Brånemark Implants (brånemark + implant)

Distribution by Scientific Domains


Selected Abstracts


One-Year Prospective Three-Center Study Comparing the Outcome of a "Soft Bone Implant" (Prototype Mk IV) and the Standard Brånemark Implant

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2003
Bertil Friberg DDS
ABSTRACT Background: Oral implant treatment ad modum Brånemark has been used for decades in the rehabilitation of edentate and partially dentate patients. Posterior jaw regions frequently exhibit bone of poor texture, and it is often difficult to obtain primary stability. Thus, it may prove beneficial to deviate from the original protocol and to use implants with a modified design, for example, with a slightly tapered geometry. Purpose: The purpose of the investigation was to compare the early behavior of a modified (prototype Mk IV, Branemark System, Nobel Biocare AB, Gothenburg, Sweden; test) implant with that of the standard Brånemark implant (control) in regions of mainly type 4 bone. Materials and Methods: Three Swedish centers participated, and a total of 44 patients were treated with oral implants for 39 maxillas and 5 mandibles. The study focused on the most distal right and left implant sites (88 implants), which were randomized to receive either a test or a control implant. Various parameters were recorded, such as registered insertion torque (OsseoCare, Nobel Biocare AB), wobbling during insertion, primary and secondary stability (as measured with resonance frequency), and marginal bone loss. The implants were followed up for 1 year. Results.: The test implant more frequently required a higher insertion torque and showed a significantly higher primary stability than the control implant. This difference in stability leveled out over time, and test and control implants exhibited similar secondary stability at abutment operation and at the 1-year visit. Wobbling during insertion was rarely recorded for either of the implant designs. The 1-year cumulative success rate was 93.1% for test implants and 88.4% for control implants. Conclusions: The modified implant design resulted in an increased primary stability, which may be important when placing implants in jaw regions of type 4 bone. However, independent of the achieved primary stability, successful implants tended to approach similar secondary stability in the two designs tested. [source]


Fixed Mandibular Restorations on Three Early-Loaded Regular Platform Brånemark Implants

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2001
Hugo De Bruyn DDS
ABSTRACT Background: Originally, the Brånemark System was used as a two-stage surgical procedure. Comparable clinical results have made one-stage and early-loading concepts possible alternatives in the edentulous mandible. From the patient's point of view, the financial aspect of implant treatment is important. In an attempt to decrease financial burden, the reduction of surgical interventions and reduction of the number of implants could be considered. Purpose: This prospective multicenter study evaluated (1) the 1-and 3-year success rates of implants loaded within 1 month after one-stage surgery with a fixed 10- to 12-unit bridge on three regular platform Brånemark System implants in the mandible, (2) the outcome of the prosthetic treatment, and (3) the opinion of patients regarding the treatment procedure. Materials and Methods: Of 20 patients, 19 received five implants in the mandible, of which three were functionally loaded with the one-stage technique (group 1). The loaded implants were inserted in a tripodal position, one implant in the symphysis and two located anterior of the mental foramen in the bicuspid area. Two additional implants were inserted for safety reasons but were not intended to be included in the restoration. These two additional implants served as either an unloaded one-stage control implant (group 2) or an unloaded control implant installed with the submerged technique (group 3). Immediately after surgery, the implants were loaded with a relined denture. The patients received a 10- to 12-unit prosthetic reconstruction an average 31 days (range, 4-53 d) after surgery. Implant stability was clinically checked at 3, 12, and 36 months. Radiographs were taken at corresponding follow-up visits to calculate bone-to-implant level and marginal bone resorption. Results: Six of 60 functionally loaded implants (10%) and 3 of 20 prostheses (15%) failed within the first year. The cumulative implant failure rate in group 1, both after 1 and after 3 years, was 9.5%. No implant failure occurred in the control groups 2 and 3. The average marginal bone level measured at 1 and 3 years was 1.6 mm (SD = 0.8 mm) and 2.1 mm (SD = 0.2 mm), respectively, for group 1; 1.5 mm (SD = 1.3 mm) and 2.4 mm (SD = 0.6 mm), respectively, for group 2; 0.8 mm (SD = 1.4 mm) and 0.7 mm (SD = 0.9 mm), respectively, for group 3. Conclusions: The results of treatment using three regular platform Brånemark System implants supporting a fixed mandibular arch reconstruction were less favorable than the outcome that can be expected with a standard four- to six-implant with one-stage surgery. [source]


One-Year Prospective Three-Center Study Comparing the Outcome of a "Soft Bone Implant" (Prototype Mk IV) and the Standard Brånemark Implant

