Early functional loading of unsplinted roughened surface implants with mandibular overdentures 2 weeks after surgery. Rehabilitation of oral function in head and neck cancer patients after radiotherapy with implant-retained dentures: effects of hyperbaric oxygen therapy. A randomized controlled clinical trial of conventional and immediately loaded tapered implants with screw-retained crowns. Clinical and radiographic evaluation of implant-retained mandibular overdentures with immediate loading. Implant-retained mandibular overdentures with ITI implants. One-stage operative procedure using two different implant systems: a prospective study on implant overdentures in the edentulous mandible. Autogenous onlay bone grafts vs. alveolar distraction osteogenesis for the correction of vertically deficient edentulous ridges: a 2-4-year prospective study on humans. Standards of reporting of randomized controlled trials in general surgery: can we do better? Immediate loading of dental implants supporting fixed partial dentures in the posterior mandible: a randomized controlled split-mouth study--machined versus titanium oxide implant surface.
Before early functional loading of unsplinted implants with mandibular overdentures can become widespread, more clinical studies are needed to investigate the success of the approach.
                To evaluate the success rates of two types of roughened titanium surface implants with early 2-week functional loading of paired mandibular interforaminal implants with overdentures.
                Random allocation divided 24 strictly selected edentulous participants into two groups, with each group to receive a different implant system (ITI Dental Implant System, Straumann AG, Waldenburg, Switzerland; or Southern Implant System, Southern Implants, Irene, South Africa). Two implants were placed in the anterior mandible of all participants using one-stage standardized surgical procedures. Previously constructed conventional mandibular dentures (opposing maxillary complete dentures) were temporarily relined and worn by the participants for the first 2 weeks; participants used a soft diet. Two weeks after implant surgery and following some mucosal healing, the mandibular dentures had the tissue conditioner removed and the appropriate matrices included for an unsplinted prosthodontic design.
                No implant from either group was lost. Resonance frequency analysis (RFA) indicated higher primary stability at surgery for the Southern group than for the ITI group, with a statistically significant difference between the groups throughout the study period. The drop in RF values between surgery and 6 weeks was significant and was greater for the Southern group. RFA also indicated stabilized osseointegration between 6 to 12 and 12 to 52 weeks, with no participant showing any decrease in those values over time. Participants with type 3 bone showed a significant improvement in RF values between 12 and 52 weeks, eventually matching those of participants with type 2 bone. There were no significant differences in marginal bone loss, periimplant parameters, or prosthodontic maintenance between the groups over the study period.
                Using only strict patient selection criteria, 1-year follow-up data indicate that early functional loading of ITI and Southern implants with mandibular two-implant overdentures is possible as early as 2 weeks after implant surgery. Surgical treatment of malignancies in the oral cavity and subsequent radiotherapy often result in an anatomic and physiological oral condition unfavorable for prosthodontic rehabilitation. The objective of this prospective study was to assess the effect of hyperbaric oxygen therapy on treatment outcome (condition of peri-implant tissues, implant survival, oral functioning and quality of life) of prosthodontic rehabilitation with implant-retained lower dentures in radiated head and neck cancer patients 6 weeks and 1 year after placing the new dentures. The treatment outcome was assessed in a group of 26 head neck cancer patients who were subjected to radiotherapy after tumour surgery. Standardized questionnaires were completed and clinical and radiographic assessments were performed. After randomization, endosseous Brånemark implants were placed in the anterior part of the mandible either under antibiotic prophylaxis (13 patients) or under antibiotic prophylaxis combined with pre and postsurgery hyperbaric oxygen (HBO) treatment (13 patients). In the HBO and non-HBO group eight implants (implant survival 85.2%) and three implants (implant survival 93.9%) were lost, respectively. Peri-implant tissues had a healthy appearance in both groups. Osteoradionecrosis developed in one patient in the HBO group. All patients functioned well with their implant-retained lower denture. The quality of life related to oral functioning and denture satisfaction were improved to a comparable extent in the HBO and non-HBO group. Implant-retained lower dentures can improve the quality of life related to oral functioning and denture satisfaction in head and neck cancer patients. Adjuvant hyperbaric oxygen therapy could not be shown to enhance implant survival in radiated mandibular jaw bone. Surgical, prosthodontic, and esthetic outcomes of conventional and immediately loaded, single, tapered, roughened-surface Southern implants in the anterior maxilla that were restored with screw-retained crowns were compared over 1 year.
                Standardized surgical and prosthodontic procedures were followed and accepted criteria were used for assessment.
