Reducing Bone Loss in Oral Implants

[drmithila]

Researchers have found that less bone loss is experienced in an oral implant when a 2-stage approach to surgery is used. Simultaneously inserted im­plants, which require one operation to transplant bone tissue and to insert implants, have shown excellent results.

How­ever, when the implants were inserted in a second operation about 6 months after the bone tissue grafts, crestal bone loss was reduced. A retrospective study compared simultaneously inserted implants with de­layed implants. In cases where there was not enough bone tissue to anchor the implant, freeze-dried bone was used as the graft material. The study examined 81 patients with a median age of 52 years, treated between Decem­ber 2003 and December 2006; 17 patients re­ceived grafts and 48 implants in a simultaneous operation, and 64 patients re­ceived a total of 302 implants in a second operation within a mean of 6 months following their graft surgeries.

Examina­tion of crestal bone resorption around the im­plant’s neck and specific cutoff values showed the delayed im­plant procedure to have better clinical outcomes by allowing less bone loss. This is important because bone quality of the host (patient) is considered to be a strong predictor for the out­come of the implants. 

        

[siteadmin]

 If the prostheseis is properly made then the bone loss around the implants is minimal. Pt. must use the oral irrigator

        

[drmithila]

 Bone loss around dental implants is far more common than previously realised, reveals a thesis from the Sahlgrenska Academy at the University of Gothenburg, Sweden. Around a quarter of patients loose some degree of supporting bone around their implants.

The study analysed X-rays of over 600 patients. The more implants a patient had in the jaw, the more common it was to find loss of supporting bone. Just over a quarter – 28 per cent – of patients had lost some degree of supporting bone around their implants.

"Contrary to what we had previously assumed, the bone loss in these patients was not linear, but instead accelerated with time," says consultant dental surgeon Christer Fransson, who wrote the thesis. "This is a new discovery that shows just how important it is to detect and treat bone loss around implants at an early stage."

Smoking is one of several factors that increase the risk of bone loss. In the study smokers had more implants with bone loss than non-smokers.

The thesis also shows that the soft tissues surrounding an implant with bone loss is often inflamed.

"It’s important to examine the tissues around implants in the same way as we examine the tissues around teeth," says Fransson. "In that way we can notice early signs of inflammation and treat it before the bone loss has any serious consequences."

DENTAL IMPLANTS

Hundreds of thousands of Swedes have dental implants, which are a type of artificial tooth root made from titanium. A surgical procedure is carried out to insert a titanium screw into the jawbone, where it integrates and forms a base for crowns, bridges or prostheses. There are several types of titanium implants, but all are based on the finding that titanium has an unique property to integrate with the bone. The method was pioneered by professor Per-Ingvar Br-nemark at the Sahlgrenska Academy during the 1960s.

 

        

[drmithila]

 Bone loss around dental implants is far more common than previously realised, reveals a thesis from the Sahlgrenska Academy at the University of Gothenburg, Sweden. Around a quarter of patients loose some degree of supporting bone around their implants.

The study analysed X-rays of over 600 patients. The more implants a patient had in the jaw, the more common it was to find loss of supporting bone. Just over a quarter – 28 per cent – of patients had lost some degree of supporting bone around their implants.

"Contrary to what we had previously assumed, the bone loss in these patients was not linear, but instead accelerated with time," says consultant dental surgeon Christer Fransson, who wrote the thesis. "This is a new discovery that shows just how important it is to detect and treat bone loss around implants at an early stage."

Smoking is one of several factors that increase the risk of bone loss. In the study smokers had more implants with bone loss than non-smokers.

The thesis also shows that the soft tissues surrounding an implant with bone loss is often inflamed.

"It’s important to examine the tissues around implants in the same way as we examine the tissues around teeth," says Fransson. "In that way we can notice early signs of inflammation and treat it before the bone loss has any serious consequences."

