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Marginal Bone Level (marginal + bone_level)

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Medical Sciences	100%

Selected Abstracts

Marginal Bone Level around Implants Assessed in Digital and Film Radiographs: In Vivo Study in the Dog

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2000
Eva Borg DDS
ABSTRACT Background: One of the objectives of postoperative radiographic examinations of implants is to evaluate the marginal bone height and its changes over time. Purpose: The purpose of this study was to assess the influence of digital image processing on measurements of the marginal bone level around implants. Material and Methods: Implants in beagle dogs, used to study the development of peri-implantitis and subsequent healing following treatment, were monitored with conventional radiography and a digital image plate system. Five observers measured the distance between a reference point and the bone level. Measurements in conventional radiographs were made with the use of an x-ray viewer (2X) and a magnifying lens (7X). For the digital images, the system's built-in measuring function was used together with five image processing techniques: edge enhancement (matrixes set on 5 and 25), inverted grey scale, single color highlight, and color intensity mapping together with the brightness and contrast control. From the time of maximum breakdown and the end of the experiment, histologic values were available. Results: Differences between techniques and observers increased toward the end of the healing period. Measurements made at maximum breakdown did not differ significantly from the histologic value. Measurements made after healing all methods, except that using edge enhancement and a 25 × 25 kernel, differed significantly from the histologic value by underestimating the bone level. Conclusions: Measurements of bone level around implants from digital radiographs are as accurate and precise as those from film images. In particular cases, the use of specific image processing algorithms may improve both accuracy and precision. After healing, the histologic specimens showed an incomplete bone fill in the crater with a remaining thin layer of connective tissue in contact with the fixture, and in such situations, the morphology of the bone will give a more complicated diagnostic task. [source]

Intraoral condition in children with juvenile idiopathic arthritis compared to controls

INTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 6 2008
EVA LEKSELL
Aims. The aims of this study were to compare the periodontal conditions in children and adolescents with juvenile idiopathic arthritis (JIA) in comparison to age-matched healthy individuals, and to describe intraoral health in relation to medical assessments. Design. Forty-one JIA patients, 10,19 years old, were compared to 41 controls. Plaque, calculus, probing depth, bleeding on probing, clinical attachment loss, as well as mucosal lesions were registered. Marginal bone level was recorded on radiographs. A questionnaire was included. Data were analysed with chi-squared test, Fisher's exact test, and Mann,Whitney U -test (P < 0.05). Results. The JIA patients reported pain from jaws (P = 0.001), hands (P = 0.001), and oral ulcers (P = 0.015) more often than controls. They avoided certain types of food because of oral ulcers (P = 0.037). The frequencies of sites with plaque (32% vs. 19%, P = 0.013), calculus (11% vs. 5%, 5 = 0.034), bleeding on probing (26% vs. 14%, P < 0.01), and probing depth 2 mm (32% vs. 2%, P < 0.001) were higher among JIA patients. No sites with attachment loss or reduced marginal bone level were observed. Conclusions. These obtained results are probably because of joint pain, making it difficult to perform oral hygiene as well as the use of medication and general disease activity. [source]

Correlation between early perforation of cover screws and marginal bone loss: a retrospective study

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2008
Nele Van Assche
Abstract Aim: This retrospective study aimed to determine the consequence of early cover screw exposure on peri-implant marginal bone level. Material and Methods: Sixty Astra Tech® MicroThread implants installed in partially edentulous jaws were compared: 20 implants were placed following a two-stage procedure and were unintentionally exposed to the oral cavity (two-stage exposed), 20 implants were placed following a two-stage procedure and were surgically exposed after a subgingival healing time of 3,6 months (two-stage submerged), and 20 implants were placed following a one-stage surgical protocol (one-stage). Digital radiographs were taken at implant placement for all implants, and after abutment surgery for the two-stage exposed and two-stage submerged groups or after 3 months for the one-stage group. Bone loss mesially and distally was measured with an on-screen cursor after calibration. Results: Mean bone re-modelling was 1.96 mm (range: 0.2,3.2 mm) around the two-stage exposed implants, 0.01 mm (range: 0.0,0.3 mm) around the two-stage submerged implants and 0.14 mm (range: 0.0,1.2 mm) around the one-stage implants. Conclusion: The unintentional perforation of two-stage implants resulted in significant bone destruction, probably because the biological width was not considered. [source]

Influence of smoking on marginal bone loss and tooth loss , a prospective study over 20 years

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2002
Leif Jansson
Abstract Aims:, The aim was to investigate the influence of smoking on longitudinal marginal bone loss and tooth loss in a prospective study over 20 years. In addition, the effect of cessation of smoking on bone loss and the interaction between smoking, plaque and marginal bone loss were evaluated. Material and Methods:, A total of 507 dentate individuals from an epidemiological study were examined in 1970 and 1990. The clinical investigation included registration of number of remaining teeth and presence of plaque. The marginal bone level was determined by assessments on the proximal surfaces on the radiographs from 1970 and 1990. The marginal bone loss was defined as the difference in marginal bone level over 20 years. The subjects were interviewed about smoking habits. Stepwise multiple regression analyses were adopted to calculate the influence of the independent variables on longitudinal marginal bone loss and tooth loss. Results:, In 1970, 50.7% of the subjects were smokers, while the corresponding relative frequency in 1990 had decreased to 31.0%. Smoking was significantly correlated to an increased marginal bone loss over 20 years. Individuals who stopped smoking between 1970 and 1990 lost significantly less marginal bone during this period than those who declared that they smoked during the 20-year period. Smoking was not found to be significantly correlated to tooth loss over 20 years. Conclusions:, The results support the hypothesis that smoking is a significant risk factor of periodontal disease. [source]

Analysis of the possibility of the relationship between various implant-related measures: an 18-month follow-up study

JOURNAL OF ORAL REHABILITATION, Issue 2 2008
T. F. TÖZÜM
Summary, Better clarification of the long-term relationship among the various implant-related measures could improve the evaluation process for dental implants. Thus, the aim of the present study was to determine the potential correlations among the volumetric features and nitric oxide content of peri-implant sulcus fluid (PISF) and measures of implant stability, and the marginal bone loss. Completely edentulous patients (n = 15) treated with dental implants and ball attachment mandibular over dentures were included. Resonance frequency analysis (RFA), marginal bone level measurements, PISF volume and spectrophotometrically determined nitrite levels were recorded for all dental implant sites. Measures for early (n = 16) and delayed (n = 14) loaded dental implants were comparatively analysed for a period of 18 months. Some random correlations between PISF volume and marginal bone level, PISF nitrite level and marginal bone level and PISF volume and PISF nitrite content, and RFA and PISF volume were observed. However, the only constant correlation was noticed between implant stability (RFA scores) and marginal bone level. This correlation was negative and significant for all dental implants and for delayed loaded implants (P < 0·05). The pattern of loading seemed to affect the extent, but not the pattern of this relationship. While some of the implant-related measures may be strongly associated (e.g. dental implant stability and marginal bone level), not all measures from a single implant site are likely to be related. Such associations may be under the influence of a variety of factors including the loading protocol of dental implants. [source]

Clinical Outcome of Overdenture Treatment on Two Nonsubmerged and Nonsplinted Astra Tech MicrothreadÔ Implants