                There were no significant differences within or between the control and test groups for age, gender, bone quality or quantity, implant stability measurements at surgery, or implant length.
                After 1 year, the implants that had been immediately loaded with single provisional crowns at surgery and definitive crowns 8 weeks later were as successful as conventionally loaded 2-stage implants. The aim of this study was to evaluate and compare immediate-loaded implant-retained mandibular overdentures and delayed-loaded implant-retained mandibular overdentures.
                Ten completely edentulous male patients received 40 dental implants. Patients were randomly divided into 2 equal groups, 5 patients each. Patients of both groups received conventional maxillary complete denture and had stage 1 surgery for placing 4 dental implant fixtures, 2 on each side anterior to the mental foramina. Group A: One-stage surgical procedure and immediate loading. Patients in this group received mandibular bar-retained overdenture supported by 4 endosseous implants loaded immediately after implant placement. Group B: The original 2-stage concept and delayed loading. Patients in this group received mandibular bar-retained overdenture supported by 4 endosseous implants that remained submerged for a period of 4 months before loading. The patients were evaluated clinically and radiographically immediately after overdenture delivery and after 6 months, 12 months, 18 months, and 24 months.
                The results of clinical evaluation showed no statistical significant difference between the 2 groups regarding the effect of treatment. The radiographic assessment showed no statistical significant difference in mesial and distal alveolar bone loss at the different intervals of the follow-up period, except at the 12-month period, where immediately loaded implants showed a decrease in the amount of alveolar bone loss mesially and distally compared to delayed loaded implants.
                The results suggest that immediate-loaded implants provide promising results compared to delayed-loaded implants and can be a possible alternative procedure in implant dentistry. This prospective study has been designed to compare the results of immediate and delayed loading of implant-retained mandibular overdentures after a 2-year follow-up. Twenty patients have been randomly divided into two groups. Group 1 patients (test group) received four ITI implants in the intraforaminal area of the mandible. Octa abutments were immediately screwed on implants; 2 days after surgery, the implants were rigidly connected with a U-shaped Dolder gold bar and loaded with an overdenture. Group 2 patients (control group) received, in the same area, the same type and number of implants, which were left to heal according to the standard protocol. At 3-4 months, Octa abutments were screwed on the implants and the same prosthetic procedure of the test group was applied. The minimum follow-up period lasted 2 years, with recall appointments at 2 weeks, 1, 3, 6 months, 1 year and every following year postoperatively, evaluating: MPI, MBI, PD, Periotest and radiographic peri-implant bone resorption. Success criteria according to Albrektsson et al. were used. Only one implant out of the 40 of group 2 failed, whereas none failed in group 1. No statistical difference of the clinical parameters evaluated was noticed in the two groups. Therefore, immediate loading of implants, if connected with a U-shaped bar, can provide the same results of the 'traditional' technique as far as osseointegration and short-term survival rates of implants are concerned. Moreover, this method significantly shortens the treatment period, thus increasing patient satisfaction. Evidence-based reports are needed to support the application of a one-stage surgical protocol for unsplinted implants supporting mandibular overdentures.
                To examine the feasibility and success of using two different dental implant systems (originally designed for two-stage operative technique) using a one-stage operative procedure in patients being rehabilitated with implant mandibular overdentures.
                The study sample involved 24 edentulous subjects (aged 55-80 yr) randomly allocated to two different implant systems, one with a machined titanium implant surface (Steri-Oss, Nobel Biocare, Göteborg, Sweden) and the other with a roughened titanium surface (Southern Implants, Ltd., Irene, South Africa). Two unsplinted implants to support implant overdentures were placed in the anterior mandible of all patients, using a standardized one-stage surgical and prosthodontic procedure. Primary stability and bicortical anchorage of the implants was mandatory before healing abutments were connected at the time of implant placement. Implant overdentures and their respective matrices were inserted following a standard 12-week healing period. Data relating to mobility tests, radiographs, and peri-implant parameters were documented at 12, 16, and 52 weeks after surgery.
                A success rate of 95.8% for the Steri-Oss and 100% for the Southern Implants was found, without any statistically significant differences in the marginal bone loss. Significant changes in Periotest values were observed for both types between 12 and 52 weeks (p < .001). Minor changes were observed in the peri-implant parameters evaluated.
                These preliminary findings show a successful application of this one-stage approach for unsplinted implants supporting mandibular overdentures with Steri-Oss and Southern Implant Systems. The purposes of this study were to compare: (a) autogenous bone grafts (ABG) and distraction osteogenesis (DO) for their ability in correcting vertically deficient mandibular ridges and their capability in maintaining over time the vertical bone gain obtained before and after implant placement; and (b) the survival and success rates of implants placed in the reconstructed or distracted areas.
