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ORIGINAL ARTICLE
Year : 2015  |  Volume : 18  |  Issue : 4  |  Page : 149-155

A concise overview of dental implantology


Department of Surgery, College of Health Sciences, Usmanu Danfodiyo University Sokoto, Nigeria

Date of Web Publication16-Feb-2016

Correspondence Address:
Olanrewaju Abdurrazaq Taiwo
Department of Surgery, College of Health Sciences, Usmanu Danfodiyo University, PMB 12003, Sokoto
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1118-8561.176585

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  Abstract 

Background: The emergence of osseointegrated dental implants has resulted in several applications in diverse clinical settings. Hence, has contributed to the suitable replacement of missing teeth and the realization of an optimal facial appearance. This paper describes the benefits, applications, contraindications, and complications of dental implants in contemporary dental practice. Materials and Methods: An electronic search was undertaken in PUBMED without time restriction for appropriate English papers on dental implants based on a series of keywords in different combinations. Results: Fifty-eight acceptable, relevant articles were selected for review. The review identified the various components of dental implants, classification, and brands. It also looked at osseointegration and factors promoting and inimical to it. It also explored primary and secondary stability; and patients' selection for a dental implant. Complications of dental implants were also highlighted. Conclusion: With over 95% success rate, dental implants remain the gold standard for achieving aesthetic and functional oral rehabilitation.

Keywords: Dental implants, osseointegration, peri-implantitis, soft tissue


How to cite this article:
Taiwo OA. A concise overview of dental implantology. Sahel Med J 2015;18:149-55

How to cite this URL:
Taiwo OA. A concise overview of dental implantology. Sahel Med J [serial online] 2015 [cited 2024 Feb 23];18:149-55. Available from: https://www.smjonline.org/text.asp?2015/18/4/149/176585


  Introduction Top


The emergence of dental implants has contributed to the realization of an optimal appearance and suitable alternative for tooth replacement.[1] The dawn of dental implantology was heralded by the groundbreaking work of Branemark and his team more than 30 years ago when they successfully submerged artificial titanium fixture into dogs' long bones.[1],[2],[3] Osseointegration involved “a direct structural and functional connection between ordered, living bone and the surface of a load-bearing implant.” Schroeder et al. termed it “functional ankylosis.”[4] It implies a firm, direct, and lasting connection between vital bone and screw-shaped titanium implants of defined finish and geometry-fixtures. Thus, there is no interposed tissue between the fixture and bone.[5]

The revolutionary impact of dental implants on dentistry is unprecedented, presenting cocktail of benefits to numerous categories of patients which include improved esthetics, better denture retention and improvement in self-esteem.[6],[7] In recent years, osseointegrated dental implants have gained momentum fuelled by mounting demand for natural-looking esthetics especially in developed Western countries of Europe, Asia, and America.[2],[3],[7] Published reports by Akeredolu et al. highlight similar trend across major Nigeria cities indicating its growing acceptance.[7],[8]

Titanium and titanium alloys are widely used for the fabrication of dental implants owing to its excellent biocompatibility (bioinert and bioactive forming titanium oxide), osteoconductive and good mechanical properties. Gold, ceramics, and especially Zirconium though less common has also demonstrated great promise.[1],[2]

The long-term success of dental implants in combined maxilla and mandible has been demonstrated in literature ranging from 84% to 97%.[9],[10] Kent et al. in a 5 years study noticed 95% success rate [10] and Albrektsson et al. mentioned a success outcome of 84.9% in 5–7 years study of maxillary implants while isolated mandibular implants demonstrated 93% in 5–12 years study.[11] In another study, Adell et al. observed 94–97% success rate in anterior mandible compared to 91% in the posterior mandible.[5] Furthermore, Andersson et al., demonstrated that titanium implant does well even in irradiated bone reporting a 97.8% success rate in 15 patients with 90 implants exposed to 44–68 cGy irradiation without adjunctive hyperbaric oxygen therapy.[12]

Therefore, this study reviews literature regarding the benefits, applications, contraindications, and complications of dental implants.


