Since their introduction over 40 years ago, dental implants have become an established treatment modality that had revolutionized the concept of replacing missing teeth. Dr. Ryne Johnson, prosthodontist and managing partner of Newton Wellesley Dental Partners has been considered a pioneer in computer-assisted implant dentistry. His first implant case was in 1988. According to Dr. Johnson, “The recent material of choice for manufacturing dental implants is commercially pure titanium, because of its excellent biocompatibilty and mechanical properties However, the gray colour of the titanium may be disadvantageous and give rise to esthetic problems, especially if the soft tissue situation is not optimal and the dark colour shines through the thin peri-implant mucosa. The profession has been looking for options to address this concern. Some implant companies are wrapping a pink material along the collar of the implant while others are developing ceramic implants.”
Zirconia ceramics (yttrium-stabilized tetragonal poly-crystals) seem to be a suitable material for dental implants because of their tooth-like colour, their excellent mechanical properties and their good biocompatibility. They have extensively been used as ball heads in total hip replacements with remarkable clinical outcomes. Recent animal studies have also shown successful bone healing of dental zirconia implants under both unloaded and loaded conditions. Dr. Johnson has been using zirconia to fabricate his dental crowns for many years without outstanding success. As the conventional fabrication of zirconia rods usually results in realtively smooth surfaces, only few studies have investigated rough surface modifications of zirconia implants. This is a critical aspect, since it has been already demonstrated that surface roughness and topography also influence osseointegration of zirconia implants.
A recent study by Rita Depprich, et al, in Head and Face Medicine, looks at the comparison of titanium and zirconia implants on pigs and concludes that, “zirconia implants with modified surfaces display features of osseointegration similar to those of titanium implants. These results are promising for using zirconia implants for dental applications in the future”.
“It’s still early in the game” according to Dr. Johnson, “but it may be available in the next few years after clinical trials are complete. Until then, titanium implants are sill the gold standard. ”
Original article: https://head-face-med.biomedcentral.com Artwork: www.southerdentalimplant.com
However, research published in the journal Oncotarget, which focuses on cancer-related issues, suggests that electronic cigarette smoke may wreak the same type of havoc on teeth and gums that conventional tobacco does. A team of scientists from the University of Rochester and Stony Brook University found that the vapors released in e-cigarettes can cause tissue inflammation and damage comparable to that produces by regular ones.
Some caveats: This particular experiment was conducted on gum tissue, not live human participants. It’s possible that there are other confounding factors that may contribute to gum disease and in e-cig and regular cigarette users alike.
But it’s the latest example of scientific skepticism surrounding the health benefits of e-cigarettes. Manufacturers claim that they are an obviously superior alternative to conventional products that contain known carcinogens; but the overall public health ramifications of the products remain unclear, including whether or not they may actually be encouraging more kids to smoke.
Original article: http://fortune.com/2016/11/17/e-cigarettes-yellow-teeth-study/ Artwork: www.motherjones.com
After the first dental implant patient was treated in the 1980s, a discussion began around the optimal number of implants needed to anchor a fixed dental prosthesis in edentulous patients. Some clinicians tended to install as many implants as possible, often one per tooth. Others argued that biomechanically, only four or even three were needed. Only long-term clinical data could provide answers.
At the forefront
The records of the early patients of P-I Brånemark allowed for an early retrospective study. After a 10-year observation period, the survival rates were demonstrated to be the same for restorations with four and six implants assuming that the bone levels and distribution of implants were ideal. The challenge of advanced resorption remained, however. Because it is not possible in many cases to insert distal implants without grafting and/or nerve lateralization, the concept of tilting the two distal implants was introduced.
In 2003, the concept of immediate loading (placing a dental prosthesis on implants the same day the implants are placed) of four implants in edentulous lower—and soon after also upper—jaws with two tilted distal implants. This one-stage procedure substantially reduced the costly and time-consuming bone grafting procedures, number of surgeries and healing time.
The success continues
In an early reported a cumulative survival rate of 96.7% for implants and 100% for prostheses at up to 3-year follow up.2 Since then, he and others have repeatedly reproduced high survival rates for both upper and lower jaws. Today, the All-on-4® treatment concept is used around the world with similar high survival rates and patient satisfaction that is enhanced by limited costs.
Dr. Johnson, with his in-office periodontist, has done hundreds of implant cases with outstanding results. To arrange a consultation with Dr. Johnson, contact Newton Wellesley Dental Partners.
A body of research indicates that in order to raise the odds that dental implants will attach properly, there are clear benefits to taking certain common medications and avoiding others.
Bone cell growth, healing and death
"The success of procedures like dental implants depends mainly on how the existing bone accepts the implants to create a connection between the living bone and the surface of the implant," says Dr. Johnson, who has been involved in implant dentistry since 1988. "Because some medications affect bone metabolism and the way that bone cells heal and multiply or die, they can have an important effect on the success of implants."
A McGill research team reviewed data about the integration of dental implants gathered from over 700 patients. They then confirmed the results they saw in human patients through studies in rats.
Implications for hip and knee replacements
"We believe that this research may have implications for orthopedic interventions such as hip and knee replacements, because the same mechanisms of bone cell growth break down, and healing take place in all the bones in the body," says one of the researchers. "Our work with implants in rats suggest that this is indeed the case, but further research will be needed to confirm it."
Drugs that aid integration of implants - Beta blockers
- Conclusions are based on 1499 dental implants in 728 patients between Jan. 2007 -- Sept. 2013 at the East Coast Oral Surgery in Moncton, New Brunswick
- 327 implants were in 142 people who took beta blockers for hypertension
- 1172 implants were in 586 people who didn't take beta blockers
- Failure rates of implants for people using beta blockers was 0.6%
- Failure rates of implants in people who don't take beta blockers was 4.1%
- More than 640 million patients around the world take beta blockers to control hypertension.
"We carried out this study because we knew that beta blockers have been reported to increase bone formation," says Prof. Tamimi from McGill's Faculty of Dentistry. "So we thought it was possible that they would also decrease the risk of failure of dental implants. However we didn't expect that there would be such a clear difference in the failure rates for implants between users and non-users of beta blockers. Randomized clinical trials will need to be carried out as well as other studies of large numbers of patients to investigate this phenomenon in more depth."
Drugs that impede integration of dental implants - Heartburn treatment
- Conclusions are based on 1773 dental implants in 799 patients between Jan. 2007 -- Sept. 2015 at the East Coast Oral Surgery in Moncton, New Brunswick
- 133 implants were in 58 people who took heartburn medication
- 1640 implants were in 741 people who don't take heartburn medication
- Failure rates of implants for people using heartburn medication were 6.8%
- Failure rates of implants for people not taking heartburn medication were 3.2%
- More than 20 million Americans, about one in 14 people, take heartburn medication.
- Heartburn medication is rapidly becoming the third most prescribed pharmaceutical product worldwide, especially for elderly people, who take it either on an occasional or long-term basis.
"Scientists already knew that drugs for heartburn reduce calcium absorption in bones and generally increase the risk of bone fractures," says Dr. Tamimi, of McGill's Faculty of Dentistry. "That is why we wanted to look at how it affects the integration of implants and bone healing after this type of surgery. But we didn't expect to find that the negative effects of these type of drugs would be as great as they are. Further work will need to be done to find the appropriate dosages and time periods that people should take or avoid these medications."
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To learn more about Dental Implants, contact Newton Wellesley Dental Partners.
Original article: www.eurekalert.org