DENTAL IMPLANTS

Hundreds of thousands of Swedes have dental implants, which are a type of artificial tooth root made from titanium. A surgical procedure is carried out to insert a titanium screw into the jawbone, where it integrates and forms a base for crowns, bridges or prostheses. There are several types of titanium implants, but all are based on the finding that titanium has an unique property to integrate with the bone. The method was pioneered by professor Per-Ingvar Br-nemark at the Sahlgrenska Academy during the 1960s.

 

        

[drmithila]

 Bone loss around dental implants is far more common than previously realised, reveals a thesis from the Sahlgrenska Academy at the University of Gothenburg, Sweden. Around a quarter of patients loose some degree of supporting bone around their implants.

The study analysed X-rays of over 600 patients. The more implants a patient had in the jaw, the more common it was to find loss of supporting bone. Just over a quarter – 28 per cent – of patients had lost some degree of supporting bone around their implants.

"Contrary to what we had previously assumed, the bone loss in these patients was not linear, but instead accelerated with time," says consultant dental surgeon Christer Fransson, who wrote the thesis. "This is a new discovery that shows just how important it is to detect and treat bone loss around implants at an early stage."

Smoking is one of several factors that increase the risk of bone loss. In the study smokers had more implants with bone loss than non-smokers.

The thesis also shows that the soft tissues surrounding an implant with bone loss is often inflamed.

"It’s important to examine the tissues around implants in the same way as we examine the tissues around teeth," says Fransson. "In that way we can notice early signs of inflammation and treat it before the bone loss has any serious consequences."

DENTAL IMPLANTS

Hundreds of thousands of Swedes have dental implants, which are a type of artificial tooth root made from titanium. A surgical procedure is carried out to insert a titanium screw into the jawbone, where it integrates and forms a base for crowns, bridges or prostheses. There are several types of titanium implants, but all are based on the finding that titanium has an unique property to integrate with the bone. The method was pioneered by professor Per-Ingvar Br-nemark at the Sahlgrenska Academy during the 1960s.

 

        

[drmithila]

 Bone loss around dental implants is far more common than previously realised, reveals a thesis from the Sahlgrenska Academy at the University of Gothenburg, Sweden. Around a quarter of patients loose some degree of supporting bone around their implants.

The study analysed X-rays of over 600 patients. The more implants a patient had in the jaw, the more common it was to find loss of supporting bone. Just over a quarter – 28 per cent – of patients had lost some degree of supporting bone around their implants.

"Contrary to what we had previously assumed, the bone loss in these patients was not linear, but instead accelerated with time," says consultant dental surgeon Christer Fransson, who wrote the thesis. "This is a new discovery that shows just how important it is to detect and treat bone loss around implants at an early stage."

Smoking is one of several factors that increase the risk of bone loss. In the study smokers had more implants with bone loss than non-smokers.

The thesis also shows that the soft tissues surrounding an implant with bone loss is often inflamed.

"It’s important to examine the tissues around implants in the same way as we examine the tissues around teeth," says Fransson. "In that way we can notice early signs of inflammation and treat it before the bone loss has any serious consequences."

DENTAL IMPLANTS

Hundreds of thousands of Swedes have dental implants, which are a type of artificial tooth root made from titanium. A surgical procedure is carried out to insert a titanium screw into the jawbone, where it integrates and forms a base for crowns, bridges or prostheses. There are several types of titanium implants, but all are based on the finding that titanium has an unique property to integrate with the bone. The method was pioneered by professor Per-Ingvar Br-nemark at the Sahlgrenska Academy during the 1960s.

 

        

[drmithila]

 Bone loss around dental implants is far more common than previously realised, reveals a thesis from the Sahlgrenska Academy at the University of Gothenburg, Sweden. Around a quarter of patients loose some degree of supporting bone around their implants.