  Materials and Methods Top


An electronic search was undertaken in PUBMED without time restriction for appropriate English papers on dental implants based on a series of keywords in different combinations: “dental implantology,” “design,” “implant,” “immediate loading,” “implant length,” “bone density, “implant surface topography,” “implant diameter,” “maxilla,” “mandible,” “implant loss,” “osseointegration,” “primary stability,” “secondary stability,” “surgical technique,” “systemic diseases,” “implant failure,” “implant complications,” and “peri-implantitis.” Prospective, as well as retrospective studies (randomized/nonrandomized clinical trials, meta-analysis, cohort studies, case–control studies, and case reports) were considered. The reference lists of original and review articles were also sought. Letters to the Editor, historical reviews, and unpublished articles were not considered. The structure of the current literature review was tailored to principally summarize the pertinent information.


  Results Top


Fifty-eight acceptable, relevant articles were selected for review. The review identified the various components of dental implants, classification, and brands. It also looked at osseointegration and factors promoting and inimical to it. It also explored primary and secondary stability; and patients' selection for dental implants. Complications of dental implants were also highlighted.

Components of dental implant

Dental implants consist of the following components;[13] implant fixture, cover screw, and abutment. The implant fixture is that component that is embedded in bone following drilling while the cover screw is used to prevent the ingrowth of tissues into the embedded fixture during the healing period [Figure 1]. The abutment connects the implant fixture to the superstructure, i.e., either a crown or denture.[14]
Figure 1: Dental implants with the major components

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Classification and brands of dental implants

Dental implants are widely classified into the following: Subperiosteal, endosteal, and transosseous. Subperiosteal and transosseous were the antiquated earlier forms of dental implants and were only of historical interest.[1],[9],[13] Endosteal dental implants are contemporarily in use and exist in various designs.[9] There are the root types which are widely popular and comes with different kinds of the surface which include smooth, threaded, perforated, solid or hollow, vented, coated, or textured. The surface of dental implants should enhance firm attachment of the implant to the junctional epithelium, soft connective tissue, and bone.[9],[14] Surface-modified implant surface performed superiorly in a compromised situation such as in bone grafts and immediate loading situation. The other less popular type of dental implants are the plate or blade forms.[13]

As a result of the growing demand and expansion of the dental implant market, thousands of brands have emerged from different manufacturers which are widely spread across many parts of the globe. These include Nobel Biocare TiUnite (Nobel Biocare AB, Göteborg, Sweden), Nobel Biocare Steri-Oss HA-coated (Nobel Biocare AB, Yorba Linda, CA, USA), Astra-Tech OsseoSpeed (Astra Tech AB, Mölndal, Sweden), Straumann SLA (Straumann AG, Waldenburg, Switzerland), the Brånemark Integration Original Fixture implants (Brånemark Integration, Göteborg, Sweden), and several others.[15]

Biological principles of osseointegration

Osseointegration is the core of dental implantology and was defined by Branemark as the process whereby clinically asymptomatic rigid fixation of alloplastic material is achieved and maintained in bone during functional loading.[1],[2],[7] Healing around implants has been shown to be similar to normal bone healing; while cytokines and mesenchymal cells have been shown to play vital roles in this process.[1]

Osseointegration is divided into contact and distance osseointegration.[1] Contact osseointegration is the direct formation of bone on the implant surface with implant bone interface <200 µm.[1],[14] On the other hand, if the gap between the bone and the implant surface is >200 µm then new bone formation is by distance osseointegration.[1],[15]

