|Year : 2012 | Volume
| Issue : 1 | Page : 32-36
Analysis of 413 AIDI dental implants: A retrospective study
William YS Hung1, Sami Sherif2, Glenn Hsuan-Chen Chang3, Chien-Ho Chen4
1 Prosthodontist, Private Practice, USC Advanced Prosthodontic Gruaduate, CEO of AIDI Biomedical Inc., Wiodomar, CA, USA
2 Prosthodontist, Private Practice, Los Angeles, CA, USA
3 Periodontist, Private Practice, Los Angeles, CA, USA
4 Prosthodontist, Private Practice, Wiodomar, CA, USA
|Date of Web Publication||24-May-2012|
William YS Hung
34859 Frederick St. Suite 105 Wildomar
| Abstract|| |
Purpose: The purpose of this retrospective study was to determine the success of AIDI dental implants placed in partially or completely edentulous jaws restored with fixed prostheses.
Materials and Methods: A total of 413 dental implants were placed between January 2009 and May 2011. Ninety-six dental implants were placed in 15 edentulous jaws of 11 patients (58 dental implants in maxillae and 38 dental implants in mandibles). Forty-six dental implants were placed in 25 anterior partially edentulous jaws of 23 patients. Two hundred and seventy-one dental implants were placed in 66 posterior partially edentulous jaws of 59 patients. The patients included 49 men and 44 women, with a median age of 49.1 years and an age range of 25-80 years at the time of implant surgery. A single implant was placed in 11 jaws (6 maxillae and 5 mandibles), while multiple implants were placed in the other patients. Among the 106 jaws, 15 jaws received full arch rehabilitation and the other jaws were restored with implant-supported fixed partial denture.
Results: Among the 413 implants, 6 maxillary implants and 4 mandibular implants were unsuccessful. The success rate for the implants was 97.58% (97.14% in the maxillae and 98.03% in the mandibles).
Conclusion: The dental implant was designed to improve initial stability in compromised bone, which makes it a proper implant choice for different clinical applications.
Keywords: AIDI implants, dental implant, soluable blasted madia surface, success rate
|How to cite this article:|
Hung WY, Sherif S, Chang GH, Chen CH. Analysis of 413 AIDI dental implants: A retrospective study. J Dent Implant 2012;2:32-6
| Introduction|| |
The use of osseointegrated implants to support prosthetic reconstruction has become a common treatment modality for patients with partially or completely edentulous jaws. The early studies of Brånemark et al. , and Schroeder et al. , demonstrated a direct bone-to-titanium contact referred to as osseointegration. These studies reported encouraging mid-term results associated with titanium implants in fully/partially edentulous patients. [,6]
Surface properties of implants play an important role in the success of osseointegration.  The surface of IDI dental implants has a highly biocompatible roughness that proved to be excellent for osseointegration. , The implants are blasted with a resorbable SBM (a resorbable HA crystal) from apex to implant body and then all residues are removed from the blasting material.  In comparison to machined implant surfaces and others, this surface has repeatedly proven to elicit a more enhanced bone response. 
Thread and implant body design may condense bone and increase initial stability. 
The goal of this study was to retrospectively evaluate the outcome of AIDI dental implants in clinical use.
Macrostructure of aidi dental implants
Platform switching design
The dental implant has a platform switching design [Figure 1] that can reduce stress to crestal bone.  Platform switching design can also minimize the loss of crestal bone height. The implant is designed to be placed at bone level. The coronal portion of the implant has a platform switching design, which is intended to maximize the alveolar bone around the collar of the implant and provide soft-tissue support. ,,
The microthread design [Figure 1], which is located 1.3 mm apical to platform, can counteract marginal bone resorption in accordance with Wolff's law.  This design increases the resistance to shear forces significantly, and optimize implant stability in suboptimal clinical conditions.  It is worth mentioning that the relocated microthread of dental implant is different from other companies' products, such as Astra Tech® MicroThread implants, which can result in significant bone destruction while unintentional exposure of two-stage implants thread. 
Body thread design
The body thread [Figure 1] of AIDI dental implant is a deeper single-thread design (triple-thread design can increase micro-motion). , Further, the new design of thread (asymmetric thread design) focuses on increasing apical face angle/decreasing coronal face angle [Figure 2] and narrowing implant apex to reduce resistance of dental implant insertion coupled with underprepared implant site, which can maximize bone preservation. This design allows for gradual expansion of the bone as the implant advances, which is similar to the utilization of osteotome , to achieve high insertion torque (90 N cm) and increase initial stability. It is, therefore, possible to facilitate immediate dental implant placement and immediate loading with appropriate occlusal loading even under the circumstances of compromised quality of alveolar bone.
A "sinolift" feature [Figure 1] which forms a concaved internally threaded cavity with different variations is located at the apical end of the implant. This design functions as an osteotome which can simultaneously lift maxillary sinus and condense the bone. ,,
This apical design allows for preparing a narrower-than-typical initial implant osteotomy and placing the implant in a method similar to turning a "corkscrew." A gradual expansion of the maxillary alveolar bone and cortical bone of sinus floor as the implant advances can be achieved, similar to the use of an osteotome  to lift the sinus floor but in a much smoother manner to avoid possible complication of rupturing Schneiderian membrane. Therefore, it becomes possible for the dentist to place the dental implant and perform sinus elevation simultaneously in a compromised implant site with a much better result. 