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2009
Hugo De Bruyn DDS
ABSTRACT Background: The use of two implants for mandibular overdenture stabilization improves the patients' comfort and well-being. This treatment could be more cost-effective if surgery and prosthetic treatment could be performed by one clinician in the normal setting of a dental clinic. Purpose: The aim of this retrospective clinical study was to describe implant success, restorative outcome, and the patients' opinion of mandibular overdenture treatment on two early-loaded, nonsplinted Astra Tech TiOblast MicrothreadÔ (Astra Tech Dental, Mölndal, Sweden) implants. Materials and Methods: Thirty-seven consecutive patients treated with implant-supported mandibular overdentures were invited for a clinical examination. Implant survival, marginal bone level, quality of implant and prosthetic treatment, and the patients' opinion by means of questionnaires were scored. Results: Thirty-four patients attended the examination. Two implants were lost in one patient and the failure rate for the total group of patients was 3%. As 8 of the 33 remaining patients were still in the provisional loading stage, they were not included in the final clinical and radiographic examination. Based on 25 patients and 50 implants with a mean follow-up of 18.8 months (range 4,33), implant positioning and occlusion/articulation scored perfect in 74 to 80% of the cases. Retention of the dentures was rated perfect in 80%, but 20% needed minor activation of the attachments, 20% showed signs of abrasion, and 20% had already been repaired. The average marginal bone level was 0.8 mm below the reference point. The mean pocket depth was 2.1 mm, and 54% of the peri-implant tissues were free of bleeding. The patients were appreciative of the work carried out by their dentist and they indicated a significant improvement in their well-being and quality of life. Conclusions: It can be concluded that the Astra Tech implant system was successfully used by the general dentist both surgically and prosthetically with minimal implant failures and prosthetic complications and that this led to high levels of patient appreciation and overall satisfaction. [source]

Marginal Bone Loss at Implants: A Retrospective, Long-Term Follow-Up of Turned Brånemark System® Implants

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2009
Odont Lic, Solweig Sundén Pikner DDS
ABSTRACT Background: Lately, presence of progressive bone loss around oral implants has been discussed. Purpose: The aim of this study was to report in a large patient group with different prosthetic restorations marginal bone level and its change as measured in radiographs obtained from prosthesis insertion up to a maximum 20 years in service. Further, it also aimed to study the impact of gender, age, jaw, prosthetic restoration, and calendar year of surgery. Materials and Methods: Out of 1,716 patients recorded for clinical examination during 1999, 1,346 patients (78.4%) could be identified. A total of 640 patients (3,462 originally installed Brånemark System® implants, Nobel Biocare, Göteborg, Sweden) with a follow-up of ,5 years were included in the study, while patients with continuous overdentures and augmentation procedures were not. Distance between the fixture/abutment junction (FAJ) and the marginal bone level was recorded. Results: The number of implants with a mean bone level of ,3 mm below FAJ increased from 2.8% at prosthesis insertion to 5.6% at year 1, and 10.8% after 5 years. Corresponding values after 10, 15, and 20 years were 15.2, 17.2, and 23.5%, respectively. Implant-based bone loss was as a mean 0.8 mm (SD 0.8) after 5 years, followed by only minor average changes. Mean bone loss on patient level followed a similar pattern. Disregarding follow-up time, altogether 183 implants (107 patients) showed a bone loss ,3 mm from prosthesis insertion to last examination. Significantly larger bone loss was found the older the patient was at surgery and for lower jaw implants. Conclusions: Marginal bone support at Brånemark implants was with few exceptions stable over years. [source]

Implant Stability during Initiation and Resolution of Experimental Periimplantitis: An Experimental Study in the Dog

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2005
Lars Sennerby DDS
ABSTRACT Background: Histologic studies have demonstrated the possibility to reestablish direct bone-implant contacts after ligature-induced periimplantitis. The influence of the reosseointegration on the stability of implants is not known. Purpose: The aim of the present investigation was to study bone tissue and associated implant stability alterations that occurred during induction and resolution of periimplantitis using resonance frequency analysis (RFA), radiography, and histology. Materials and Methods: Three implants with smooth (turned) or roughened (SLA®) surfaces were placed in each side of the edentulous mandible of four dogs. Experimental periimplantitis was induced for 3 months. Five weeks later, the animals were treated with antibiotics and surgical therapy and were followed for another 6 months. Periapical radiographs and RFA were used to evaluate marginal bone levels and implant stability throughout the study period. After termination, the tissue-implant interface was evaluated by light microscopy in ground sections. Results: There was a linear relationship between radiographic and RFA findings because continuous loss of marginal bone and a decrease in implant stability were observed for both implant surfaces during the periimplantitis period. Antibiotic treatment and surgical therapy resulted in some reosseointegration, which was more marked for the SLA surface. The resonance frequency values corresponded well to the histometric measurements because reosseointegration resulted in an increase in implant stability. Conclusions: The findings from the present study indicate a linear relationship between marginal bone level and resonance frequency value. It is suggested that the RFA technique is sensitive and may be used to detect even a minor change in the level of bone-implant contact. [source]

A Three-Year Follow-Up Report of a Comparative Study of ITI Dental Implants® and Brånemark System® Implants in the Treatment of the Partially Edentulous Maxilla

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2004
Per Åstrand DDS
ABSTRACT Background: Many longitudinal studies of different implant systems have been published but few controlled randomized investigations have been reported. A 1-year report of a comparative study of ITI Dental Implant System® implants (Straumann AG, Waldenburg, Switzerland) and Brånemark System® implants (Nobel Biocare AB, Gothenburg, Sweden) has been published by the present authors. This paper is a 3-year follow-up of that randomized study. Purpose: The aim of the study was to compare the outcome of fixed partial prostheses supported by ITI or Branemark implants. The outcome was evaluated primarily in terms of survival rates and changes in marginal bone level. Material and Methods: The study group comprised 28 patients with anterior residual dentition in the maxilla. The patients were provided with two to four implants on each side of the dentition and were randomly allocated to Brånemark implants or ITI implants; 77 ITI implants and 73 Brånemark implants were inserted. After 6 months abutment connections were made to both ITI and Brånemark implants. All patients were provided with fked partial prostheses of gold-ceramic. The patients were followed up annually with clinical and radiographic examinations for 3 years. Results: Two Brånemark implants and two ITI implants were lost. The Brånemark implants were lost before loading whereas the ITI implants were lost because of periimplantitis. The survival rate for both groups was 97.3%. The mean marginal bone level of the Brånemark implants was situated 1.8 mm from the reference point at both the baseline and the 3-year examinations. The corresponding values for the ITI implants were 1.4 mm at baseline and 1.3 mm after 3 years. There was no significant difference between the implant systems with regard to bone level or bone level change. A steady state of the marginal bone level was calculated to have been reached after 3 years for 95.5% of the Brånemark implants and 87.1% of the ITI implants. Periimplantitis (infection including pus and bone loss) was observed with seven ITI implants but with none of the Brånemark implants. This difference was statistically significant. Conclusions: No statistically significant differences were found between the implants studied, except for the frequency of periimplantitis, which was higher for the ITI implants. The survival rates were high, and the marginal bone loss was small for both systems. [source]

Stability Measurements of Osseointegrated Implants Using Osstell in Partially Edentulous Jaws after 1 Year of Loading: A Pilot Study

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2002
Piero Balleri MD
ABSTRACT Background: The introduction of resonance frequency analysis (RFA) as a commercially available technique has made it possible to measure implant stability in implant stability quotient (ISQ) units at any time during the course of implant treatment and loading. However, no information on normal ISQ levels can be found in the literature. Purpose: The aim of this pilot study was to measure the stability of clinically successful implants in partially edentulous patients after 1 year of loading and to study the influence of jaw, anterior/posterior position, implant length, and marginal bone level on implant stability. Materials and Methods: Fourteen partially edentulous patients previously treated with 45 implants were subjected to clinical and radiographie evaluations and RFA measurements using Osstell (Integration Diagnostics, Sävedalen, Sweden) after 1 year of loading. Results: All 45 implants were stable, and implant stability levels were in the range of 57 to 82 ISQ units with a mean of 69 ± 6.5 ISQ after 1 year of loading. Mandibular implants were more stable than were maxillary ones. There were no differences between anterior and posterior implants. No correlation could be found between implant length and stability. Only minor marginal bone resorption was observed. Conclusions: The results from this limited material showed that successfully integrated implants have ISQ levels from 57 to 82 ISQ with a mean of 69 ISQ after 1 year of loading. Mandibular implants are more stable than are maxillary ones. High implant stability can be achieved with short implants and placement in posterior regions. [source]