Factors that affect osseointegration

Several factors have been shown to affect osseointegration. These are implant-related factors include design, chemical composition, surface topography, coatings, and wide porosity.[1],[15],[16] Osseointegration essentially needs a bioinert/bioactive material and osteophilic surface that is attractive for bone deposition.[14] Titanium possesses these properties and forms a spontaneously, dense oxide film on exposure to air and an aqueous electrolyte which promotes bone formation and bonding.[1] Several reports have demonstrated that implants with modified surfaces can be loaded immediately [16],[17] than turned surface owing to greater contact areas that lead to increased mechanical stability between the bone and implant; and more blood retention hence better bone healing.[1],[9],[16] Various methods such as electropolishing, mechanical polishing, blasting, etching, and oxidation have been observed to alter implant surfaces.[14] Additive processes such as hydroxyapatite and other calcium phosphate coatings, ion deposition, and plasma sprayed have also been highlighted as means of altering implant surfaces to enhance osseointegration. This has shown a good promise in this direction. However, the degradation of the coatings is an issue of controversy.[14],[15] Screw design has overtaken others in popularity and long-term success.[1],[13]

The state of the host bed has been shown to be highly instrumental in successful osseointegration.[18] High vascularity and cellularity of implant site are essential for optimal bone healing and osseointegration.[13] Minimal surgical trauma during bone preparation and the type of bone, especially cortical bone have been advocated for optimal osseointegration.[1],[18] Slow drilling will generate minimal heat thus avoiding serious harm to the osteoprogenitor cells. In contrast, osteoporosis, smoking, rheumatoid arthritis, and advanced age all adversely impede osseointegration.[18],[19],[20],[21]

Mechanical stability whether primary or secondary stability effects has been reported to be significant in osseointegration.[1],[13]

Adjunctive therapies such as bone grafting, osteogenic coating, and biophysical stimulation have aided osseointegration in less than promising sites such as in atrophic bone and Class IV bone type [Figure 2].[18] Irradiation impairs neovascularization and bone healing and subsequently osseointegration by the destruction of the osteoblasts and other progenitor cells.[1],[18],[22] However, treatment with hyperbaric oxygen has shown some promise though is quite expensive.[23] Chemotherapeutics such as cyclosporine, methotrexate, and other immunosuppressants have been found to impede osseointegration.[1],[24] However, an animal study revealed that short-term immunosuppressive therapy did not impede osseointegration.[24] Bryant found that increased age, especially above 65 years old (qualify the reference age), did not affect osseointegration.[19]
Figure 2: Dental implants and natural teeth side by side in the bone and periapical radiograph

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Pertinently, the most crucial factors for implant success include surgery without a compromising technique,[1],[18] implants placement in sound bone,[11] avoidance of thin bone or implant dehiscence at the time of implant placement,[17] avoidance of premature implant exposure during the healing period,[25] establishing a balanced restoration,[26] and ensuring appropriate follow-up comprehensive oral hygiene care and periodontal maintenance.[27],[28] In the posterior mandible, the presence of keratinized gingiva was strongly correlated with optimal soft- and hard-tissue health.[1],[21]

Primary stability

This is the mechanical engagement of the implant surface and surrounding bone tissue following dental implant placement.[13],[29],[30] The biomechanical property of bone is determined by the ratio of cortical to trabecular bone.[1],[31],[32] The cortical bone is reported to be 20 times stiffer than trabecular bone.[1],[29],[30] Hence, the former offers greater rigidity and stability than the latter.[13],[32] Findings by Miyamoto et al.[33] showed that dental implant stability is positively correlated to the cortical bone thickness. The qualities of bone vary in different anatomical regions (anterior and posterior sites of maxilla and mandible) dictating site-specific bone tissue evaluation prior to implant installation.[34],[35],[36]

Several reports [4],[9] have demonstrated a lower failure rate of dental implants in the mandible in contrast to the maxilla. In another study, Turkyilmaz et al. established the superiority of bone quality in the mandible over the maxilla in implant stability.[34]

Implant design has been discovered to be crucial to primary stability.[32] This includes the three-dimensional structure (geometry), material component, diameter, and surface characteristics of the dental implant.[32],[37],[38],[39] Geometric designs include parallel, tapered, and cylindrical shape; and they presents with different surface modifications.[14],[31] Owing to the weak correlation between dental implants and primary stability, Chong et al.[39] mentioned that inadequate design could be compensated by optimal bone quality and quantity. Surface characteristics differ in different implants system, and it has been shown to be associated with primary stability. Research have shown that rough implant surfaces promote favorable healing via cellular response and cell surface interactions.[31] Finally, progressive thread design, particularly at the neck of implants, reduces the loss of crestal bone.[39],[40] Lan et al. suggested that trapezoidal-threaded implant of 1.6 mm thread pitch affords greater primary stability.[41]

