical performance of oxidized titanium implants (TiUnite, Nobel Biocare AB, Gothenburg, Sweden) when used for early function in the maxilla and in the posterior mandible, locations where the bone density often is low. A further aim was to evaluate the marginal bone level at oxidized implants and compare it with that of machined-surface implants used in a previous study. MATERIALS AND METHODS Thirty-one patients were consecutively included in the study, and 37 edentulous areas in maxillas and posterior mandibles were treated. Bruxism and uncontrolled periodontal disease were exclusion criteria. Temporary prostheses were generally placed within 9 days but not after 16 days from implant placement. A previous study applying the same study design and clinical protocol but using machined-surface implants was used for comparisons. RESULTS Of the 111 implants installed, 1 failed, giving an overall survival rate of 99.1% after 18 months. The prosthesis survival was 100%. The marginal bone resorption was 0.8 mm (standard deviation [SD], 1.0), as opposed to 1.6 mm (SD, 1.3) in the previous study with machined-surface implants, but was not statistically significantly different (p = .10). CONCLUSION The present clinical protocol (aiming at high primary stability) and the use of oxidized titanium implants for early functional loading in the maxilla and the posterior mandible resulted in a high implant survival rate and a favorable marginal bone level during a follow-up of 18 months. The difference in marginal bone resorption between the oxidized implants in the present study and the machined implants from a previous investigation with the same study design was not statistically significant.