Does excessive occlusal load affect osseointegration? An experimental study in the dog.

AIM The purpose of this study was to evaluate the effect of excessive occlusal load following placement of titanium implants in the presence of healthy peri-implant mucosal tissues. MATERIALS AND METHODS Mandibular bilateral recipient sites in six Labrador dogs were established by extracting premolars and molars. After 3 months, two TPS (titanium plasma sprayed) implants and two SLA (sandblasted, large grit, acid etched) implants were placed on each side of the mandible in each dog. Three implants were lost in the initial healing phase, leaving 45 implants for evaluation. Following 6 months of healing, gold crowns were placed on implants on the test side of the mandible. The crowns were in supra-occlusal contact with the opposing teeth in order to create excessive occlusal load. Implants on the control side were not loaded. Plaque control was performed throughout the experimental period. Clinical measurements and standardised radiographs were obtained at baseline and 1, 3 and 8 months after loading. At 8 months, the dogs were killed and histologic analyses were performed. RESULTS At 8 months, all implants were osseointegrated. The mean probing depth was 2.5+/-0.3 and 2.6+/-0.3 mm at unloaded and loaded implants, respectively. Radiographically, the mean distance from the implant shoulder to the marginal bone level was 3.6+/-0.4 mm in the control group and 3.7+/-0.2 mm in the test group. Control and test groups were compared using paired non-parametric analyses. There were no statistically significant changes for any of the parameters from baseline to 8 months in the loaded and unloaded implants. Histologic evaluation showed a mean mineralised bone-to-implant contact of 73% in the control implants and 74% in the test implants, with no statistically significant difference between test and control implants. CONCLUSION In the presence of peri-implant mucosal health, a period of 8 months of excessive occlusal load on titanium implants did not result in loss of osseointegration or marginal bone loss when compared with non-loaded implants.

[1]  N. Lang,et al.  Colonization of osseointegrated titanium implants in edentulous patients. Early results. , 1988, Oral microbiology and immunology.

[2]  R. Giardino,et al.  Bone response to orthodontic loading of endosseous implants in the rabbit calvaria: early continuous distalizing forces. , 1999, European Journal of Orthodontics.

[3]  N. Lang,et al.  Antimicrobial treatment of peri-implant infections. , 1992, Clinical oral implants research.

[4]  J. Lindhe,et al.  Soft tissue reaction to de novo plaque formation on implants and teeth. An experimental study in the dog. , 1992, Clinical oral implants research.

[5]  S. Socransky,et al.  The clinical, microbial, and host response characteristics of the failing implant. , 1997, The International journal of oral & maxillofacial implants.

[6]  E. Weibel Practical methods for biological morphometry , 1979 .

[7]  J. Lindhe,et al.  Bone reactions adjacent to titanium implants subjected to static load of different duration. A study in the dog (III). , 2001, Clinical oral implants research.

[8]  K. Stoltze,et al.  Ligature-induced marginal inflammation around osseointegrated implants and ankylosed teeth. , 1993, Clinical oral implants research.

[9]  N. Lang,et al.  Ligature-induced peri-implant infection in cynomolgus monkeys. I. Clinical and radiographic findings. , 1993, Clinical oral implants research.

[10]  G A Niznick,et al.  Bending overload and implant fracture: a retrospective clinical analysis. , 1996, The International journal of oral & maxillofacial implants.

[11]  J. Lindhe,et al.  Osseintegration following treatment of peri-implantitis and replacement of implant components. An experimental study in the dog. , 2001, Journal of clinical periodontology.

[12]  P. Branemark,et al.  Marginal tissue reactions at osseointegrated titanium fixtures (I). A 3-year longitudinal prospective study. , 1986, International journal of oral and maxillofacial surgery.

[13]  N. Lang,et al.  Image processing for the evaluation of dental implants. , 1992, Dento maxillo facial radiology.

[14]  T. W. Roberts,et al.  The subgingival microbial flora associated with human dental implants. , 1984, The Journal of prosthetic dentistry.

[15]  P. Branemark,et al.  Marginal tissue reactions at osseointegrated titanium fixtures. , 1985, Swedish dental journal. Supplement.

[16]  J. Lindhe,et al.  Long-standing plaque and gingivitis at implants and teeth in the dog. , 1992, Clinical oral implants research.

[17]  T. Flemmig,et al.  Controlled local delivery of tetracycline HCl in the treatment of periimplant mucosal hyperplasia and mucositis. A controlled case series. , 1997, Clinical oral implants research.

[18]  G C Michaels,et al.  Effect of prosthetic superstructure accuracy on the osteointegrated implant bone interface. , 1997, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[19]  M. Razzoog,et al.  Microbial colonization of dental implants in partially edentulous subjects. , 1993, The Journal of prosthetic dentistry.

[20]  F Sutter,et al.  The reactions of bone, connective tissue, and epithelium to endosteal implants with titanium-sprayed surfaces. , 1981, Journal of maxillofacial surgery.

[21]  N. Lang,et al.  Experimentally induced peri-implant mucositis. A clinical study in humans. , 1994, Clinical oral implants research.

