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"Internal connection implants have been attracting attention in recent years leading to their being adopted for many implant systems and an increase in market share over other connections. However, internal connection implants have only been used clinically for a short period of time resulting in few clinical studies investigating outcomes and a lack of comparative clinical evidence to support their use over external hex systems at this time. Given the fact that clinical evidence is lacking regarding implant connection performance comparisons, it is important to understand what information clinicians use to choose between systems. The purpose of this study regarding implant decision-making was to ask clinicians to provide subjective evaluations of internal connection implants, in comparison with external connection implants. The survey was constructed to cover four aspects of interest; general responder information, surgical procedures and experience, prosthodontic treatments and outcomes, and implant complications. The dentists’ responses indicated that internal connection implants are as user-friendly as external hex implants with respect to implant surgery, but they are favored for prosthodontic handling because impression coping and abutment placement are felt to be easier. In addition, it was revealed that dentists strongly feel that there is a lack of biological and prosthodontic evidence to support the use of internal connection implants. The findings reveal the responding clinicians recognize that they often make decisions without compelling evidence to favor one system over another. Decisions are often based on perceived ease of use or third party (colleague or manufacturer) input. For future investigations, we will seek to better understand the relative influence and validity of all forms of information used (especially third party input), as well as what barriers exist to clinicians’ use of more evidence based data."

"Latar belakang. Kehilangan gigi menjadi kasus yang umum dijumpai oleh seorang dokter gigi dan dapat diatasi dengan menggunakan berbagai macam gigi tiruan. Salah satu yang sedang marak dan banyak diminati adalah gigi tiruan dengan dukungan implan. Lebih dari 220 sistem implan telah tersedia di pasaran, diproduksi oleh sekitar 80 produsen, dibuat dari material, panjang, dan diameter yang berbeda dengan modifikasi topografi permukaan dan bentuk pada setiap sistem nya, dapat dipakai oleh dokter gigi spesialis maupun dokter gigi umum. Pertimbangan dan pemilihan sistem implan gigi yang tepat umumnya menjadi kunci keberhasilan perawatan implan. Hal tersebut mengakibatkan sering timbul dilema pada dokter- dokter gigi di Indonesia tentang pemilihan sistem dan kepuasan mereka terhadap suatu sistem implan yang dipakai. Tujuan. Mengetahui sistem implan yang paling diminati dan faktor- faktor apa saja yang menjadi pertimbangan dalam pemilihan sistem implan gigi oleh dokter gigi di Indonesia. Metode penelitian. Penelitian ini merupakan penelitian potong lintang secara observasional atau survei dengan menggunakan kuesioner yang diberikan kepada dokter gigi di Indonesia yang telah memenuhi kriteri inklusi, pengambilan data responden dengan teknik snowball sampling, serta diolah secara deskriptif. Hasil penelitian. Sebanyak 100 subjek responden yang memenuhi kriteria inklusi telah mengikuti dan mengisi kuesioner dari penelitian ini. Sekitar satu per tiga dari responden penelitian merupakan dokter gigi spesialis prostondonsia sebesar 32% yang mendominasi penelitian ini. Hasil olah data menunjukkan tiga urutan teratas pada sistem implan gigi yang paling diminati oleh dokter gigi di Indonesia adalah implan Straumann (50%), implan Dentium (20%), dan implan Osstem (13%). Bukti hasil penelitian ilmiah (460) menjadi faktor yang paling berpengaruh dalam pemilihan suatu sistem implan gigi diikuti dengan ketersediaan produk (421) dan sistem permukaan pada suatu sistem implan gigi (416). Permukaan implan gigi yang paling mendominasi pilihan dari responden adalah permukaan implan dengan sistem SLA (sandblasted large gritted acid etched) (82%) Kesimpulan. Mayoritas responden penelitian memilih Straumann sebagai sistem implan gigi pilihanya dengan mempertimbangkan faktor hasil penelitian ilmiah.

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Introduction. Tooth loss is a common cases that can be resolved by dentists using various kinds of dentures. Implant supported denture is currently on the rise and most in demand by dentists. More than 220 implant system made of different materials, lengths and diameters with modified surface topography and shapes in each system are produced by around 80 manufactures, can be used by specialist dentists as well as general dentists. Consideration and choosing the right dental implant system is generally the key to successful implant treatment. This has resulted in frequent dilemmas of dentists in Indonesia regarding system selection and their satisfaction with a system of implants used. Objectives. Knowing the most implant systems are used in demand and any consideration factors in choosing a dental implant system by dentists in Indonesia. Methods. This is an observational cross-section study or a survey using questionnaire given to dentists in Indonesia who have met the inclusion criteria. Snowball sampling technique and descriptive analysis of the frequency were used in this study. Results. A total of 100 respondent subjects who have met the inclusion criteria had followed and filled out the questionnaire from this study. Approximately one third of the study (32%) respondents were prosthodontist. The analysis shows that the top three dental implant systems most preferred by dentists in Indonesia are Straumann implants (50%), Dentium implants (20%), and Osstem implants (13%). Scientific based evidence (460) is the most significant factor in choosing a dental implant system followed by product availability (421) and the surface system of a dental implant system (416). The surface of the dental implant that dominates the choice of respondents is SLA (sandblasted large gritted acid etched) system (82%).

Conclusion. The majority of respondents choosed Straumann implant as their dental implant system by considering the factor of scientific based evidence."

