Dental Tribune United Kingdom Edition

May 23-29, 201116 Implant Tribune United Kingdom Edition page 15DTß The application of this theory (Fig. 2) to dental implant reha- bilitation explains bone resorp- tion at the crestal level of loaded implants, a condition that may occur because of the stress shielding effect, due to both the solid metal structure of the im- plant and the implant design. These features can play a role on load transfer to the bone, re- ducing strain magnitude under the lower physiologic thresh- old and, thus, promoting osteo= clast resorption at the crestal level. The rigid metal structure of the implant acquires most of the oc- clusal stresses, transferring them deeper into the basal bone, ex- cluding the crestal bone from the physiologic stimulation. Implants with a slim design at the crestal level, for example, dem- onstrate a wide bone formation, corroborating Frost’s theory. Effect of implant geometry Implant design consists of the combination of the implant body three-dimensional geometry, presence of threads, thread design, surface topography and surface treatments that may affect strain stimulation of peri-implant bone.20 Finiteelementanalysisreported thattaperedimplantspresentabet- ter mechanical performance than cylindrical implants to avoid punching stresses.21, 22 It has been demonstrated that threads and their location on the implant body have a role in the load transferring pressure patterns to the bone.23 The outcome of comparative clinical research on different im- plant systems have reported anal- ogous marginal bone loss per year (1–3), even if smooth surfaced im- plants with a conical collar have demonstrated higher bone loss than self-tapping and standard implants.29, 30 In this respect, marginal bone loss might be primarily related to the smoothness of the implant surface, leading to stress protec- tion, and thus, to bone resorption (bone shielding).31 Effect of the implant surface on the peri-implant bone Surface microgeography plays a primary role in facilitating bio- logical interactions between bone precursor cells and implant. Rough implant surfaces facilitate high osteoblast adhesion levels24 , and since osteoblasts are spread on implant surfaces, the rough- ness seems to induce osteoblasts toward synthesis and the release of biological factors affecting the tissue response at the interface. Surface roughness is a crucial fac- tor affecting bone apposition at the interface and improving the inter- face resistance because of better mechanical interlocking. However, increased bone mass around rough surfaces may also be attributed to a lower bone remodelling level during the early stages of implantation, as reported in a comparative research study between plasma sprayed and smooth surfaced implants.25, 26 A poor implant design like smooth machined coronal part could be related to a reduction in mechanical interlocking between implant and crestal bone, acting like a stress shield and inducing crestal bone loss.27, 28 The stability of the peri-im- plant cervical bone around the neck of the implant and the ab- sence of resorption are the key to maintaining gingival papillae and bone in the anterior region. According to reference litera- ture, several changes should oc- cur after abutment connection. Bone resorption of approximately © MIS Corporation. All Rights Reserved. The MIS SEVEN implant has a highly advanced surface with a high rate of successful osseointegration (98%), which was validated by extensiveworldwideresearchandclinicalstudies in cooperation with world-class universities and scientificresearchinstitutes.Itsuniquegeometrical design gives the SEVEN implant the important features of simple, quick and safe insertion, high primary stability, and compatibility in the most complex cases in every area of the jaw. Simplicity is The Key to Success Innovation Movement by MIS... INNOVATION The MIS SEVEN implant is the only implant system in the world that comes with a specially designed and sterilized final drill, allowing a short and safe drilling procedure. MIS makes it simple with SEVEN implant. The only implant in the world that comes with a specially designed and sterilized, single use, final drill, allowing a short and safe drilling procedure. To learn more about MIS visit our website: www.mis-implants.com or call us: 01255 424624 M a k e i t S i m p l e UK ® ®