Marginal Bone Level around Implants Assessed in Digital and Film Radiographs: In Vivo Study in the Dog

Effect of conical configuration of fixture on the maintenance of marginal bone level: preliminary results at 1 year of function

CLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2010
Jung-Joo Kim
Abstract Objectives: To evaluate and to compare the effect of the conical neck design on marginal bone loss around the fixtures, when both implants were provided with micro-threads to the top of the fixture. Materials and methods: Two types of implant, one with a straight shape (S) and the other with a conical neck design (C) provided with a retentive element to the top of the fixture, were placed adjacent to each other in the partially edentulous areas of 12 patients. Bone loss around each implant was analyzed after 1 year of functional loading. The bone losses after loading were compared using Wilcoxon's signed-rank test. Results: The mean marginal bone losses (S, 0.05±0.09 mm; C, 0.07±0.14 mm) were not statistically significant between the two groups (P=0.578). Conclusions: There was no significant difference between conical and straight neck implants in terms of marginal bone loss after 1 year of loading. To cite this article: Kim J-J, Lee D-W, Kim C-K, Park K-H, Moon I-S. Effect of conical configuration of fixture on the maintenance of marginal bone level: preliminary results at 1 year of function. Clin. Oral Impl. Res. 21, 2010; 439,444 doi: 10.1111/j.1600-0501.2009.01871.x [source]

A randomized-controlled clinical trial evaluating clinical and radiological outcomes after 3 and 5 years of dental implants placed in bone regenerated by means of GBR techniques with or without the addition of BMP-2

CLINICAL ORAL IMPLANTS RESEARCH, Issue 7 2009
Ronald E. Jung
Abstract Objective: The aim of this randomized-controlled clinical trial was to evaluate the long-term outcome of implants placed in bone augmented with a xenogenic bone substitute material and a collagen membrane with or without the addition of recombinant human bone morphogenetic protein-2 (rhBMP-2). Material and methods: Eleven patients received a total of 34 implants placed into sites exhibiting lateral bone defects. In a split mouth design, the defects were randomly treated with the graft material and the collagen membrane either with (test) or without (control) rhBMP-2. The patients were examined 3 and 5 years after insertion of the prosthetic restoration. Student's paired t -test was performed to detect differences between the two groups. Results: The survival rate at 3 and 5 years was 100% for both groups. The peri-implant soft tissues were stable and healthy without any difference between the two groups. The prosthetic reevaluation demonstrated four loose prosthetic screws during the first 3 years and seven ceramic chippings after 3 and 5 years. The mean distance between the first bone to implant contact to implant abutment junction at 3 years was 1.37 mm (test), 1.22 mm (control), and 1.38 mm (test), and 1.23 mm (control) at 5 years. The difference of <0.2 mm between test and control implants was not statistically significant. The mean change of the marginal bone level between baseline and 5 years ranged from ,0.07 mm (mesial, test), ,0.11 mm (distal, test), ,0.03 mm (mesial, control), to +0.13 mm (distal, control). No statistically significant differences were observed between test and control sites. Conclusion: Implants placed in bone augmented with and without rhBMP-2 revealed excellent clinical and radiological outcomes after 3 and 5 years. [source]

Radiographic evaluation of marginal bone levels adjacent to parallel-screw cylinder machined-neck implants and rough-surfaced microthreaded implants using digitized panoramic radiographs

CLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2009
Hans-Joachim Nickenig
Abstract Objective: The purpose of this split-mouth study was to compare macro- and microstructure implant surfaces at the marginal bone level during a stress-free healing period and under functional loading. Material and methods: From January to February 2006, 133 implants (70 rough-surfaced microthreaded implants and 63 machined-neck implants) were inserted in the mandible of 34 patients with Kennedy Class I residual dentitions and followed until February 2008. The marginal bone level was radiographically determined, using digitized panoramic radiographs, at four time points: at implant placement (baseline level), after the healing period, after 6 months of functional loading, and at the end of follow-up. Results: The median follow-up time was 1.9 (range: 1.9,2.1) years. The machined-neck group had a mean crestal bone loss of 0.5 mm (range: 0,2.3) after the healing period, 0.8 mm after 6 months (range: 0,2.4), and 1.1 mm (range: 0,3) at the end of follow-up. The rough-surfaced microthreaded implant group had a mean bone loss of 0.1 mm (range: ,0.4,2) after the healing period, 0.4 mm (range: 0,2.1) after 6 months, and 0.5 mm (range: 0,2.1) at the end of follow-up. The two implant types showed significant differences in marginal bone levels (healing period: P=0.01; end of follow-up: P<0.01). Conclusions: Radiographic evaluation of marginal bone levels adjacent to machined-neck or rough-surfaced microthreaded implants showed that implants with the microthreaded design caused minimal changes in crestal bone levels during healing (stress-free) and under functional loading. [source]

Bone level changes at implants supporting crowns or fixed partial dentures with or without cantilevers

CLINICAL ORAL IMPLANTS RESEARCH, Issue 10 2008
Gian Andrea Hälg
Abstract Objective: The aim of this study was to analyze whether or not a cantilever extension on a fixed dental prosthesis (FDP) supported by implants increased the amount of peri-implant bone loss or technical complications compared with reconstructions without cantilevers. Materials and Methods: Fifty-four partially dentate patients with a total of 54 FDPs supported by 78 implants were enrolled in the study. Twenty-seven FDPs were with cantilever and 27 FDPs were without cantilever (control group). All FDPs were supported by one or two implants and were located in the posterior maxilla or mandible. The primary outcome variable was change in peri-implant marginal bone level from the time of FDP placement to the last follow-up visit. FDPs were under functional loading for a period of 3 up to 12.7 years. Statistical analysis was carried out with Student's t -test. Regression analyses were carried out to evaluate the influence of confounding factors on the peri-implant bone level change. In addition, implant survival rates were calculated and technical complications assessed. Results: After a mean observation period of 5.3 years, the mean peri-implant bone loss for the FDPs with cantilevers was 0.23 mm (SD±0.63 mm) and 0.09 mm (SD±0.43 mm) for FDPs without cantilever. Concerning the bone level change at implants supporting FDPs with or without cantilevers no statistically significant differences were found. The regression analysis revealed that jaw of implant placement had a statistically significant influence on peri-implant bone loss. When the bone loss in the cantilever group and the control group were compared within the maxilla or mandible separately, no statistically significant difference was found. Implant survival rates reached 95.7% for implants supporting cantilever prostheses and 96.9% for implants of the control group. Five FDPs in the cantilever group showed minor technical complications, none were observed in the control group. Conclusion: Within the limitations of this study it was concluded that cantilever on FDPs did not lead to a higher implant failure rate and did not lead to more bone loss around supporting implants compared with implants supporting conventional FDPs. In contrast to these results more technical complications were observed in the group reconstructed with cantilever. [source]

Direct loading of Nobel Direct® and Nobel Perfect® one-piece implants: a 1-year prospective clinical and radiographic study

CLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2007
Per-Olov Östman
Abstract Objectives: The aim of this prospective study was to evaluate the Nobel Direct® and Nobel Perfect® one-piece implants (OPIs) when used for immediate function. Material and methods: Forty-eight patients were provided with 115 OPIs for loading with a provisional crown or a bridge within 24 h and followed for at least 12 months with clinical and radiographic examinations. A group of 97 patients previously treated under identical conditions by the same team with 380 two-piece implants (TPIs) for immediate loading in the mandible and maxilla served as the reference group. Results: Six (5.2%) OPIs failed during the follow-up due to extensive bone loss. Five (1.3%) implants failed in the reference group. After 1 year, the mean marginal bone loss was 2.1 mm (SD 1.3) for OPIs and 0.8 mm (SD 1) for TPIs. 20% of OPIs showed more than 3 mm of bone loss compared with 0.6% for TPIs. When compensating for vertical placement depth, OPIs still showed a lower marginal bone level and thus more exposed threads than TPIs. Depending on the criteria used, the success rate for OPIs was 46.1% or 72.2% compared with 85% or 91.6% for TPIs. Conclusions: The Nobel Direct® and Nobel Perfect® OPIs show lower success rates and more bone resorption than TPIs after 1 year in function. Factors such as implant design, insertion depth, rough surface towards the mucosa, in situ preparation and immediate loading may have an influence on the clinical outcome. [source]

