Tomas Albrektsson

Reasons for Marginal Bone Loss around Oral Implants

BACKGROUNDnThe reasons for long-term marginal bone loss around oral implants are not well understood.nnnPURPOSEnThe aim of this paper is to analyze presented evidence behind anticipated reasons for long-term marginal bone loss around oral implants.nnnMATERIALS AND METHODSnA computerized research was conducted on PubMed in April 2011 with the following keywords: oral implants and marginal bone resorption/crestal bone loss/bone loss/bone resorption. This search resulted in a total of one thousand one hundred ninety-four papers of which seven hundred fifty-three were clinical contributions. Further search and filtering finally resulted in 21 experimental studies and one hundred sixteen clinical studies, which were reviewed.nnnRESULTSnNo evidence was found that primary infection caused marginal bone resorption. Clinical papers that have reported high levels of peri-implantitis were not supported by data given. Clinical evidence was presented that the so-called combined factors (implant hardware, clinical handling, and patient characteristics) may lead to marginal bone resorption. However, once tissue damage has been caused by combined factors, inflammation and/or infection may develop secondarily and then result in peri-implantitis that may need particular clinical treatment.nnnCONCLUSIONSnAs marginal bone loss primarily depends on numerous background factors, it seems logical that, for example, the use of poorly constructed implants placed and handled by untrained clinicians may result in high numbers of patients with secondary problems in form of peri-implantitis; having said this, control of combined factors may likewise lead to very good clinical results where peri-implantitis would represent a very rare disease indeed even at follow-up times of 10 years or more.

Implant survival and complications. The Third EAO consensus conference 2012

OBJECTIVESnThe task of this working group was to analyze biological, technical and aesthetic complications of single crowns on implants and fixed dental prostheses with or without cantilevers on implants over 5 years or more. In addition, the group analyzed economic aspects on such implant treatment.nnnMATERIALS AND METHODSnA systematic search of the relevant literature was conducted and critically reviewed. Four manuscripts were presented to cover the topics.nnnRESULTSnThe consensus statements prepared by the group and later accepted at the plenary session as well as suggestions for future research are presented in this article. The four reviews by Jung et al., Pjetursson et al., Romeo & Storelli and Scheuber et al. are printed separately and present detailed analyses of the research topics.

Experimental and Clinical Knowledge of Surface Micro-topography

Implant surface micro-topography has been of great interest for many years. Scientific evidence indicates that the micro-roughness of the implant is one of the regulatory factors for osseointegration, and roughness within a certain range has been proven to present the strongest bone responses. The so-called moderately rough micro-topography has been applied to most of the commercially available implants of today and has shown high clinical success rates, especially in compromised bone quality sites. This chapter will focus on the importance of micro-topography on implant osseointegration by exploring the experimental and clinical evidence available. Furthermore, the recent topics regarding micro-topography in relation to marginal bone maintenance will be briefly discussed.

Overview of Surface Evaluation Techniques

Surface characterisation is necessary if we want to understand biological processes influenced by surface properties and eventually their clinical importance. In addition, we need surface characterisation if researchers want to distinguish between the components forming the implant surface, i.e. topography, chemistry, physics and mechanics. The techniques should provide objective data to decrease the possibility for subjective interpretation and biases. This chapter is a brief overview of commonly used evaluation techniques of the four different surface properties with the emphasis on topographical evaluations.