The study analysed X-rays of over 600 patients. The more implants a patient had in the jaw, the more common it was to find loss of supporting bone. Just over a quarter – 28 per cent – of patients had lost some degree of supporting bone around their implants.

"Contrary to what we had previously assumed, the bone loss in these patients was not linear, but instead accelerated with time," says consultant dental surgeon Christer Fransson, who wrote the thesis. "This is a new discovery that shows just how important it is to detect and treat bone loss around implants at an early stage."

Smoking is one of several factors that increase the risk of bone loss. In the study smokers had more implants with bone loss than non-smokers.

The thesis also shows that the soft tissues surrounding an implant with bone loss is often inflamed.

"It’s important to examine the tissues around implants in the same way as we examine the tissues around teeth," says Fransson. "In that way we can notice early signs of inflammation and treat it before the bone loss has any serious consequences."

DENTAL IMPLANTS

Hundreds of thousands of Swedes have dental implants, which are a type of artificial tooth root made from titanium. A surgical procedure is carried out to insert a titanium screw into the jawbone, where it integrates and forms a base for crowns, bridges or prostheses. There are several types of titanium implants, but all are based on the finding that titanium has an unique property to integrate with the bone. The method was pioneered by professor Per-Ingvar Br-nemark at the Sahlgrenska Academy during the 1960s.

 

        

[drmithila]

 Bone loss around dental implants is far more common than previously realised, reveals a thesis from the Sahlgrenska Academy at the University of Gothenburg, Sweden. Around a quarter of patients loose some degree of supporting bone around their implants.

The study analysed X-rays of over 600 patients. The more implants a patient had in the jaw, the more common it was to find loss of supporting bone. Just over a quarter – 28 per cent – of patients had lost some degree of supporting bone around their implants.

"Contrary to what we had previously assumed, the bone loss in these patients was not linear, but instead accelerated with time," says consultant dental surgeon Christer Fransson, who wrote the thesis. "This is a new discovery that shows just how important it is to detect and treat bone loss around implants at an early stage."

Smoking is one of several factors that increase the risk of bone loss. In the study smokers had more implants with bone loss than non-smokers.

The thesis also shows that the soft tissues surrounding an implant with bone loss is often inflamed.

"It’s important to examine the tissues around implants in the same way as we examine the tissues around teeth," says Fransson. "In that way we can notice early signs of inflammation and treat it before the bone loss has any serious consequences."

DENTAL IMPLANTS

Hundreds of thousands of Swedes have dental implants, which are a type of artificial tooth root made from titanium. A surgical procedure is carried out to insert a titanium screw into the jawbone, where it integrates and forms a base for crowns, bridges or prostheses. There are several types of titanium implants, but all are based on the finding that titanium has an unique property to integrate with the bone. The method was pioneered by professor Per-Ingvar Br-nemark at the Sahlgrenska Academy during the 1960s.

 

        

[Drsumitra]