Microbiological and clinical outcomes and patient satisfaction for two treatment options in the edentulous lower jaw after 10 years of function

CLINICAL ORAL IMPLANTS RESEARCH, Issue 3 2005
Marc Quirynen
Abstract Background: Long-term data on microbiological and clinical outcome as well as on patient satisfaction after implant therapy in the edentulous mandible are limited. Especially comparisons between fixed full prostheses (FFPs) and overdentures (ODs), or between anchoring systems for the latter are scarce. Aim: This study aimed to evaluate both of these parameters at the 10-year follow-up in a group of fully edentulous patients rehabilitated via an OD or a FFP (the latter to allow inter-group comparison). Material and methods: A total of 37 fully edentulous patients (25 ODs, 12 FFPs, age at implant installation ranged from 36 to 85 years) participated in this study. All subjects received their implants (Brånemark System®, Nobel Biocare AB, Gothenburg, Sweden) 10 years previously. For the ODs different attachment systems (bar, magnets, ball) had been applied that allowed a further intra-group comparison. At the follow-up visit, 10 years after the abutment insertion, a series of periodontal parameters were recorded, long-cone radiographs were taken and subgingival plaque samples were collected for analysis using checkerboard DNA,DNA hybridization. The clinical and radiographic data were recorded at abutment connection and after 1 and 10 years. Results: After 10 years of loading, mean plaque and bleeding indices and changes in attachment or marginal bone level were not significantly different, neither between the OD and FFP group, nor within the OD group. The marginal bone loss between abutment connection and year 10 was 0.86 and 0.73 mm for OD and FFP groups, respectively. The subgingival microbiota at implant sites from all (sub)-groups was comparable, with low numbers of DNA counts (±10 × 105) but high detection frequencies of Actinobacillus actinomycetemcomitans (>90%), Porphyromonas gingivalis (>85%) and Tannerella forsythensis (30%). The composition of the subgingival microbiota was influenced by probing depth and bleeding tendency. Patient satisfaction was very high for both types of prosthetic rehabilitation. The FFP group scored only slightly better for chewing comfort and general satisfaction. Conclusion: These data indicate that from the clinical and microbiological standpoint, as well as patient satisfaction, both an OD and a FFP offer a favourable long-term outcome. Résumé Les données à long terme de la guérison clinique et microbiologique ainsi que la satisfaction du patient après un traitement par implants dans la mandibule édentée sont limitées. Essentiellement des comparaisons entre les prothèses fixées complètes et les prothèses fixées amovibles ou entre les systèmes d'ancrage pour ces derniers sont rares. Cette étude a eu pour but d'évaluer ces paramètres après dix ans dans un groupe de patients complètement édentés qui avaient été soignés par une prothèse amovible ou fixée (cette dernière pour permettre la comparaison intergroupes). Trente-sept patients édentés [25 prothèses amovibles (OD), douze prothèses fixées (FFP), l'âge au moment du placement des implants était de 36 à 85 ans] ont participéà cette étude. Tous les sujets avaient reçu des implants Brånemark® 10 ans auparavant. Pour les prothèses amovibles, différents types d'attache (balle, aimant) avaient été utilisés, ce qui permettaient une comparaison intragroupe supplémentaire. Lors de la visite du suivi, dix ans après l'insertion des implants, une série de paramètres parodontaux ont été enregistrés, des radiographies par long cône prises et des échantillons de plaque sous-gingivale prélevés pour l'analyse utilisant l'hybridisation ADN-ADN échiquier. Les données cliniques et radiographiques ont été enregistrées au moment de la connexion de l'implant et après une et dix années. Dix années après la mise en charge, les indices de plaque et de saignement et les variations dans l'attache ou les niveaux osseux marginaux n'étaient pas significativement différents ni entre les groupes OD et FFP ni à l'intérieur du groupe OD. La perte osseuse marginale entre les connexions des piliers et dix ans après étaient respectivement de 0,86 et 0,73 mm pour les groupes OD et FFP. La flore sous-gingivale au niveau des implants pour tous les groupes et sous-groupes étaient semblables avec de faibles comptages ADN (±10 × 105) mais des fréquences de détection importantes de A. actinomycetemcomitans (>90%), P. gingivalis (>85%) et T.forsythensis (30%). La composition de la flore sous-gingivale a été influencée par la profondeur de la poche et la tendance au saignement. La satisfaction du patient était très élevée pour les deux types de prothèses. Le groupe FFP n'était qu'un petit peu meilleur pour le confort à la mastication et la satisfaction générale. Ces données indiquent que d'un point de vue clinique et microbiologique autant que d'un point de vue de satisfaction du patient les prothèses amovibles et fixées sont favorables à long terme. Zusammenfassung Hintergrund: Die Langzeitresultate über den mikrobiologischen und klinischen Verlauf und über die Zufriedenheit der Patienten nach Implantatversorgung im zahnlosen Unterkiefer sind limitiert. Im Speziellen sind Vergleiche zwischen festsitzenden totalen Brücken und Hybridprothesen und den verschiedenen Befestigungssystemen für Hybridprothesen selten. Ziel: Das Ziel der Studie war, beide Parameter anlässlich der Nachuntersuchung nach 10 Jahren bei einer Gruppe von zahnlosen Patienten, welche mit einer Hybridprothese oder mit einer festsitzenden Brücke wiederhergestellt worden waren, auszuwerten (bei den Hybridprothesen sollten auch Vergleiche innerhalb der Gruppe durchgeführt werden). Material und Methoden: Insgesamt nahmen 37 zahnlose Patienten an der Studie teil (25 Hybridprothesen (OD), 12 festsitzende Prothesen (FFP), Alter zum Zeitpunkt der Implantation 36 bis 85 Jahre). Alle Subjekte hatte vor 10 Jahren ihre Implantate erhalten (Brånemark System®, Nobel Biocare, Schweden). Bei den Hybridprothesen waren verschiedene Befestigungssysteme verwendet worden (Steg, Magnet, Kugeln). Dies erlaubte Vergleiche innerhalb der Gruppe. Bei der Nachuntersuchung 10 Jahre nach Einsetzten der Prothetikteile wurden parodontale Parameter aufgenommen, Röntgenbilder mit der Langkonustechnik angefertigt und subgingivale Plaqueproben zur Analyse mittels Ceckerboard DNA,DNA Hybridisierung entnommen. Die klinischen und radiologischen Daten wurden beim Einsetzten der Prothetikteile und nach 1 und 10 Jahren aufgenommen. Resultate: Nach 10 Jahren Belastung bestanden weder zwischen der OD und FFP Gruppe, noch innerhalb der OD Gruppe statistisch signifikante Unterschiede im mittleren Plaque- und Blutungsindex und in der Attachment- und marginalen Knochenhöhe. Der Verlust an marginalem Knochen zwischen der Montage der Prothetikteile und nach 10 Jahren betrug 0.86 mm für die OD Gruppe und 0.73 mm für die FFP Gruppe. Die subgingivale Flora war bei allen Implantatstellen der (Sub-) Gruppen vergleichbar. Es bestand eine geringe Anzahl an DNA Zählungen (±10 × 105) aber eine hohe Entdeckungsfrequenz für A. actinomycetemcomitans (>90%), P. gingivalis (>85%) und T. forsythensis (30%). Die Zusammensetzung der subgingivalen Mirkoflora wurde durch die Sondierungstiefe und die Blutungstendenz beeinflusst. Die Zufriedenheit der Patienten war für beide Arten der prothetischen Wiederherstellung sehr hoch. Die FFP Gruppe erreichte nur geringfügig bessere Werte bezüglich Kaukomfort und genereller Zufriedenheit. Schlussfolgerung: Diese Daten zeigen, dass sowohl vom klinischen und mikrobiologischen Standpunkt aus als auch seitens der Patientenzufriedenheit die Hybridprothese und die festsitzende totale Brücke gute Langzeitresultate zeigen. Resumen Antecedentes: Los datos a largo plazo sobre los resultados microbiológicos y clínicos al igual que la satisfacción del paciente tras la terapia de implantes en la mandíbula edéntula son limitados. Son especialmente escasas las comparaciones entre prótesis fija completa y sobredentaduras, o entre sistemas de anclaje. Intención: Este estudio se intentó para evaluar ambos parámetros en el control de seguimiento de los 10 años en un grupo de pacientes totalmente edéntulos rehabilitados por medio de una sobredentadura o una prótesis completa fija (la última para permitir comparaciones intergrupo). Material y métodos: Un total de 37 pacientes totalmente edéntulos (25 sobredentaduras (OD), 12 prótesis completas fijas (FFP), la edad en el momento de la implantación varió entre 36 a 85 años) participaron en este estudio. Todos los sujetos recibieron sus implantes (Brånemark System®, Nobel Biocare, Suecia) 10 años antes. Para las sobredentaduras se aplicaron diferentes sistemas de anclaje (barras, imanes, bolas) lo que permitieron una ulterior comparación intragrupo. En la visita de seguimiento, 10 años tras la colocación de los pilares, se recogieron una serie de parámetros periodontales, se tomaron radiografías de cono largo y se recogieron muestras de la placa subgingival para análisis usando la cuadrícula de DNA-DNA hibridación. Los datos clínicos y radiográficos se recogieron al conectar los pilares y tras 1 y 10 años. Resultados: Tras 10 años de carga, los índices medios de placa y sangrado y los cambios en el nivel óseo marginal y de inserción no fueron significativos, ni entre los grupos OD y FFP, ni dentro del grupo OD. La pérdida de hueso marginal entre la conexión de los pilares y el año 10 fue de 0.86 y 0.73 mm para los grupos OD y FFP, respectivamente. La microflora subgingival en los lugares de implantes fue comparable entre todos los (sub)-grupos, con un bajo recuento de DNA (±10 × 105) pero una alta detección de A. actinomycetemcomitans (>90%), P. gingivalis (>85%) y T. forsythensis (30%). La composición de la microflora subgingival fue influida por la profundidad de sondaje y la tendencia al sangrado. La satisfacción de los pacientes fue muy alta para ambos grupos de rehabilitación protésica. El grupo FFP puntuó solo un poco mejor para la satisfacción masticatoria y satisfacción general. Conclusión: Estos datos indican que desde el punto de vista clínico y microbiológico al igual que la satisfacción del paciente, tanto la sobredentadura como la prótesis completa fija ofrecen unos resultados favorables a largo plazo. [source]