[22]  D van Steenberghe,et al.  A study of 589 consecutive implants supporting complete fixed prostheses. Part II: Prosthetic aspects. , 1992, The Journal of prosthetic dentistry.

[23]  C. Overall,et al.  Microbiota and crevicular fluid collagenase activity in the osseointegrated dental implant sulcus: a comparison of sites in edentulous and partially edentulous patients. , 1989, Journal of periodontal research.

[24]  A B Carr,et al.  The response of bone in primates around unloaded dental implants supporting prostheses with different levels of fit. , 1996, The Journal of prosthetic dentistry.

[25]  J. Lindhe,et al.  Experimental breakdown of peri-implant and periodontal tissues. A study in the beagle dog. , 1992, Clinical oral implants research.

[26]  H Vaillancourt,et al.  Factors affecting crestal bone loss with dental implants partially covered with a porous coating: a finite element analysis. , 1996, The International journal of oral & maxillofacial implants.

[27]  U. Häfeli,et al.  Evaluation of postsurgical crestal bone levels adjacent to non-submerged dental implants. , 1998, Clinical oral implants research.

[28]  M. Quirynen,et al.  Microbial differences in 2 clinically distinct types of failures of osseointegrated implants , 1991 .

[29]  K. Gröndahl,et al.  Resolution of peri-implantitis following treatment. An experimental study in the dog. , 1999, Clinical oral implants research.

[30]  N. Lang,et al.  The microbiota associated with successful or failing osseointegrated titanium implants. , 1987, Oral microbiology and immunology.

[31]  T. Miyata,et al.  The influence of controlled occlusal overload on peri-implant tissue: a histologic study in monkeys. , 1998, The International journal of oral & maxillofacial implants.

[32]  S. Hansson,et al.  The implant neck: smooth or provided with retention elements. A biomechanical approach. , 1999, Clinical oral implants research.

[33]  M. Quirynen,et al.  Histo-pathologic characteristics of peri-implant soft tissues in Brånemark implants with 2 distinct clinical and radiological patterns. , 1991, Clinical oral implants research.

[34]  P. Henry,et al.  Clinical and microscopic findings in edentulous patients 3 years after incorporation of osseointegrated implant-supported bridgework. , 1989, Journal of clinical periodontology.

[35]  R. Mericske-Stern,et al.  Microbiological features of stable osseointegrated implants used as abutments for overdentures. , 1990, Clinical Oral Implants Research.

[36]  T Vuillemin,et al.  Titanium implants and lateral forces. An experimental study with sheep. , 1997, Clinical oral implants research.

[37]  J. Lindhe,et al.  The effect of antimicrobial theram on peri‐implantitis lesions. An experimental study in the dog. , 1996 .

[38]  J. Lindhe,et al.  Bone reactions adjacent to titanium implants subjected to static load. A study in the dog (I). , 2001, Clinical oral implants research.

[39]  N. Lang,et al.  The effect of subcrestal placement of the polished surface of ITI implants on marginal soft and hard tissues. , 1996, Clinical oral implants research.

[40]  T. Miyata,et al.  The influence of controlled occlusal overload on peri-implant tissue. Part 3: A histologic study in monkeys. , 2000, The International journal of oral & maxillofacial implants.

[41]  F. Isidor,et al.  Loss of osseointegration caused by occlusal load of oral implants. A clinical and radiographic study in monkeys. , 1996, Clinical oral implants research.

[42]  B Melsen,et al.  Biological reactions of alveolar bone to orthodontic loading of oral implants. , 2001, Clinical oral implants research.

[43]  S. Nyman,et al.  Clinical and microbiologic findings that may contribute to dental implant failure. , 1990, The International journal of oral & maxillofacial implants.

[44]  R K Gongloff,et al.  Rigid endosseous implants for orthodontic and orthopedic anchorage. , 1989, The Angle orthodontist.

[45]  J. Fiorellini,et al.  Radiographic evaluation of crestal bone levels adjacent to nonsubmerged titanium implants. , 1992, Clinical oral implants research.

[46]  T. Waris,et al.  Cold injury of the rat skin. A fluorescence histochemical study of adrenergic nerves, mast cells and patency of cutaneous blood vessels. , 1982, Scandinavian journal of plastic and reconstructive surgery.

[47]  R M Pilliar,et al.  Dental implant design--effect on bone remodeling. , 1991, Journal of biomedical materials research.

[48]  M. Quirynen,et al.  Distribution of bacterial morphotypes around natural teeth and titanium implants ad modum Brånemark. , 1990, Clinical oral implants research.

[49]  Niklaus P. Lang,et al.  Periodontal tissues and their counterparts around endosseous implants [corrected and republished with original paging, article orginally printed in Clin Oral Implants Res 1991 Jan-Mar;2(1):1-19]. , 1991 .

[50]  N. Lang,et al.  Attempts to obtain re-osseointegration following experimental peri-implantitis in dogs. , 1999, Clinical oral implants research.

[51]  G. Zafiropoulos,et al.  Clinical and microbiological status of osseointegrated implants , 1995 .