                In a 2-year period (2001-2002), 17 patients presenting with vertically atrophied partially edentulous mandibles requiring implant-supported prosthetic rehabilitation, were included in this study. Patients were randomly assigned to two groups. Eight patients (group 1) were treated with ABG harvested from the mandibular ramus, while nine patients (group 2) were treated by means of DO. In group 1, patients received implants 4-5 months after the reconstructive procedure, while in group 2 implants were placed at the time of distraction device removal (approximately 3 months after the completion of distraction). A total of 19 endosseous implants were placed in group 1, and 21 implants were placed in group 2 patients. For both groups, after an additional 3-5-month period, prosthetic rehabilitation was started.
                Bone resorption before implant placement was significantly higher in group 1 (P=0.01), while no statistically significant differences were found between the two groups as far as survival and success rates of implants and peri-implant bone resorption after the start of prosthetic loading were concerned.
                The results suggested that: (a) both techniques may effectively improve the deficit of vertically resorbed edentulous ridges; (b) survival and success rates of implants placed in the reconstructed/distracted areas are consistent with those of implants placed in native bone. To evaluate the quality of reporting of surgical randomized controlled trials published in surgical and general medical journals using Jadad score, allocation concealment, and adherence to CONSORT guidelines and to identify factors associated with good quality.
                Randomized controlled trials (RCTs) provide the best evidence about the relative effectiveness of different interventions. Improper methodology and reporting of RCTs can lead to erroneous conclusions about treatment effects, which may mislead decision-making in health care at all levels.
                Information was obtained on RCTs published in 6 general surgical and 4 general medical journals in the year 2003. The quality of reporting of RCTs was assessed under masked conditions using allocation concealment, Jadad score, and a CONSORT checklist devised for the purpose.
                Of the 69 RCTs analyzed, only 37.7% had a Jadad score of > or =3, and only 13% of the trials clearly explained allocation concealment. The modified CONSORT score of surgical trials reported in medical journals was significantly higher than those reported in surgical journals (Mann-Whitney U test, P < 0.001). Overall, the modified CONSORT score was higher in studies with higher author numbers (P = 0.03), multicenter studies (P = 0.002), and studies with a declared funding source (P = 0.022).
                The overall quality of reporting of surgical RCTs was suboptimal. There is a need for improving awareness of the CONSORT statement among authors, reviewers, and editors of surgical journals and better quality control measures for trial reporting and methodology. A split-mouth study was conducted to compare dental implants with either machined or titanium oxide (TiO) surfaces immediately loaded with fixed partial dentures in the posterior mandible.
                Ten patients with bilateral partial edentulism in the posterior mandible received 42 implants; 20 on the test (TiO) and 22 on the control (machined) side. The implants were loaded within 24 hours postsurgery. At implant placement the maximum insertion torque (IT) was recorded. Implant stability quotient (ISQ) was also evaluated at baseline (day 0) and 1, 2, 4, 12, 24, and 52 weeks following implant placement. The radiographic bone level (RBL) change was measured on periapical radiographs at baseline and 12 months after loading. Means for the 2 groups were compared by paired t test.
                The overall implant success rate was 95%. No implants were lost in the test group; 2 failed in the control group. The difference between the groups in RBL change after 1 year of function was not statistically significant (P = .224). However, average RBL change for machined implants in distal positions was significantly higher than for TiO surface implants in the same position (post-hoc comparison; P = .048). ISQ and peak IT values did not differ between the groups (P = .414 and P = .762, respectively). The high IT necessary to insert the implants did not seem to affect the RBL change (P = .203).
                No significant difference was observed between machined and TiO implant surface in terms of RBL change or ISQ, although TiO implants may provide a lower RBL change compared to machined implants when utilized in the distal position. Immediate loading of implants using fixed partial dentures in posterior mandible may be considered as a treatment option if implants are inserted with IT > or = 20 Ncm and ISQ > or = 60 into nonaugmented bone and loaded with light centric occlusal contact.
There is weak evidence from the results of one randomised controlled trial including 60 subjects that patients are generally less satisfied with preprosthetic surgery and a conventional denture than with an implant retained denture. There is a need for more well designed trials comparing the success and cost-effectiveness of preprosthetic surgery and implant supported dentures. Such trials should be reported according to the CONSORT guidelines (www.consort-statement.org/). However, since preprosthetic surgery is considered to be an obsolete treatment nowadays, almost completely replaced by dental implants, it may be that new RCTs on this topic will not be designed.