Besides the earlier highlighted variables, the surgical technique adopted is indispensable to primary stability.[29],[33] Implants should be inserted in bone in a surgically prepared site, using graded series of drills followed by a tap rotating at 15 rotation/min and absolute temperature control at the surgical site should not exceed 47°C to avoid thermal necrosis of bone.[14],[30] In the posterior maxilla where bone quality is poor and large sinuses are present, a novel technique of bone condensing by Summers [42] using osteotomes has been widely adopted in literature.[43],[44]

Summarily, rough surfaces, high bone density, primary tapering of dental implants, thinner drill diameter, and avoiding pretapping insertion of the dental implants contribute significantly to primary stability.[1],[29],[30]

Secondary dental implant stability

Secondary stability occurs following osseointegration.[1] Some studies suggest that dental implants with low primary stability need a longer period of healing while an implant with high primary stability needs only a short or no healing period before loading.[1],[14],[45] Bone healing and remodeling occurred between 12 and 18 months of implant placement.[1],[14] Poor general health, Crohn's disease, osteoporosis, use of illicit drugs, bisphosphonates, smoking, and diabetes have been suggested as factors that could compromise this healing period.[14],[20],[21],[22] The level of evidence indicative of absolute and relative contraindications for implant therapy due to systemic diseases is low.[45] Studies comparing patients with and without the condition in a controlled setting are sparse.[14],[45]

Loading is done after osseointegration to ensure long-term secondary stability.[16],[17],[20],[31] Secondary dental implant stability increases with loading.[47] However, the maintenance of the stability is achieved by avoiding overloading of the implant and appropriate follow-up of oral hygiene measures as most failures occurred in the 1st year.[1],[13],[18],[21] Immediate loading of dental implants has been linked to optimal stability due to well-controlled micro-motion that enhance bone healing.[48] A meta-analysis of randomized studies showed no significant difference in success rates between immediate, early or conventional loading in dental implants with a high degree of primary stability.[49]

Transmucosal attachment

The quality of soft tissue seal around a dental implant provides an essential physiological and biological barrier from oral pathogens and mastication.[1],[13] Attached gingiva provides that ideal soft tissue seal similar to that in the natural tooth.[1]

Patient's selection

It is vital that the clinicians determine all potential risks and patients' suitability for dental implants.[18] Patients' with full or partially edentulous mandible or maxilla can be considered for this treatment modality provided that they are in good general health [Figure 3].
Figure 3: Dental implants compared to traditional bridge restoration

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Several detrimental factors have been identified in dental implant placement.[18],[20],[21],[22] These include local factors such as oral infections or malignancies and active periodontal diseases.[26],[29],[50],[51] General medical conditions such as blood dyscrasias, uncontrolled diabetes, hyperthyroidism, renal disease, uncontrolled hypertension, liver problems, leukemia, severe vascular heart disease, hepatitis, or any immunosuppressive disorder.[13] The role of medications such as intravenous bisphosphonates (such as pamidronate) and chemotherapy should be properly clarified before implants placement.[15],[20],[21],[22],[52]

Relative medical conditions include tobacco use, excessive alcohol consumption, poor oral hygiene, bruxism, nail or pencil biting, tongue habits, and chronic sinusitis.[1], 13, [20],[21],[22] All these are rectifiable.