Highly compatible sbm surface treatment
The surface of the dental implants has a highly biocompatible roughness that proves to be excellent for osseointegration. , The implants are blasted with a resorbable SBM from apex to implant body and then all residues are removed from the blasting material. 
| Materials and Methods|| |
We identified a total of 93 patients who received the dental implant treatment between January 2009 and May 2011 in four different dental implant centers in California, USA. All patients visited the dental implant centers for replacement of single or multiple teeth with osseointegrated implants. Of the 93 patients, 49 were men and 44 were women. The median age was 49.1 years, with a range of 25-80 years, at the time of implant surgery [Figure 3]. The implantation was performed by following either immediate or delayed surgical protocols. There were 11 cases of completely edentulous jaws (8 maxillae and 7 mandibles) and 91 cases of partially edentulous jaws (25 anterior and 60 posterior jaws). Alveolar availability at the edentulous sites was evaluated by radiograph and physical examination. A single implant was placed in 11 jaws (6 maxillae and 5 mandibles), while multiple implants were placed in the other patients. Among the 106 jaws, 15 received full arch rehabilitation and the other jaws were restored with partially fixed prostheses. After implant surgery, all patients were followed periodically until November 2011.
| Results|| |
A total of 106 jaws from 93 patients had 413 implants placed from January 2009 through May 2011 in four dental implant centers. The reasons for the missing teeth included periodontitis or dental caries (64 cases/68.8%), trauma (5 cases/5.4%), loss of previous implants (4 cases/4.3%), tooth root fracture (5 cases/5.4%), apical lesion (12 cases/12.9%), and congenital absence of teeth (3 cases/3.1%) [Figure 4].
Distribution of the implant sites is shown in [Figure 5]. The majority of the fixtures were placed in the first premolar region of the maxilla and in the first molar region of the mandibles.
A single implant was placed in 11 jaws (6 maxillae and 5 mandibles), while multiple implants were placed in the other patients. Among the 106 jaws, 15 received full arch rehabilitation and the other jaws were restored with partially fixed prostheses.
The distribution of fixture sizes is shown in [Figure 6]. The fixture with a diameter of 4.3 mm and a length of 10.5 mm was most frequently employed in both the maxilla (11.7%) and the mandibles (10.1%). The other frequently used sizes were 4.3 mm diameter (13.5 mm length) on the maxilla and 4.3 mm diameter (10.5 mm length) on the mandibles. The risk factors associated with implant therapy are shown in [Table 1]. There were 18 smokers (95 implants), 5 patients with dry mouth (28 implants), 4 patients with diabetes (12 implants), 1 patient with a metal allergy (2 implants), and 2 patients with osteoporosis (6 implants). Twenty-two patients admitted that they were bruxors or clenchers (110 implants). However, we do not know how many patients did have parafunction. Among the 413 implants, only 6 maxillary implants and 4 mandibular implants were unsuccessful (success rates: 97.14 and 98.03%, respectively). The overall success rate was 97.58% in this study [Table 2].
There were four failed implants related to smokers and six failed implants related to bruxors. However, there were no unsuccessful implants in patients affected by diabetes or metal allergy. Among the 10 failed implants, 5 failed prior to loading and 5 failed after loading.
| Discussion|| |
The initial stability is the most important single factor in dental implant surgery. A high insertion torque achieved during dental implant placement can be obtained by a new dental implant design using asymmetric thread design and a narrow implant apex (Paulo Malo) with internal thread, which forms an opposite direction of the outer asymmetric thread design. The asymmetric thread is designed by increasing the apical face angle and reducing the coronal face angle and increasing the length of thread. This design dramatically reduces the insertion resistance and allows continuous osteotome of osseous tissue by progressively condensing and compressing the osseous tissue during dental implant insertion.
The surface properties of implants are key factors for successful osseointegration.  Since the surfaces of the dental implants are blasted with a resorbable SBM from apex to implant body, they have a highly biocompatible roughness that proves to be excellent for osseointegration. ,
Because of the above reasons, the AIDI dental implants can achieve high initial stability and osseointegration. Clinically, it demonstrates a success rate of 97.58%.
Klokkevold et al. showed that there were statistically significant differences in the success rates for dental implants between smokers and nonsmokers,  and smoking is thought to have an adverse affect on implant success statistically. However, Klokkevold et al. also showed no difference in the implant success rate between patients with and without diabetes.  We found the same result in the present study. Dao et al. also suggested that osteoporosis is not a risk factor for dental implants.  In the present study, there were no failed implants in patients with diabetes or osteoporosis. However, it is considered that the factors involved in implant failure in this study were improper (excessive) occlusal overloading, surgical mistake, poor oral hygiene, and insufficient supporting bone, and these factors were exacerbated by smoking and parafunction.
| Conclusion|| |
The dental implant was designed to improve initial stability in compromised bone, which makes it a proper implant choice for different clinical applications. Sinolift® feature was designed to function as an osteotome simultaneously lifting the maxillary sinus and condensing the bone.
In summary, it can be concluded from the present retrospective study that SBM-treated surface of slightly tapered dental implant, associated with immediate/delayed dental implant placement, early load of full arch rehabilitation, and a protocol of underprepared implant site, can be a successful treatment protocol in edentulous maxillae or mandibles. The advantages of the immediate implant placement and immediate loading protocols, which can result in reduced morbidity, high patient satisfaction, and relatively low costs of the treatment, should be taken into account for considering it as a viable option.
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[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]
[Table 1], [Table 2]