implants - international magazine of oral implantology

I case report Fig. 1_Pre-op view of missing upper right lateral incisor. Fig. 2_Osteotomy. Fig. 3_Engaging the Trabecular Metal portion of the implant allows for early bone in-growth. _Introduction TrabecularMetal(ZimmerDental),aporous(80%) tantalum biomaterial with a trabecular structure for 3-D bone in-growth, has been used for over a decade inorthopaedicsurgery.1 Asaresultofgreatsuccessin orthopaedics, a new tapered, threaded titanium den- tal implant with a Trabecular Metal midsection was developed and tested in animal models, followed by human trials. The current findings suggest that Tra- becular Metal implants with both on-growth and in- growth(duetoactiveboneformationintheTrabecu- larMetalpores)providegoodboneanchorageduring early healing when placed in extraction sockets. The preliminarypilotstudydemonstratedthatimmediate loading of Trabecular Metal implants with non-oc- cluding provisional restorations within 48 hours and definitiveloadingoftheimplantswithfullyoccluding restorationssevento14dayslaterinselectedpatients was safe and effective over the six-month follow-up period.2 Porous tantalum material has the ability to facili- tateosseointegrationandprovideasubstrateforcell adhesion that makes it desirable for use in or- thopaedic surgery.1 In a dog study, Trabecular Metal implantswerecomparedwithstandardtitaniumim- plants (control). Osseointegration of control im- plantswasachievedviaon-growth,whereastheTra- becular Metal implants achieved osseointegration via both on-growth around the threaded sections and in-growth through the pores of the Trabecular Metal shell. The ISQ values for the Trabecular Metal implants illustrated an increasing trend over a 12- week healing period, whereas the ISQ values for the control implants did not demonstrate any such trend—althoughthevaluesweregreaterthan60.The histopathological findings indicated no evidence of acuteinflammationforanyTrabecularMetalorcon- trol implant.2–3 In a proof of principle study, two investigational sites with up to 20 subjects for each site, with up to two implants per subject (total of 36 implants), were examined. Implant sizes were 4.7 and 6 mm in diam- eter and 10, 11.5 and 13 mm in length, with posterior indication only. Healthy, sufficient bone volume and primary stability (>35 Ncm) were the inclusion crite- ria. The prosthetic treatment followed the One Abut- ment—One Time restoration protocol (Zimmer Den- tal), with immediate provisionalisation within 48 hoursandthefinalrestorationatorbeforetwoweeks post-implant placement. The six-month follow-up with a survival rate of 97.2% was comparable to the 97.9%survivalrateofimmediatelyloadedmolarim- plants reported in a systematic review and meta- analysis of seven studies with 188 implants by Atieh et al. (2010). Within the limitation of the preliminary pilotstudy,immediateloadingoftheTrabecularMetal implants with non-occluding provisional restora- tionswithin48hoursanddefinitiveloadingoftheim- plants with fully occluding restorations seven to 14 days later in selected patients was safe and effective over the six-month follow-up period. From orthopaedics to dental implantology Author_Dr Suheil M. Boutros, USA 28 I implants1_2013 Fig. 2 Fig. 3Fig. 1