Anatomical factors could be a contraindication for dental implants.[13] Theses include insufficient ridge dimensions to accommodate proper implant placement. The ideal ridge width is considered to be 6 mm or more.[1],[18],[19],[21] Furthermore, low maxillary sinus extending to the alveolus could be a contraindication but modifiable by sinus lifting and bone grafting.[43]

Successful dental implants are expedited by collaboration between numerous specialists consisting of oral and maxillofacial surgeons, periodontologists, and prosthodontists.[13]

A well-prepared treatment plan is critical for implant success [Figure 4], including but not limited to: Complete oral examination, treatment of existing pathologies prior to implant placement, radiographic assessment, good quality panoramic film, appropriate long-cone periapical films, and additional specialized films for the site being treated, for example, computed tomography (CT) scans. Others are occlusal, panoramic radiographs, cone beam CT, study models, presurgical prosthetic guide using the patient's prosthesis, or natural teeth as a reference so that the implants can be placed in the most suitable locations during the surgery.[13]
Figure 4: Dental implant before and after crowning

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Complications of dental implants

Although not very common, complications of dental implants reported include infection, implant failure, bone resorption around implant, nerve injury and numbness, perforation of the maxillary sinus and nasal cavity, and fracture of the mandible.[30],[51] However, two major complications are prominent: The lack of bone tissue integration and implant-centered infection (peri-implantitis).[13],[53] Implant failure is defined as the lack of integration and eventual loss of the implant.[17],[18] Quirynen et al.[54] in a systematic review reported that dental implants' loss remained below 5% for both immediate and early placed implants, with a tendency toward higher losses when implants were also immediately loaded.[54] The surface of the implant, through its interactions with proteins, bacteria, and tissue cells, plays a determining role in the success or failure of the implant.[55] Smokers and patients with a history of periodontal disease are at higher risk of developing peri-implantitis.[53] To diminish infections after dental implant placements, diverse prophylactic, systemic antibiotic regimens have been recommended. More recent protocols suggested short-term prophylaxis of broad spectrum antibiotics like amoxicillin/clavulanic acid.[56],[57],[58] To ensure the optimal peri-implant health, the patient must maintain daily biofilm removal and maintain regular professional care.[29],[53] Silverstein et al. further elaborated that negation of early microbial accumulation on the dental implant surfaces and the elimination of at least 85% of plaque biofilm by the patient is crucial for long-term success.[28]


  Conclusion Top


In recent years, the practice of dental implantology has witnessed phenomenal acceptance and global interest from clinicians and patients alike. With over 95% success rate, dental implants remain the gold standard for achieving esthetic and functional oral rehabilitation.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Sahoo S, Goel M, Gandhi P, Saxena S. Biological aspects of dental implant; current knowledge and perspectives in oral implantology. Dent Hypotheses 2013;4:87-91.  Back to cited text no. 1
  Medknow Journal  
2.
Albrektsson CJ, Sennerby L. What is osseointegration? In: Worthington P, Evans JR, editors. Controversies in Oral and Maxillofacial Surgery. Philadelphia: W.B. Saunders; 1997. p. 436-46.  Back to cited text no. 2
    
3.
Paul SJ, Pietrobon N. Aesthetic evolution of anterior maxillary crowns: A literature review. Pract Periodontics Aesthet Dent 1998;10:87-94.  Back to cited text no. 3
    
4.
Schroeder A, van der Zypen E, Stich H, Sutter F. The reactions of bone, connective tissue, and epithelium to endosteal implants with titanium-sprayed surfaces. J Maxillofac Surg 1981;9:15-25.  Back to cited text no. 4
    
5.
Adell R, Lekholm U, Rockler B, Brånemark PI. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 1981;10:387-416.  Back to cited text no. 5
    
6.
Kent G, Johns R. Effects of osseointegrated implants on psychological and social well-being: A comparison with replacement removable prostheses. Int J Oral Maxillofac Implants 1994;9:103-6.  Back to cited text no. 6
    
7.
Akeredolu PA, Adeyemo WL, Omololu OB, Karunwi O. Implant restoration of partially edentulous ridges: A review of 121 Nigerian patients. Implant Dent 2010;19:65-72.  Back to cited text no. 7
    
