NDI Medical
By Dr. Michael Claar
Retrospective study of the osseointegration of 164 NDI Medical dental implants
Aim of the study:
These days, the osseointegration of dental implants is scientifically very well investigated and generally accepted. As part of this study, an implant system with subtractive surface characteristics (blasted and acid-etched) was the subject of a follow-up investigation in a special implantology practice.

Introduction:
According to the definition on (German) Wikipedia, osseointegration is "a direct functional and structural connection, visible under a light-optical microscope, between the organised, living bone tissue and the surface of a load-bearing bone implant."

This term has its origins in Professor Brånemark and is scientifically undisputed. On the national and international implant market, there are a large number of different implant systems, which differ from one other through variations in micro and macro designs and differences in diameter and length. The majority of dental implants used in implantological practice today are made of titanium. A special manufacturing process is used to lend this material a kind of surface that particularly promotes osseointegration.

The dental implant we have used, from the brand NDI, is available to the user in three different diameters and four different lengths. This is thus a multi-indicative implant system. The prosthetic connection geometry is realised using a Torx connection.

The implant system is approved for both immediate restoration and loading and for conventional delayed and late implantation, and is CE-certified accordingly.

Materials and methods:
All patients who had one or more NDI implants inserted in the dental practice of Dr Claar and colleagues in Kassel between May 2014 and December 2015 were included in the study. A further inclusion criterion was that a prosthetic restoration also had to have been carried out during this period. All implants were placed under the gums. The denudation procedure was carried out according to the classic protocol after three months, at the earliest, in the lower jaw, and after five months, at the earliest, in the upper jaw. Pre-operative diagnostics and evaluation of bone quantity was performed by means of three-dimensional imaging by volume tomography, using the Kavo/Gendex CB 500.

After denudation, two weeks were allowed for transgingival healing before the corresponding implant impression was taken using the repositioning technique.

An X-ray was taken during casting to assess the correct position of the impression post and the line of the crestal bone.

All indication classes were covered.

The follow-up examination was carried out using Albrektsson's classification:

- Implant in situ

- Immobility in the sense of degree 0 loosening (clinically, a bright, metallic sound upon percussion)

- No signs or symptoms of pain, infection, neuropathy, or paraesthesia

- The X-ray image must not show any signs of radiological translucency around the implant.

Results:
A total of 164 NDI implants in 68 patients were included in the retrospective study. There were 45 female patients and 23 male patients. The mean age of these patients was 64 years.

Fig. 1 shows the distribution of implants between the maxilla and the mandible. It was revealed that 103 implants were placed in the maxilla, and 61 implants in the mandible

In addition, the number of implants placed per patient was also examined and is shown in Figure 2

After evaluation of all the patient data, 163 implants were osseointegrated and accordingly prosthetically restored, using both fixed and removable superstructures.

Figure 3 shows the corresponding form of prosthetic restoration

The single non-osseointegrated implant, which involved immediate implantation in region 11, resulted in early loss three weeks post implantation.
This results in a total osseointegration rate of 99.4% (see Fig. 4). With regard to distribution between the two jaws, this means that osseointegration in the lower jaw was 100%, and in the upper jaw was 99.03%.

Discussion:

The results of the retrospective examination of the osseointegration of 164 dental implants from the company NDI in a specialist implantology practice in Kassel reveal a healing rate of over 99%.

These results confirm the clinical reliability of the implant system used (tested by means of the internationally recognised Albrektsson classification).

Since it was used across all indication classes and also in combination with augmentative procedures, the results obtained can be compared with other studies and retrospective examinations unproblematically.

Author:
Dr Michael Claar
Specialist dentist for oral surgery
Certified expert in implantology of the German Society of Oral Implantology (DGOI)

Leipziger Str. 164
34123 Kassel, Germany
Tel: 0561 – 51088000