"Angiogenesis plays a key role in bone formation and maintenance. Bone formation has been reported to initiate in the concavities rather than the convexities in a hydroxyapatite substratum and the implant threads of dental implants. The aim of the present study was to evaluate the number of the blood vessels inside the concavities and around the convexities of the threads of implants in a rabbit tibia model. A total of 32 thread-shaped implants blasted with apatitic calcium phosphate (TCP/HA blend) (Resorbable Blast Texturing, RBT) (Maestro, BioHorizons®, Birmingham, AL, USA) were inserted in 8 rabbits. Each rabbit received 4 implants, 2 in the right and 2 in left tibia. Implants were retrieved after 1, 2, 4, and 8 weeks and treated to obtain thin ground sections. Statistically significant differences were found in the number of vessels that had formed in in the concavities rather than the convexities of the implants after 1 (p = 0.000), and 2 weeks (p = 0.000), whilst no significant differences after 4 (p = 0.546) and 8 weeks (p = 0.275) were detected. The present results supported the hypothesis that blood vessel formation was stimulated by the presence of the concavities, which may provide a suitable environment in which mechanical forces, concentrations and gradients of chemotactic molecules and blood clot retention may all drive vascular and bone cell migration."

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Latar Belakang: Implan gigi sebagai alternatif perawatan kehilangan gigi dapat mengalami kegagalan akibat distribusi stress yang berlebihan. Desain implan berupa implant thread depth menjadi bagian penting dari struktur implan yang dapat mempengaruhi distribusi stress. Adapun arah pembebanan dan tulang dengan densitas rendah merupakan faktor lain yang dapat mempengaruhi distribusi stress. Tujuan: Untuk mengetahui gambaran distribusi stress pada single implant dengan variasi ukuran thread depth dan arah pembebanan di tulang densitas rendah. Metode: Penelitian ini adalah penelitian observasional deskriptif. Model 3D regio posterior tulang maksila  dan tiga implan dengan komponen implan berupa panjang 10 mm, diameter 4,1 mm, thread pitch 0,8 mm, thread shape berupa V-thread dan kedalaman thread depth yang terbagi menjadi 0,25 mm; 0,35mm; dan 0,45mm dibuat dengan modeling software dan disusun menjadi solid model. Dilakukan simulasi pemberian beban preload 200 N arah axial pada screw dan dilanjutkan dengan pemberian beban mastikasi sebesar 100 N arah axial dan oblique pada molar pertama. Dilakukan analisis dengan metode finite element untuk mengetahui distribusi stress berupa von Mises stress pada komponen implan dan tulang. Hasil : Nilai von Mises stress maksimum tertinggi pada pembebanan axial (abutment = 222,63 MPa, implant body = 179,68 MPa, dan screw = 154,97 MPa), pada pembebanan oblique (abutment = 1086,9 MPa, implant body = 852,46 MPa, dan screw = 628,56 MPa). Pada tulang alveolar, nilai von Mises stress maksimum dengan pembebanan axial pada masing-masing thread depth (0,25 mm = 29,421 MPa; 0,35 mm = 30,201 MPa; 0,45 mm = 31,091 MPa), dan dengan pembebanan oblique pada masing-masing thread depth (0,25 mm = 74,103 MPa; 0,35 mm = 75,102 MPa; 0,45 mm = 76,557 MPa). Kesimpulan : Hasil metode finite element menunjukkan bahwa pada pembebanan axial, abutment mengalami peningkatan stress seiring peningkatan thread depth. Pada pembebanan oblique seluruh komponen implan mengalami peningkatan stress seiring peningkatan thread depth. Nilai von Mises stress terbesar pada tulang ditemukan pada thread depth 0,45 mm dengan pembebanan oblique.

 

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Background: Dental implants as an alternative treatment for tooth loss can fail due to excessive stress distribution. Implant design in the form of implant thread depth is an important part of the implant structure that can affect stress distribution. The direction of loading and low-density bone are other factors that can affect stress distribution. Objective: To determine the overview of stress distribution of a single implant with varying thread depth in low-density bone. Methods: This study was a descriptive observational study. A 3D model of the posterior region of the maxillary bone and three implants with implant components of 10 mm length, 4 mm diameter, 0.8 mm thread pitch, V-thread thread shape, and thread depth divided into 0.25 mm; 0.35mm; and 0.45mm were created with modeling software and compiled into a solid model.  Simulation of 200 N axial preload was applied to the screw and followed by 100 N axial and oblique mastication load on the first molar. Finite element method analysis was performed to determine the stress distribution in the form of von Mises stress on the implant and bone components. Results: The highest maximum von Mises stress values under axial loading (abutment = 222.63 MPa, implant body = 179.68 MPa, and screw = 154.97 MPa), under oblique loading (abutment = 1086.9 MPa, implant body = 852.46 MPa, and screw = 628.56 MPa). In alveolar bone, the maximum von Mises stress value with axial loading at each thread depth (0.25 mm = 29.421 MPa; 0.35 mm = 30.201 MPa; 0.45 mm = 31.091 MPa), and with oblique loading at each thread depth (0.25 mm = 74.103 MPa; 0.35 mm = 75.102 MPa; 0.45 mm = 76.557 MPa). Conclusion: The results of the finite element analysis showed that in axial loading, the abutment experienced increased stress as thread depth increased. In oblique loading, all implant components experienced increased stress as thread depth increased. The largest von Mises stress value in the bone was found at a thread depth of 0.45 mm with oblique loading.

 

 

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