Tissue-engineered injectable bone regeneration for osseointegrated dental implants

CLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2004
Yoichi Yamada
Abstract: The present study investigated a correlation between osseointegration in dental implants and an injectable tissue-engineered bone, using mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP). Initially, the teeth in the mandible region were extracted and the healing period was 1 month. Bone defects on both sides of the mandible were prepared with a trephine bar. The defects were implanted with graft materials as follows: PRP, dog MSCs (dMSCs), and PRP, autogenous particulate cancellous bone and marrow (PCBM), and control (defect only). Two months later, the animals were evaluated by histology, and at the same time dental implants were installed. Two months later, the animals were sacrificed and nondecalcified sections were evaluated histologically and histometrically. According to the histological observations, the dMSCs/PRP group had well-formed mature bone and neovascularization, compared with the control (defect only) and PRP groups, as was the same for the PCBM group. A higher marginal bone level was observed around implants with PRP, PCBM, and dMSCs/PRP compared with the control. Furthermore, the values describing the amount of bone,implant contact (BIC) at the bone/implant interface were significantly different between the PRP, PCBM, dMSCs/PRP, and control groups. Significant differences were also found between the dMSCs/PRP and control groups in bone density. The findings of this experimental study indicate that the use of a mixture of dMSCs/PRP results in good results such as the amount of BIC and bone density comparable with that achieved by PCBM. Résumé L'étude présente a analysé une corrélation entre l'ostéïntégration d'implants dentaires et un os injectable traité en utilisant des cellules souches mésenchymateuses (MSC) et du plasma riche en plaquette (PRP). Initialement, les dents de la région mandibulaire ont été avulsées et la période de guérison a été d'un mois. Les lésions osseuses des deux côtés de la mandibule ont été préparées avec un trépan. Les lésions ont été traitées avec les matériaux de greffe suivants : PRP, MSC canin (dMSC) et PRP, moelle l'os spongieux en petites particules autogènes (PCBM) et contrôle (lésion seulement). Deux mois plus tard, les animaux ont étéévalués et en même temps les implants dentaires ont été placés. Deux mois plus tard, les animaux ont été euthanasiés et des coupes non-décalcifiées ont étéévaluées histologiquement et histométriquement. Suivant les observations histologiques, le groupe dMSC/PRP avait de l'os mûr bien formé et une néovascularisation comparé au contrôle et aux groupes PRP, comme pour le groupe PCBM. Un niveau osseux marginal plus important a été observé autour des implants avec PRP, PCBM et dMSC/PRP comparé au contrôle. De plus les valeurs décrivant la quantité de contact os/implant à l'interface os/implant étaient significativement différentes entre les groupes PRP, PCBM, dMSC/PRP et contrôles. Des différences significatives étaient aussi trouvées entre les groupes dMSC/PRP et contrôle en ce qui concernait la densité osseuse. Ces découvertes indiquent que l'utilisation d'un mélange dMSC/PRP résulte en de bons résultats tels que la quantité de contact os-implant et la densité osseuse comparéà ce qui se passe après l'utilisation du PCBM. Zusammenfassung Gewebemanipulierte injizierbare Knochenregenerate für osseointegrierte dentale Implantate Die vorliegende Studie untersuchte eine Korrelation zwischen der Osseointegration bei dentalen Implantaten und einem injizierbaren gewebemanipulierten Knochenregenerat aus mesenchymalen Stammzellen (MSCs) und plättchenreichem Plasma (PRP). Zuerst wurden die Zähne im Unterkiefer extrahiert. Darauf folgte eine Heilungsperiode von 1 Monat. Auf beiden Seiten der Unterkiefer wurden mit einer Hohlfräse Knochendefekte präpariert. Die Defekte wurden mit folgenden Transplantatmaterialien aufgefüllt: PRP, Hunde MSCs (dMSCs) und PRP, autologer zerkleinerter Knochen und Knochenmark (PCBM) und kein Füllmaterial (Kontrolle). Zwei Monate später wurden die Tiere histologisch untersucht und es wurden dentale Implantate eingesetzt. Nach weiteren zwei Monaten wurden die Tiere geopfert und nicht entkalkte Schnitte wurden histologisch und histometrisch ausgewertet. Gemäss der histologischen Beobachtungen zeigten die dMSCs/PRP Gruppe im Vergleich zur Kontrollgruppe und zur PRP Gruppe gut ausgebildeten reifen Knochen und neue Gefässe. Das Selbe galt für die PCBM Gruppe. Bei den Implantaten mit PRP, PCBM und dMSCs/PRP konnte im Vergleich zur Kontrollgruppe ein höheres marginales Knocheniveau beobachtet werden. Zudem waren die Werte, welche das Ausmass an Knochen-Implantat-Kontakt an der Kochen/Implantat Berührungsfläche beschreiben, zwischen den PRP, PCBM, dMSCs/PRP und der Kontrollgruppe signifikant verschieden. Signifikante Unterschiede wurden auch bezüglich Knochendichte zwischen der dMSCs/PRP und der Kontrollgruppe gefunden. Die Ergebnisse dieser experimentellen Studie zeigen, dass die Anwendung eines Gemisches aus dMSCs/PRP zu guten Resultaten bezüglich Ausmass an Knochen-Implantat-Kontakt und Knochendichte führt. Die erzielten Resultate sind mit den mit PCBM erreichten vergleichbar. Resumen El presente estudio investigó la correlación entre osteointegración en implantes dentales y un tejido-elaborado óseo inyectable, usando células madre mesenquimales (MSCs) y plasma rico en plaquetas (PRP). Inicialmente, se extrajeron los dientes de la mandíbula y el periodo de cicatrización fue de un mes. Se prepararon defectos óseos en ambos lados de la mandíbula con una fresa trépano. Los defectos se implantaron con material de injerto de la siguiente manera: PRP, MSCs de perro (dMSCs) y PRP, partículas de hueso esponjoso y médula autógenos (PCBM), y control (defecto solo). Dos meses mas tarde, los animales se evaluaron por histología, al mismo tiempo se instalaron implantes dentales. Dos meses mas tarde se sacrificaron los animales y se evaluaron secciones no descalcificadas histológica e histometricamente. De acuerdo con las observaciones histológicas, el grupo dMSCs/PRP había formado bien un hueso maduro y una neovascularización, comparado con el control (defecto solo) y grupos PRP, también fue igual para el grupo PCBM. Se observó un nivel óseo marginal mas alto alrededor de los implantes con PRP, PCBM, y dMSCs/PRP comparados con el control. Mas aun, los valores que describen la cantidad de contacto hueso-implante en la interfase hueso/implante fueron significativamente diferentes entre los grupos PRP, PCBM, dMSCs/PRP, y de control en la densidad ósea. Estos hallazgos de este estudio experimental indican que el uso de una mezcla de dMSCs/PRP resulta en buenos resultados tales como la cantidad de contacto hueso-implante y densidad ósea comparable a aquella lograda por PCBM. [source]