8.
Akeredolu PA, Adeyemo WL, Gbotolorun OM, James O, Olorunfemi BO, Arotiba GT. Knowledge, attitude, and practice of dental implantology in Nigeria. Implant Dent 2007;16:110-8.  Back to cited text no. 8
    
9.
Albrektsson T, Dahl E, Enbom L, Engevall S, Engquist B, Eriksson AR, et al. Osseointegrated oral implants. A Swedish multicenter study of 8139 consecutively inserted Nobelpharma implants. J Periodontol 1988;59:287-96.  Back to cited text no. 9
    
10.
Kent JN, Block MS, Finger IM, Guerra L, Larsen H, Misiek DJ. Biointegrated hydroxylapatite-coated dental implants: 5-year clinical observations. J Am Dent Assoc 1990;121:138-44.  Back to cited text no. 10
    
11.
Albrektsson T, Brånemark PI, Hansson HA, Lindström J. Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man. Acta Orthop Scand 1981;52:155-70.  Back to cited text no. 11
    
12.
Andersson G, Andreasson L, Bjelkengren G. Oral implant rehabilitation in irradiated patients without adjunctive hyperbaric oxygen. Int J Oral Maxillofac Implants 1998;13:647-54.  Back to cited text no. 12
    
13.
Rasmusson L, Sennerby L. Implantology. In: Andersson L, Kahnberg KE, Pogrel MA, editors. Oral and maxillofacial surgery. New Jersey Wiley-Blackwell; 2010. p. 341-55.  Back to cited text no. 13
    
14.
Lesmes D, Laster Z. Innovations in dental implant design for current therapy. Oral Maxillofac Surg Clin North Am 2011;23:193-200, v.  Back to cited text no. 14
    
15.
Jarmar T, Palmquist A, Brånemark R, Hermansson L, Engqvist H, Thomsen P. Characterization of the surface properties of commercially available dental implants using scanning electron microscopy, focused ion beam, and high-resolution transmission electron microscopy. Clin Implant Dent Relat Res 2008;10:11-22.  Back to cited text no. 15
    
16.
Pieri F, Lizio G, Bianchi A, Corinaldesi G, Marchetti C. Immediate loading of dental implants placed in severely resorbed edentulous maxillae reconstructed with Le Fort I osteotomy and interpositional bone grafting. J Periodontol 2012;83:963-72.  Back to cited text no. 16
    
17.
Khorshid HE, Hamed HA, Aziz EA. Complications, risk factors, and failures of immediate functional loading of implants placed in the completely edentulous maxillae: A report of 3 consecutive cases. Implant Dent 2014;23:125-31.  Back to cited text no. 17
    
18.
Chrcanovic BR, Albrektsson T, Wennerberg A. Reasons for failures of oral implants. J Oral Rehabil 2014;41:443-76.  Back to cited text no. 18
    
19.
Bryant SR. The effects of age, jaw site, and bone condition on oral implant outcomes. Int J Prosthodont 1998;11:470-90.  Back to cited text no. 19
    
20.
Alsaadi G, Quirynen M, Komárek A, van Steenberghe D. Impact of local and systemic factors on the incidence of late oral implant loss. Clin Oral Implants Res 2008;19:670-6.  Back to cited text no. 20
    
21.
Block MS, Kent JN. Factors associated with soft- and hard-tissue compromise of endosseous implants. J Oral Maxillofac Surg 1990;48:1153-60.  Back to cited text no. 21
    
22.
Esposito M, Hirsch JM, Lekholm U, Thomsen P. Biological factors contributing to failures of osseointegrated oral implants. (II). Etiopathogenesis. Eur J Oral Sci 1998;106:721-64.  Back to cited text no. 22
    
23.
Granström G. Placement of dental implants in irradiated bone: The case for using hyperbaric oxygen. J Oral Maxillofac Surg 2006;64:812-8.  Back to cited text no. 23
    
24.
Sakakura CE, Marcantonio E Jr, Wenzel A, Scaf G. Influence of cyclosporin A on quality of bone around integrated dental implants: A radiographic study in rabbits. Clin Oral Implants Res 2007;18:34-9.  Back to cited text no. 24
    
