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Results from large international clinical trials provide dentists and patients with a new level of confidence in dental implant

Results from two of the largest international clinical studies performed to date with dental implants have just been published and demonstrate excellent clinical performance. Together, the studies have evaluated more than one thousand Straumann Bone Level implants in Europe, the US and Australia. The scope of these studies is particularly remarkable in view of the fact that most dental implant companies do not conduct clinical trials because they want to cut costs and do not have the capabilities.

 The studies are also remarkable in that they both reported very high implant survival rates of more than 98% with practically no bone loss around the implants. The findings are considerably better than values reported in a comprehensive review of previously published studies with other implants[1]. The new studies add to the wealth of strong clinical evidence backing the Straumann dental implant system and thus provide very good reasons for patients and dentists to insist on Straumann implants rather than undocumented alternatives.

 

The benchmark in clinical research

The first study was a randomized controlled clinical trial (RCT) at 11 clinical centers in Europe, USA and Australia[2]. RCTs are the benchmark in clinical research because they offer the highest level of clinical evidence. However, few are performed with dental implants and very rarely on such a large scale.

 This RCT has evaluated 106 patients each treated with one implant and followed for three years. The investigators compared the outcomes of two different approaches - the first involving two surgical steps, in which the implant is covered with gum tissue ('submerged') during healing, and the second involving just a single step, in which part of the implant is left exposed ('transmucosal') thus saving a second surgical operation. The most impressive highlight reported was the fact that only a single implant was lost, yielding 3-year implant-survival rates of 98.1% and 100% for the transmucosal and submerged groups respectively.

 Because bone loss around implants has been documented as a common undesirable effect of implant treatment[3], this study looked carefully at bone level changes. It showed that bone level was impressively stable over 3 years after implant placement, with mean decreases of less than 0.7 mm and 0.6 mm in the submerged and transmucosal groups respectively. These values are well below the data presented in previous studies with other implants. An analysis of published data showed that only three implant systems achieved mean marginal bone loss below 1 mm over a period of 5 years[1].

 

Excellent results also achieved in everyday practice

While RCTs demonstrate that products or treatments work well, they are usually conducted by specialists in selected and strictly controlled populations. This study was performed by dental practices and University clinics that are highly specialized in dental implantology, which raises the question of whether its excellent results can be reproduced in daily dental practice. To answer this, a large study using the same implant was conducted in Europe and the US, in which the dentists had to follow the product guidelines but were able to use the implant as they would in normal daily practice. The strength of this type of investigation, which is known as 'non-interventional study' (NIS), is that it documents real-life situations, in which indications, patients and conditions all vary widely.

 In this study[4], a total of 908 implants were evaluated in 538 patients at more than a hundred dental practices in six countries, revealing an implant survival rate of 98.5% after one year (the risk of failure is highest in the first year after implant placement5). Besides the very high survival rates, the bone level remained very stable in the majority of cases. The investigators therefore concluded that treatment with Straumann Bone Level Implants yielded very successful outcomes in 'real life' conditions.

 

Results impress further when viewed in the context of other published data

The survival rates reported in both studies are higher than those documented in the literature. The most recent analysis of published data on other implants showed an overall implant survival rate of 95.5% one year after implant placement[5], in contrast to the 98.5% achieved in this NIS in daily dental practice conditions.

 

Medicalnewstoday.com

Brian H. Williams, D.D.S., F.A.G.D., Ltd. Dentist Extraordinaire Embraces All Aspects of His Calling By Joan Holstein           Dr. Brian Williams' enthusiasm for dentistry doesn't stop at caring for patients who need preventive or reconstructive services at his new Scottsdale practice.           In fact, his zest for his chosen field includes lecturing at UCLA School of Dentistry-Division of Advanced Prosthodontics, Biomaterials and Hospital Dentistry for more than eight years, as well as conducting and publishing research. He also presents papers nationally and internationally on intra- and extra-oral implants and attachments as they relate to quality of life. Williams even creates facial prostheses for cancer and trauma survivors, plus serves as a valuable resource to fellow dentists who may need to refer a particular patient with specialized needs.           Williams, simpy put, is an expert. But far from being a typical reclusive researcher or ivory tower academician, he is a caring, personable professional driven by a deeply held philosophy. That philosophy is best summarized by three words on his business card: Function, Stability, Aesthetics.           "I believe you have to treat the whole patient, not just one component," Williams explains. "You can't just focus on making the teeth look great without addressing all aspects related to proper function and oral health. If the facial muscles are balanced, the bite is perfect, and the Temporal Mandibular Joint (TMJ) is working properly; if all those are in harmony and functioning as one, the result is great aesthetics and a stable restoration that will last the rest of the patient's lifetime." DOING DENTISTRY RIGHT           Guided by his holistic, comprehensive care philosophy, Williams is a staunch believer in "doing things the right way." At his practice, that means taking the time to provide patients with the best possible treatment. Dr. Williams' philosophy focuses on: Function, Stability, Aesthetics.            Toward this end, initial office visits may run at least an hour as Williams conducts an extensive interview to gather information and uncover any symptoms. Naturally, digital X-rays, which reduce a patient's exposure to radiation, are taken. A thorough evaluation of the muscles of mastication and TMJ is performed using Doppler technology and mounted study models are created. In addition, facial muscles are palpated, intra- and extra-oral photos are taken, and a thorough periodontal exam is done.            "It's like creating a blueprint. We can find out what problems exist, the cause of the problems, and present several solutions to the patient. We can reconstruct things in phases, taking care of the most important things first, and ultimately reach the desired outcome of function, stability and aesthetics," William says.            Along with being thorough and taking time to educate patients, Williams is adamant that patients aren't kept waiting and that any needed injections are painless. "Those are usually the two biggest complaints about seeing the dentist," he says. Another common objection—the expense of dentistry—can be eased thanks to today's affordable financing plans.            Additionally, Williams goes above and beyond to provide patients with a positive experience. "I want them treated the same way I'd want to be treated if it was me in the chair," he says. With this in mind, staff members take time to listen to patients' needs and play a role in their care. In addition to formal industry training, Williams' staff has more than 12 years of progressive experience in public health education and health care quality improvement. Williams' staff stands behind his comprehensive care philosophy and dedication to total patient care.           Williams is equally big on educating his patients about oral health as it relates to overall health throughout their lives. That can be a challenge when a patient has no dental pain and is tempted to buy that new plasma television or other wants rather than undergoing much needed dental work. Today's state-of-the-art technology can address that obstacle by providing patients with hands-on, computer generated images of their case, thus creating more opportunity for patient education.           "Technology is a real boon to patient education. Patients can hold their study models and see photos of their mouths instantly. They can see the decay and other potential problems and understand that various solutions exist to remedy these problems, even if it doesn't hurt at the moment," Williams says.           A proven practitioner, he sold his established Mesa practice in 2001 after 22 years and continued to work part time for the new owner. Unable to resist devoting himself to the profession he loves and the satisfaction of owning his own business, Williams opened a new practice in February at the foothills of the scenic McDowell Mountains in North Scottsdale. Focused on preventive and restorative dentistry, his practice is located east of the Loop 101 near Bell Road and 98th Street in Scottsdale.           "Everything is state-of-the-art," he says. As example, the new practice has digital X-ray sensors, digital photography, computerized record keeping systems, and laser diagnostic instruments. Even with all this technology, Williams still enjoys doing much of his own lab work, even creating dentures.