Implant-supported fixed prostheses in the edentulous maxilla

CLINICAL ORAL IMPLANTS RESEARCH, Issue 3 2004
A 2-year clinical, radiological follow-up of treatment with non-submerged ITI implants
Abstract Objectives: To evaluate the survival rate of non-submerged solid-screw ITI dental implants with a rough (titanium plasma sprayed, TPS) surface in the edentulous maxilla after 1 and 2 years of loading. Material and method:, Twenty-five patients (mean age 64 years) with edentulous upper jaws received five,seven implants and, after a mean healing time of 6.9 months, screw-retained implant-supported fixed prostheses. A total of 146 ITI solid screw TPS implants were inserted. The diameter of 56% of the implants was smaller (3.3 mm) than the standard (4.1 mm) and the diameter of the rest (44%) was standard. The bone quantity of the majority of the patients was low and the bone quality poor. Clinical parameters were registered at baseline and at two annual follow-ups. Radiological examinations and assessments were also made at these times. Results: Mean marginal bone level at baseline was measured at a point 4.52 mm (range 1.45,7.70, SD 1.2) apical of the reference point. Mean bone loss from baseline to 1 year of loading was 0.24 mm (SD 0.9, P=0.002) and from 1 year to 2 years of loading 0.15 mm (SD 0.4, P<0.001). Five implants failed, four of which were early failures prior to loading. One implant failed shortly after bridge installation. The cumulative survival rate was 96.6% after 1 and 2 years. Conclusion: ITI TPS solid-screw implants in combination with fixed prostheses had successful survival rates and were found to be a viable treatment alternative in the edentulous maxilla. Résumé Le but de cette étude a été d'évaluer le taux de survie d'implants dentaires ITI vis solides non-enfouis avec une surface TPS (titane plasma-spray) au niveau du maxillaire édenté après une ou deux années de mise en charge. Vingt-cinq patients d'un âge moyen de 64 ans avec des mâchoires supérieures édentées ont reçu de cinq à sept implants et, après un temps de guérison moyen de 6,9 mois, des prothèses fixées vissées à ces implants (ISFP). Un total de 146 implants TPS ITI vis pleines ont été insérés. Le diamètre de 56% des implants étaient plus petits (3,3 mm) que le reste des implants qui avaient un diamètre standard (4,1 mm). La longueur des implants variait de 6 à 16 mm. La quantité osseuse de la majorité des patients était faible et la qualité osseuse pauvre. Des paramètres cliniques ont été enregistrés lors de l'examen initial et après deux années. Des examens radiographiques ont également été effectués à ces moments. Le niveau osseux marginal moyen lors de l'examen initial a été mesuréà un point 4,52 mm (de 1,45 à 7,70 mm : SD 1,2 mm) en apical du point de référence. La perte osseuse moyenne entre l'examen de départ et un an après la mise en charge était de 0,24 mm (SD 0,9; p=0,0002) et entre la première et la deuxième année de 0,15 mm (SD 0,4; p<0,001). Cinq implants ont échoué, dont quatre avant la mise en charge. Un implant a échoué peu de temps après le placement du bridge. Le taux de survie cumulatif après une ou deux années était de 96,6%. Les implants ITI TPS vis pleines avec des prothèses fixées avaient des taux de survie excellents et représentaient un traitement alternatif de qualité pour les patients édentés du maxillaire supérieur. Zusammenfassung Ziele: Die Ueberlebensrate von transmukosalen dentalen ITI-Vollschraubenimplantaten mit einer rauen Oberfläche (titanplasmabeschichtet, TPS) im zahnlosen Oberkiefer nach 1 und 2 Jahren Belastung auszuwerten. Material und Methoden: Fünfundzwanzig Patienten (mittleres Alter 64 Jahre) mit zahnlosen Oberkiefern erhielten 5,7 Implantate und nach einer mittleren Einheilzeit von 6.9 Monaten wurden verschraubte festsitzende implantatgetragene Rekonstruktionen (ISFPs) eingesetzt. Insgesamt wurden 146 ITI-Vollschraubenimplantate eingesetzt. Der Durchmesser von 56% dieser Implantate war kleiner (3.3 mm) als der Standard (4.1 mm) und der Durchmesser der restlichen 44% war Standard. Bei der Mehrzahl der Patienten war die Knochenmenge gering und die Knochenqualität schlecht. Die klinischen Parameter wurden bei der Ausgangsuntersuchung und bei den zwei Nachuntersuchungen in jährlichen Abständen aufgenommen. Bei diesen Untersuchungen wurden auch radiologische Auswertungen durchgeführt. Resultate: Das marginale Knochenniveau zum Zeitpunkt der Ausgangsuntersuchung wurde an einem Punkt 4.52 mm (Bandbreite 1.45,7.70, SD 1.2) apikal des Referenzpunktes gemessen. Der mittlere Knochenverlust von der Ausgangsuntersuchung bis 1 Jahr nach Belastung betrug 0.24 mm (SD 0.9, P=0.002) und zwischen 1 und 2 Jahren nach Belastung betrug er 0.15 mm (SD 0.4, P>0.001). Fünf Implantate zeigten Misserfolge, vier davon waren Frühmisserfolge vor Belastung. Ein Implantat versagte kurz nach der Eingliederung der Brücke. Die kummulative Ueberlebensrate nach 1 und 2 Jahren betrug 96.6%. Schlussfolgerung: ITI TPS Vollschraubenimplantate in Kombination mit festsitzenden Rekonstruktion zeigten erfolgreiche Ueberlebensraten und scheinen eine überlebensfähige Behandlungsalternative im zahnlosen Oberkiefer darzustellen. Resumen Objetivos: Evaluar el índice de supervivencia de implantes ITI roscados macizos no sumergidos con una superficie rugosa (pulverizada con plasma de titanio, TPS) en el maxilar edéntulo tras 1 o 2 años de carga. Material y Métodos: Veinticinco pacientes (edad media 64 años) con maxilares superiores edéntulos recibieron 5,7 implantes y, tras un periodo de cicatrización medio de 6.9 meses, una prótesis fija atornillada implantosoportada (ISFPs). Se insertaron un total de 146 implantes ITI roscados macizos. El diámetro del 56% de los implantes fue menor (3.3 mm) que el estándar (4.1 mm) y el diámetro del resto (44%) fue estándar. La cantidad de hueso de la mayoría de los pacientes fue baja y la calidad de hueso baja. Los parámetros clínicos se registraron al inicio y en los exámenes anuales de seguimiento. También se realizaron exámenes radiológicos y valoraciones en estos momentos. Resultados: El nivel medio de hueso marginal al inicio se midió en un punto 4.52 (rango 1.45,7.70, SD 1.2) apical al punto de referencia. La pérdida de hueso desde el inicio hasta 1 año de carga fue de 0.24 mm (SD 0.9, P=0.002) y de 1 año a 2 años de carga fue de 0.15 mm (SD 0.4, P<0.001). Cinco implantes fracasaron al poco de instalar los puentes. El índice acumulativo de supervivencia fue del 95%. Conclusión: Los implantes roscados macizos ITI TPS en combinación con prótesis fijas tuvieron unos índices de supervivencia exitosos y se encontró que eran una alternativa de tratamiento viable en el maxilar edéntulo. [source]