25.
Duarte PM, Nogueira Filho GR, Sallum EA, Sallum AW, Nociti Júnior FH. Short-term immunosuppressive therapy does not affect the density of the pre-existing bone around titanium implants placed in rabbits. Pesqui Odontol Bras 2003;17:362-6.  Back to cited text no. 25
    
26.
Clayman L. Implant reconstruction of the bone-grafted maxilla: Review of the literature and presentation of 8 cases. J Oral Maxillofac Surg 2006;64:674-82.  Back to cited text no. 26
    
27.
Wennström JL, Ekestubbe A, Gröndahl K, Karlsson S, Lindhe J. Oral rehabilitation with implant-supported fixed partial dentures in periodontitis-susceptible subjects. A 5-year prospective study. J Clin Periodontol 2004;31:713-24.  Back to cited text no. 27
    
28.
Silverstein L, Garg A, Callan D, Shatz P. The key to success: Maintaining the long-term health of implants. Dent Today 1998;17:104, 106, 108-11.  Back to cited text no. 28
    
29.
Kracher CM, Smith WS. Oral health maintenance dental implants. Dent Assist 2010;79:27-35.  Back to cited text no. 29
    
30.
Bilhan H, Geckili O, Mumcu E, Bozdag E, Sünbüloglu E, Kutay O. Influence of surgical technique, implant shape and diameter on the primary stability in cancellous bone. J Oral Rehabil 2010;37:900-7.  Back to cited text no. 30
    
31.
O'Sullivan D. Factors of Importance for Primary Stability of Dental Implants. Thesis, University of Bristol; 2001.  Back to cited text no. 31
    
32.
Javed F, Romanos GE. The role of primary stability for successful immediate loading of dental implants. A literature review. J Dent 2010;38:612-20.  Back to cited text no. 32
    
33.
Javed F, Ahmed HB, Crespi R, Romanos GE. Role of primary stability for successful osseointegration of dental implants: Factors of influence and evaluation. Interv Med Appl Sci 2013;5:162-7.  Back to cited text no. 33
    
34.
Miyamoto I, Tsuboi Y, Wada E, Suwa H, Iizuka T. Influence of cortical bone thickness and implant length on implant stability at the time of surgery – Clinical, prospective, biomechanical, and imaging study. Bone 2005;37:776-80.  Back to cited text no. 34
    
35.
Turkyilmaz I, Tözüm TF, Tumer C. Bone density assessments of oral implant sites using computerized tomography. J Oral Rehabil 2007;34:267-72.  Back to cited text no. 35
    
36.
Fuh LJ, Huang HL, Chen CS, Fu KL, Shen YW, Tu MG, et al. Variations in bone density at dental implant sites in different regions of the jawbone. J Oral Rehabil 2010;37:346-51.  Back to cited text no. 36
    
37.
De Oliveira RC, Leles CR, Normanha LM, Lindh C, Ribeiro-Rotta RF. Assessments of trabecular bone density at implant sites on CT images. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105:231-8.  Back to cited text no. 37
    
38.
Steigenga JT, al-Shammari KF, Nociti FH, Misch CE, Wang HL. Dental implant design and its relationship to long-term implant success. Implant Dent 2003;12:306-17.  Back to cited text no. 38
    
39.
Kohn DH. Overview of factors important in implant design. J Oral Implantol 1992;18:204-19.  Back to cited text no. 39
    
40.
Chong L, Khocht A, Suzuki JB, Gaughan J. Effect of implant design on initial stability of tapered implants. J Oral Implantol 2009;35:130-5.  Back to cited text no. 40
    
41.
Hansson S, Werke M. The implant thread as a retention element in cortical bone: The effect of thread size and thread profile: A finite element study. J Biomech 2003;36:1247-58.  Back to cited text no. 41
    
42.
Lan TH, Du JK, Pan CY, Lee HE, Chung WH. Biomechanical analysis of alveolar bone stress around implants with different thread designs and pitches in the mandibular molar area. Clin Oral Investig 2012;16:363-9.  Back to cited text no. 42
    
