The scientific basis for and clinical experiences with Straumann implants including the ITI (R) Dental Implant System: a consensus report

Successful endosseous implant therapy requires integration of the implant w ith bone, soft connective tissue and epithelium. This report from a consens us conference on Straumann dental implants including the ITI(R) Dental Impl ant System documents the interaction of these nonsubmerged one-piece implan ts with the oral tissues and reviews clinical studies supporting the high s uccess achievable with these implants in patients. Light and electron micro scopy reveal that epithelial structures similar to teeth are found around t he implants. A connective tissue zone exists between the apical extension o f the junctional epithelium and the alveolar bone. This connective tissue c omprises a dense circular avascular zone of connective tissue fibers surrou nded by a loose vascular connective tissue. The histologic dimensions of th e epithelium and connective tissue comprising the biologic width are simila r to the same tissues around teeth. The nonsubmerged one-piece design of th e Straumann implants, which have been used for over 20 years, has set a sta ndard in implant dentistry, with other implants now being manufactured and placed using similar techniques, Straumann implants have an endosseous port ion that is either coated with a well-characterized and well-documented tit anium plasma-sprayed surface or is sandblasted and acid attacked. Both surf aces have been shown to have advantages for osseous integration compared to machined and other smoother implant surfaces. These advantages include gre ater amounts of bone-to-implant contact, more rapid integration with bone t issue, and higher removal torque values. The lack of component connection a t or below the alveolar crest provides additional benefits. Component conne ction at the alveolar crest, as seen with submerged implants, results in mi crobial contamination, crestal bone loss and a more apical epithelial locat ion, Numerous human clinical trials document the successful use of Strauman n implants in a variety of indications and areas of the mouth. These includ e prospective long-term trials using strict criteria of success and life ta ble analyses. Taken together, the clinical studies reveal that Straumann im plants can be used predictably in partially edentulous and completely edent ulous maxilla and mandibles with high success rates. Furthermore, the anima l and microscopic studies reviewed provide a scientific basis for the integ ration of Straumann implants with bone, connective tissue and epithelium.