[52]  J. Slots,et al.  Microbial aspects of failing osseointegrated dental implants in humans. , 1991, Journal de parodontologie.

[53]  D Buser,et al.  Osseointegration: a reality. , 1998, Periodontology 2000.

[54]  G E Carlsson,et al.  Bone resorption around fixtures in edentulous patients treated with mandibular fixed tissue-integrated prostheses. , 1988, The Journal of prosthetic dentistry.

[55]  Y Zilberman,et al.  Osseous adaptation to continuous loading of rigid endosseous implants. , 1984, American journal of orthodontics.

[56]  M Augthun,et al.  Microbial findings of deep peri-implant bone defects. , 1997, The International journal of oral & maxillofacial implants.

[57]  N. Lang,et al.  Treatment of peri-implantitis by local delivery of tetracycline. Clinical, microbiological and radiological results. , 2001, Clinical oral implants research.

[58]  M. Karnovsky,et al.  A formaldehyde-glutaraldehyde fixative of high osmolality for use in electron-microscopy , 1965 .

[59]  U. Lekholm,et al.  A longitudinal microbiological study on osseointegrated titanium implants in partially edentulous patients. , 1993, Clinical oral implants research.

[60]  P. Branemark,et al.  Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period. , 1977, Scandinavian journal of plastic and reconstructive surgery. Supplementum.

[61]  T. Rams,et al.  Microbiology of failing dental implants in humans: electron microscopic observations. , 1983, The Journal of oral implantology.

[62]  T. Flemmig,et al.  Some clinical and radiographical features of submerged and non‐submerged titanium implants. A 5‐year follow‐up study. , 1997 .

[63]  Kitetsu Shin,et al.  The influence of controlled occlusal overload on peri-implant tissue. part 4: a histologic study in monkeys. , 1998, The International journal of oral & maxillofacial implants.

[64]  F. Isidor,et al.  Histological evaluation of peri-implant bone at implants subjected to occlusal overload or plaque accumulation. , 1997, Clinical oral implants research.

[65]  H. Wehrbein,et al.  Orthodontic anchorage capacity of short titanium screw implants in the maxilla. An experimental study in the dog. , 1997, Clinical oral implants research.

[66]  H. Wehrbein,et al.  Endosseous titanium implants during and after orthodontic load--an experimental study in the dog. , 1993, Clinical oral implants research.

[67]  T. Flemmig,et al.  Characterization of the subgingival microbial flora around endosteal sapphire dental implants in partially edentulous patients. , 1990, The International Journal of Oral and Maxillofacial Implants.

[68]  H. Frost,et al.  Wolff's Law and bone's structural adaptations to mechanical usage: an overview for clinicians. , 2009, The Angle orthodontist.

[69]  K Gotfredsen,et al.  Bone reactions at implants subjected to experimental peri-implantitis and static load. A study in the dog. , 2002, Journal of clinical periodontology.

[70]  L. Barbier,et al.  Adaptive bone remodeling around oral implants under axial and nonaxial loading conditions in the dog mandible. , 1997, The International journal of oral & maxillofacial implants.

[71]  R. Kohal,et al.  Changes in peri-implant tissues subjected to orthodontic forces and ligature breakdown in monkeys. , 1998, Journal of periodontology.

[72]  N. Lang,et al.  Bleeding on probing. A predictor for the progression of periodontal disease? , 1986, Journal of clinical periodontology.

[73]  Nilgün Akin-Nergiza,et al.  Reactions of peri-implant tissues to continuous loading of osseointegrated implants. , 1998 .

[74]  M. Ogiso,et al.  A histologic comparison of the functional loading capacity of an occluded dense apatite implant and the natural dentition. , 1994, The Journal of prosthetic dentistry.

[75]  K. Berhane,et al.  Predictable crestal bone remodelling around two porous-coated titanium alloy dental implant designs. A radiographic study in dogs. , 1994, Clinical oral implants research.

[76]  N. Lang,et al.  Periodontal tissues and their counterparts around endosseous implants [corrected and republished with original paging, article orginally printed in Clin Oral Implants Res 1991 Jan-Mar;2(1):1-19]. , 1991, Clinical oral implants research.

[77]  J. Lindhe,et al.  The effect of antimicrobial therapy on periimplantitis lesions. An experimental study in the dog. , 1996, Clinical oral implants research.

[78]  J. Lindhe,et al.  Bone reactions adjacent to titanium implants with different surface characteristics subjected to static load. A study in the dog (II). , 2001, Clinical oral implants research.

[79]  N. Lang,et al.  The microbiota of osseointegrated implants in patients with a history of periodontal disease. , 2005, Journal of clinical periodontology.

[80]  P. Branemark,et al.  Marginal tissue reactions at osseointegrated titanium fixtures. (II) A cross-sectional retrospective study. , 1986, International journal of oral and maxillofacial surgery.

[81]  Lin Cc,et al.  Microbiology of failing dental implants in humans: electron microscopic observations. , 1983 .

[82]  D van Steenberghe,et al.  Fixture design and overload influence marginal bone loss and fixture success in the Brånemark system. , 1992, Clinical oral implants research.