43.
Sakka S, Baroudi K, Nassani MZ. Factors associated with early and late failure of dental implants. J Investig Clin Dent 2012;3:258-61.  Back to cited text no. 43
    
44.
Bornstein MM, Cionca N, Mombelli A. Systemic conditions and treatments as risks for implant therapy. Int J Oral Maxillofac Implants 2009;24 Suppl: 12-27.  Back to cited text no. 44
    
45.
Summers RB. A new concept in maxillary implant surgery: The osteotome technique. Compendium 1994;15:152, 154-6, 158.  Back to cited text no. 45
    
46.
Fermergård R, Astrand P. Osteotome sinus floor elevation and simultaneous placement of implants – A 1-year retrospective study with Astra Tech implants. Clin Implant Dent Relat Res 2008;10:62-9.  Back to cited text no. 46
    
47.
Davarpanah M, Martinez H, Tecucianu JF, Hage G, Lazzara R. The modified osteotome technique. Int J Periodontics Restorative Dent 2001;21:599-607.  Back to cited text no. 47
    
48.
Becker W, Becker BE, Israelson H, Lucchini JP, Handelsman M, Ammons W, et al. One-step surgical placement of Brånemark implants: A prospective multicenter clinical study. Int J Oral Maxillofac Implants 1997;12:454-62.  Back to cited text no. 48
    
49.
Fischer K, Bäckström M, Sennerby L. Immediate and early loading of oxidized tapered implants in the partially edentulous maxilla: A 1-year prospective clinical, radiographic, and resonance frequency analysis study. Clin Implant Dent Relat Res 2009;11:69-80.  Back to cited text no. 49
    
50.
Esposito M, Grusovin MG, Willings M, Coulthard P, Worthington HV. The effectiveness of immediate, early, and conventional loading of dental implants: A Cochrane systematic review of randomized controlled clinical trials. Int J Oral Maxillofac Implants 2007;22:893-904.  Back to cited text no. 50
    
51.
Karoussis IK, Kotsovilis S, Fourmousis I. A comprehensive and critical review of dental implant prognosis in periodontally compromised partially edentulous patients. Clin Oral Implants Res 2007;18:669-79.  Back to cited text no. 51
    
52.
Pancer B, Garaicoa-Pazmiño C, Bashutski JD. Accessory mandibular foramen during dental implant placement: Case report and review of literature. Implant Dent 2014;23:116-24.  Back to cited text no. 52
    
53.
Roos-Jansåker AM. Long time follow up of implant therapy and treatment of peri-implantitis. Swed Dent J Suppl 2007;188:7-66.  Back to cited text no. 53
    
54.
Quirynen M, Van Assche N, Botticelli D, Berglundh T. How does the timing of implant placement to extraction affect outcome? Int J Oral Maxillofac Implants 2007;22 Suppl: 203-23.  Back to cited text no. 54
    
55.
Neoh KG, Hu X, Zheng D, Kang ET. Balancing osteoblast functions and bacterial adhesion on functionalized titanium surfaces. Biomaterials 2012;33:2813-22.  Back to cited text no. 55
    
56.
Abukaraky AE, Afifeh KA, Khatib AA, Khdairi NO, Habarneh HM, Ahmad WKh, et al. Antibiotics prescribing practices in oral implantology among jordanian dentists. A cross sectional, observational study. BMC Res Notes 2011;4:266.  Back to cited text no. 56
    
57.
Esposito M, Grusovin MG, Loli V, Coulthard P, Worthington HV. Does antibiotic prophylaxis at implant placement decrease early implant failures? A Cochrane systematic review. Eur J Oral Implantol 2010;3:101-10.  Back to cited text no. 57
    
58.
Esposito M, Coulthard P, Oliver R, Thomsen P, Worthington HV. Antibiotics to prevent complications following dental implant treatment. Cochrane Database Syst Rev 2003;3:CD004152.  Back to cited text no. 58
    


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