 Bone grafting is a surgical procedure that replaces missing bone in order to repair bone fractures that are extremely complex, pose a significant health risk to the patient, or fail to heal properly.
Bone generally has the ability to regenerate completely but requires a very small fracture space or some sort of scaffold to do so. Bone grafts may be autologous (bone harvested from the patient’s own body, often from the iliac crest), allograft (cadaveric bone usually obtained from a bone bank), or synthetic (often made of hydroxyapatite or other naturally occurring and biocompatible substances) with similar mechanical properties to bone. Most bone grafts are expected to be reabsorbed and replaced as the natural bone heals over a few months’ time.
The principles involved in successful bone grafts include osteoconduction (guiding the reparative growth of the natural bone), osteoinduction (encouraging undifferentiated cells to become active osteoblasts), and osteogenesis (living bone cells in the graft material contribute to bone remodeling). Osteogenesis only occurs with autograftsone grafting is possible because bone tissue, unlike most other tissues, has the ability to regenerate completely if provided the space into which to grow. As native bone grows, it will generally replace the graft material completely, resulting in a fully integrated region of new bone. The biologic mechanisms that provide a rationale for bone grafting are osteoconduction, osteoinduction and osteogenesis.
Osteoconduction
Osteoconduction occurs when the bone graft material serves as a scaffold for new bone growth that is perpetuated by the native bone. Osteoblasts from the margin of the defect that is being grafted utilize the bone graft material as a framework upon which to spread and generate new bone.[1] In the very least, a bone graft material should be osteoconductive.
Osteoinduction
Osteoinduction involves the stimulation of osteoprogenitor cells to differentiate into osteoblasts that then begin new bone formation. The most widely studied type of osteoinductive cell mediators are bone morphogenetic proteins (BMPs).[1] A bone graft material that is osteoconductive and osteoinductive will not only serve as a scaffold for currently existing osteoblasts but will also trigger the formation of new osteoblasts, theoretically promoting faster integration of the graft.
Osteopromotion
Osteopromotion involves the enhancement of osteoinduction without the possession of osteoinductive properties. For example, enamel matrix derivative has been shown to enhance the osteoinductive effect of demineralized freeze dried bone allograft (DFDBA), but will not stimulate de novo bone growth alone.
Osteogenesis
Osteogenesis occurs when vital osteoblasts originating from the bone graft material contribute to new bone growth along with bone growth generated via the other two mechanisms.

        

[drmithila]

Advantages of Microimplants
Use of these devices leads to:
24 X 7 Force delivery
simplified mechanics,
improved results,
drastic reduction (upto 40%) in treatment timing,
reduction in number of extractions
Minimal dependence on patient co operation
Disadvantages of Microimplants
High Cost of the devices
Failure of about 10% fixures
Problem in site selection in patients with poor Bone quality
Patient acceptance may be an issue in some cultures
Common Indications for placement of Temporary Anchorage devices/mini implants
Every case is not suited for microimplants. Minimal anchorage cases now can be treated non extraction with MI, many other average extraction cases we found that treatment objectives are achieved and extraction space is still remaining. Hence the cases where you need molars to come forward to occupy some of the ext space, are better done without MI or done with caution.
Mini implants are used most beneficially where three dimensional stable anchorage is needed, some of these situations are:
Where you can not afford any movement of reactive units (maximum anchorage case)
Patient with several missing teeth making it difficult to engage posterior units
For difficult tooth movements, eg intrusion of anterior and posterior segments and ditalisation
Where asymmetrical tooth movement is needed
To treat borderline cases with non extraction method
Doing extreme ortho when patient is not willing to undergo orthognathic surgery
Common SITES OF PLACEMENT-see pic below
MAXILLA:
Infrazygomatic crest area.
Tuberosity area.
Between 1st and 2nd molars buccally.
Between 1st molar and 2nd premolar buccally.
Between canine and premolar buccally.
Between incisors facially.
Mid palatal Area.
MANDIBLE:
Retromolar Area.
Between 1st and 2nd molars buccally.
Between 1st molar and 2nd premolar buccally.
Between canine and premolar buccally.

 

        

[drmithila]

Methods of placement
Pre-tapping method: In this method the miniscrews is driven into the tunnel of bone formed by drilling, making it tap during implant driving). This method is used when we use small diameter miniscrews
Self tapping: Here a slight notch is made and then the screw is tapped in bone.
Self-Drilling method: Here the miniscrews is driven directly into bone without drilling.What other possible complications may arise from use of micro-implants?
1. The gums around the micro-implant may be inflamed due to the irritation from the
springs attached to the micro-implants. The inflammation is reversible, and the
health of the gums will return to normal after the removal of the springs.
2. Should you have a medical condition that affects wound healing (e.g. diabetes) or if
you are a chronic heavy smoker, there is a high likelihood of your gums being
inflamed and a poorer healing of the bone locations where the micro-implants are
placed.

 

        

[drmithila]

 

        

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