Implant Stability during Initiation and Resolution of Experimental Periimplantitis: An Experimental Study in the Dog

Fixed Implant-Supported Prostheses in Elderly Patients: A 5-Year Retrospective Study of 133 Edentulous Patients Older than 79 Years

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2004
Ingela Engfors DDS
ABSTRACT Background: An increasing number of elderly patients are treated with implants, but results for the elderly patient in terms of implant success and adaptation to implant prostheses are contradictory. Objective: To retrospectively study the 5-year clinical and radiologic performances of fixed implant-supported prostheses placed in edentulous elderly patients and to compare those results with the results of using similar prostheses in a control group of younger patients. Materials and Methods: The study group comprised 133 edentulous patients who were 80 or more years of age and who were consecutively treated with fixed implant-supported prostheses between January 1986 and August 1998. Altogether 761 Brånemark System® implants (Nobel Biocare AB, Göteborg, Sweden) were placed in 139 edentulous jaws. The control group comprised 115 edentulous patients who were younger than 80 years and who were treated consecutively from March 1996 to November 1997 with similar prostheses. In this group 670 implants were placed in 118 edentulous jaws. Information was collected from all postinsertion visits, including the fifth annual checkup, and changes of marginal bone levels were analyzed from intraoral radiographs. Results: The 5-year cumulative survival rate (CSR) for implants in the maxilla was 93.0% in the study group and 92.6% in the control group; the corresponding CSRs for implants in the mandible were 99.5% and 99.7%. The most common complications for patients in the study group were soft tissue inflammation (mucositis) and cheek and lip biting (p < .05) whereas resin veneer fractures were the most common complications for the control group. Overall 5-year marginal bone loss for the study group was 0.7 mm (standard deviation [SD], 0.45) in the upper jaw and 0.6 mm (SD, 0.50) in the lower jaw. Differences in bone levels and bone loss between the two groups did not reach significant levels (p > .05). Conclusions: Implant treatment in the elderly patients showed treatment results comparable to those observed in younger age groups. However, indications of more problems with adaptation could be observed and were reflected in more postinsertion problems. Cleaning problems and associated soft tissue inflammation (mucositis) as well as tongue, lip, and cheek biting were significantly more often observed among the elderly patients (p < .05). [source]

Maxillary sinus floor elevation using the (transalveolar) osteotome technique with or without grafting material.

CLINICAL ORAL IMPLANTS RESEARCH, Issue 7 2009
Part I: implant survival, patients' perception
Abstract Objectives: To analyze the survival and success rates of implants installed utilizing the (transalveolar) osteotome technique, to compare peri-implant soft tissue parameters and marginal bone levels of osteotome-installed implants with implants placed using standard surgical procedures, and to evaluate patient-centered outcomes. Material and methods: During 2000 to 2005, 252 Straumann® dental implants were inserted in 181 patients. The surgical technique was a modification of the original osteotome technique presented by Summers. In addition to the clinical examination, the patients were asked to give their perception of the surgical procedure, utilizing a visual analogue scale. Results: The cumulative survival rate of the osteotome-installed implants after a mean follow-up time of 3.2 years, was 97.4% (95% confidence intervals: 94.4,98.8%). From the 252 implants inserted, three were lost before loading and another three were lost in the first and second year. According to residual bone height the survival was 91.3% for implant sites with ,4 mm residual bone height, and 90% for sites with 4 mm and 5 mm, when compared with that of 100% in sites with bone height of above 5 mm. According to implant length the survival rates were 100% for 12 mm, 98.7% for 10 mm, 98.7% for 8 mm and only 47.6% for 6 mm implants. Soft tissue parameters (pocket probing depth, probing attachment level, bleeding on probing and marginal bone levels) did not yield any differences between the osteotome-installed and the conventionally placed implants. More than 90% of the patients were satisfied with the implant therapy and would undergo similar therapy again if necessary. The cost associated with implant therapy was considered to be justified. Conclusion: In conclusion, the osteotome technique was a reliable method for implant insertion in the posterior maxilla, especially at sites with 5 mm or more of preoperative residual bone height and a relatively flat sinus floor. [source]

Radiographic evaluation of marginal bone levels adjacent to parallel-screw cylinder machined-neck implants and rough-surfaced microthreaded implants using digitized panoramic radiographs

Placement of Brånemark implants in the maxillary tuber region: anatomical considerations, surgical technique and long-term results

CLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2009
Arne Ridell
Abstract Background: Fixture placement in the tuber area is one way to overcome the problem of insufficient bone volume for routine implant surgery in the posterior maxilla due to severe resorption of jawbone and an extensive enlargement of the maxillary sinus. However, little is known about the long-term results. Purpose: The aim of this study was to retrospectively evaluate the survival rate and marginal bone conditions at fixtures placed in the tuber region of the maxilla. Material and methods: Twenty-one patients previously treated with at least one implant in the tuber region of the maxilla were included in this retrospective analysis. A total of 23 standard Brånemark System fixtures with a turned surface had been surgically placed in the tuber regions and 71 additional implants in adjacent areas to support fixed dental bridges. All implants were allowed to heal for 6,8 months before abutment connection and following prosthetic treatment. The patients were radiographed after 1,12 years for evaluation of marginal bone levels. In addition, the relation between the apex of the fixture in the tuberosity area and the posterior border of the maxilla was measured. Results: Twenty of the 21 patients representing 22 tuber and 64 additional implants were radiographically evaluated. No implants in the tuber areas were lost during the follow-up whereas two fixtures in the anterior region had to be removed, one before loading and the other after 4 years of loading not interfering with the prosthesis stability. The mean marginal bone level at tuber implants was situated on average 1.6 mm (SD 1.1, n=22) from the abutment-fixture junction, whilst the other implants showed an average bone level of 1.9 mm (SD 0.8, n=64). The results were similar when comparing partially and totally edentulous patients. Conclusion: The present retrospective study shows good clinical outcome with standard Brånemark fixtures placed in the tuber region of the posterior maxilla using a two-stage procedure. In appropriate cases where bone of adequate volume and density is available, our data indicate that the technique can be used as an alternative to more extensive surgery and especially to the sinus lift procedure. However, prospective comparative studies are needed in order to evaluate the efficacy of the described technique for this purpose. [source]

In-patient comparison of immediate and conventional loaded implants in mandibular molar sites within 12 months

CLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2008
Güncü, M. Bar
Abstract Objectives: The aim of this prospective clinical study was to evaluate the clinical outcomes of dental implants placed in the mandibular molar sites and immediately functionally restored compared with conventionally loaded controls in an in-patient study. Material and methods: Twenty-four dental implants were placed in 12 patients who had first molar loss bilaterally in the mandibular area. One site of the patient was determined as immediately loaded (IL) and the other side was conventionally loaded (CL). Resonance frequency analyses for implant stability measurements, radiographic examinations for marginal bone levels and peri-implant evaluations were performed during the clinical follow-up appointments within 12 months. Results: During the 12-month follow-up period, only one implant was lost in the IL group. The mean implant stability quotient values were 74.18±5.72 and 75.18±3.51 for Groups IL and CL at surgery, respectively, and the corresponding values were 75.36±5.88 and 75.64±4.84 at 1-year recall, respectively. The difference was not statistically significant between the two groups during the 12-month study period (P>0.05). When peri-implant parameters were evaluated, excellent peri-implant health was demonstrated during the 1-year observation period and all implants showed less than 1 mm of marginal bone resorption during the first year. Conclusions: In the present study, immediate functionally loading did not negatively affect implant stability, marginal bone levels and peri-implant health when compared with conventional loading of single-tooth implants. [source]

The effect of maximum bite force on marginal bone loss in mandibular overdenture treatment: an in vivo study

CLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2005
Frits Van Kampen
Abstract: The impact of bite force on the marginal bone response around implants is a subject of debate. This study focused on the effect of maximum bite force on marginal bone levels in mandibular implant overdenture treatment. In addition, the effect of the sequence of 3 different loading conditions on marginal bone loss was evaluated in vivo. The patient population consisted of a group of 18 patients. They received 2 implants in the mandible and a new denture without attachments during the period of submerged implant healing. After second stage surgery, the denture was provided with a ball, magnet or bar-clip attachment. There was a transition of attachment type after 3 and 6 months of function. The sequence in which the attachments were used was randomised. Radiographic marginal bone loss was measured after the period of submerged implant healing and after 3, 6 and 9 months of functional implant loading. Maximum bite force measurements were obtained just prior to second stage surgery with the new denture without attachment. Bite force measurements were also obtained after 3, 6 and 9 months of loading with the implant-retained overdenture. The latter 3 values were averaged. The mean bone loss during the period of submerged healing and during functional loading was 1.7 mm (0.7 mm) and 1.3 mm (0.6 mm), respectively. A relationship between maximum bite force during the period of submerged healing or during the period of functional loading on the one hand and the amount of marginal bone loss on the other could not be demonstrated. The sequence in which the different attachment types were used did not influence the observed amount of marginal bone loss. Résumé L'impact des forces d'occlusion sur la réponse de l'os marginal autour d'implants est sujet à débat. Cette étude s'est centrée sur l'effet de la force d'occlusion maximale sur les niveaux d'os marginaux dans le traitement de prothèses mandibulaires sur implants. De plus l'effet de la séquence de trois conditions de mise en charge différentes sur la perte osseuse marginale a étéévaluée in vivo. Les patients étaient au nombre de douze. Ils avaient reçu deux implants dans la mandibule et une nouvelle prothèse sans attache durant la période de guérison lorsque les implants étaient enfouis. Après la deuxième chirurgie, la prothèse amovible a été utilisée avec une boule, un aimant ou une barre comme attache. Il y avait une transition du type d'attache après trois et six mois de mise en fonction. La séquence suivant laquelle les attaches étaient utilisées était effectuée au hasard. La perte osseuse marginale radiographique a été mesurée après la période de guérison des implants enfouis et après trois, six et neuf mois de mise en fonction. Les mesures de force d'occlusion maximale ont été obtenues juste avant la deuxième chirurgie avec la nouvelle prothèse sans attache. Les mesures de forces d'occlusion ont également été obtenues après trois, six et neuf mois de mise en charge lorsque les implants retenaient la prothèse. Les trois dernières valeurs ont été mélangées. Les pertes osseuses moyennes durant la période de guérison avec les implants enfouis et durant la charge de mise en fonction étaient respectivement de 1,7±0,7 mm et de 1,3±0,6 mm. Une relation entre la force d'occlusion maximale durant la période de guérison avec les implants enfouis ou durant la période de mise en charge fonctionnelle d'une part et la quantité de perte osseuse marginale d'autre part n'a pas pûêtre démontrée. La séquence dans laquelle les différents types d'attache ont été utilisés n'influençaient pas la quantité observée de perte osseuse marginale. Zusammenfassung Der Einfluss der Kaukraft auf die Reaktion des marginalen Knochens um Implantate wir immer wieder diskutiert. Diese Studie konzentrierte sich auf den Einfluss der maximalen Kaukraft auf das marginale Knochenniveau bei Unterkieferimplantaten und Hybridprothesen. Zusätzlich untersuchte man in vivo den Einfluss von drei Phasen mit unterschiedlichen Belastungstypen auf den marginalen Knochenverlust. Es handelte sich um eine Gruppe von 18 Probanden. Alle erhielten zwei Implantate im Unterkiefer und eine neue Prothese, während der submukösen Einheilphase der Implantate noch ohne Retentionselemente. Nach der chirurgischen Freilegung der Implantate fixierte man die Prothesen mit einem Kugelanker, einem Magneten oder einem Steg. Der Wechsel zum nächsten Retentionstyp erfolgte jeweils nach 3 bis 6 Monaten normaler Funktion der Prothesen. Die Abfolge, in welcher man die Retentionselemente einsetzte, wurde zufällig ausgewählt. Den radiologischen marginalen Knochenverlust mass man nach der submukösen Einheilphase der Implantate, sowie nach 3, 6 und 9 Monate einer funktionellen Implantatbelastung. Die maximale Kaukraft wurde genau vor der chirurgischen Freilegung der Implantate mit der neuen Prothese und ohne Attachments gemessen. Zusätzliche Messungen der Kaukraft erfolgten 3, 6 und 9 Monate nach funktioneller Belastung der implantatgetragenen Hybridprothesen. Die letzten drei Werte wurden gemittelt. Der mittlere Knochenverlust während der submukösen Einheilphase betrug 1.7 mm (0.7 mm) und während der funktionellen Belastung 1.3 mm (0.6 mm). Eine Beziehung zwischen der maximalen Kaukraft während der submukösen Einheilung oder während der funktionellen Belastung auf der einen Seite und dem marginalen Knochenverlust auf der anderen Seite konnte nicht gezeigt werden. Die Abfolge, in der die verschiedenen Retentionstypen verwendet wurden, beeinflusste das Ausmass des beobachteten marginalen Knochenverlustes nicht. Resumen El impacto de la fuerza de mordida sobre la respuesta del hueso marginal alrededor de los implantes es motivo de debate. Este estudio está enfocado sobre el efecto de la fuerza de máxima mordida en los niveles de hueso marginal en el tratamiento de sobredentadura mandibular implantosoportada. Además, se evaluó el efecto de la secuencia de 3 condiciones diferentes de carga sobre la pérdida de hueso marginal in vivo. La población de4 pacientes consistió en un grupo de 18 pacientes. Estos recibieron 2 implantes en la mandíbula y una nueva dentadura sin anclajes durante el periodo de cicatrización sumergida de los implantes. Tras la cirugía de segunda fase se suministró una dentadura con anclajes de bola, imanes o barra. Se realizó un cambio en el sistema de anclaje tras 3 y 6 meses en función. La secuencia en la que se emplearon los anclajes fue aleatoria. Se midió la pérdida de hueso marginal radiográfica tras un periodo de cicatrización sumergida y tras 3, 6 y 9 meses de carga funcional de los implantes con la sobredentadura implantosoportada. Los últimos 3 valores se promediaron. La pérdida de hueso media durante el periodo de cicatrización sumergida y durante la carga funcional fue de 1.7 mm (0.7 mm) y 1.3 mm (0.6 mm) respectivamente. No se pudo demostrar una relación entre la fuerza de máxima mordida durante el periodo de cicatrización sumergida o durante el periodo de carga funcional por un lado y la cantidad de pérdida de hueso marginal por otro. La secuencia en la que se emplearon los diferentes tipos de anclajes no influyó en la cantidad de la cantidad de pérdida de hueso marginal observado. [source]