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2003
Bertil Friberg DDS
ABSTRACT Background: Oral implant treatment ad modum Brånemark has been used for decades in the rehabilitation of edentate and partially dentate patients. Posterior jaw regions frequently exhibit bone of poor texture, and it is often difficult to obtain primary stability. Thus, it may prove beneficial to deviate from the original protocol and to use implants with a modified design, for example, with a slightly tapered geometry. Purpose: The purpose of the investigation was to compare the early behavior of a modified (prototype Mk IV, Branemark System, Nobel Biocare AB, Gothenburg, Sweden; test) implant with that of the standard Brånemark implant (control) in regions of mainly type 4 bone. Materials and Methods: Three Swedish centers participated, and a total of 44 patients were treated with oral implants for 39 maxillas and 5 mandibles. The study focused on the most distal right and left implant sites (88 implants), which were randomized to receive either a test or a control implant. Various parameters were recorded, such as registered insertion torque (OsseoCare, Nobel Biocare AB), wobbling during insertion, primary and secondary stability (as measured with resonance frequency), and marginal bone loss. The implants were followed up for 1 year. Results.: The test implant more frequently required a higher insertion torque and showed a significantly higher primary stability than the control implant. This difference in stability leveled out over time, and test and control implants exhibited similar secondary stability at abutment operation and at the 1-year visit. Wobbling during insertion was rarely recorded for either of the implant designs. The 1-year cumulative success rate was 93.1% for test implants and 88.4% for control implants. Conclusions: The modified implant design resulted in an increased primary stability, which may be important when placing implants in jaw regions of type 4 bone. However, independent of the achieved primary stability, successful implants tended to approach similar secondary stability in the two designs tested. [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]


Short Implants Placed One-Stage in Maxillae and Mandibles: A Retrospective Clinical Study with 1 to 9 Years of Follow-Up

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2007
Paulo Maló DDS
ABSTRACT Background:, The use of short implants (7,8.5 mm) has historically been associated with lower survival rates than for longer implants. However, recent clinical studies indicate that short implants may support most prosthetic restorations quite adequately, but still clinical documentation is sparse. Purpose:, The purpose of this study was to report on the placement of short Brånemark implants, testing the hypothesis that short implants in atrophied jaws might give similar long-term implant survival rates as longer implants used in larger bone volumes. Materials and Methods:, This retrospective clinical study included 237 consecutively treated patients with 408 short Brånemark implants supporting 151 fixed prostheses. One hundred thirty-one of the implants were 7-mm long, and 277 were 8.5-mm long. Final abutments were delivered at the time of surgery, and final prostheses were delivered 4 to 6 months later. Results:, One hundred and twenty six of the 7-mm implants (96%) have passed the 1-year follow-up; 110 (84%), the 2-year follow-up; and 88 (67%), the 5-year follow-up. Five implants failed in four patients before the 6-month follow-up, giving a cumulative survival rate of 96.2% at 5 years. The average bone resorption was 1 mm (SD=0.6 mm) after the first year and 1.8 mm (SD=0.8 mm) after the fifth year of function. Two hundred sixty nine of the 8.5-mm implants (97%) have passed the 1-year follow-up; 220 (79%), the 2-year follow-up; and 142 (51%), the 5-year follow-up. Eight implants failed in seven patients before the 6-month follow-up, giving a cumulative survival rate of 97.1% at 5 years. The average bone resorption was 1.3 mm (SD=0.8 mm) after the first year and 2.2 mm (SD=0.9 mm) after the fifth year of function. Conclusions:, The cumulative survival rates of 96.2 and 97.1% at 5 years for implants of 7.0- and 8.5-mm length, respectively, indicate that one-stage short Brånemark implants used in both jaws is a viable concept. [source]


Immediate Loading of Brånemark System Implants®: A Comparison Between TiUniteTM and Turned Implants Placed in the Anterior Mandible

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2006
Kjell-Krister Fröberg DDS
ABSTRACT Purpose:, The aim of the present study was to compare the treatment outcome of TiUniteTM - and turned-surfaced Brånemark System® (Nobel Biocare AB, Göteborg, Sweden) implants when applying immediate loading of cross-arch designed fixed partial dentures in the anterior mandible. Materials and Methods:, Fifteen patients with edentulous mandibles participated in the study. In one half of the jaw, between the exit of the nerve-vessel bundle and the midline, one type of implant was placed and in the remaining half the other type. The implants were loaded the day of surgery via a fixed, temporary supra-construction. Ten days later, the permanent one was screw retained to the implant pillars. Results:, The present 18-month clinical trial failed to demonstrate any differences regarding healing and cumulative success rate of an an-oxidized implant surface (TiUnite) and a turned (turned) one when implants in the anterior mandible were exposed to functional load within 24 hours after installation. Conclusion:, A high predictability regarding the treatment outcome for immediately loaded Brånemark implants in the anterior mandible was observed. Furthermore, no difference between the traditional turned and the an-oxidized implant surface (TiUnite) could be observed. However, it has to be stressed that all implants (irrespective of surface) were placed in the anterior mandible and also that all the patients demonstrated a high level of oral hygiene. [source]


A 3-Year Retrospective Study of Cresco Frameworks: Preload and Complications

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2005
Lars Hjalmarsson DDS
ABSTRACT Purpose: The aim of this retrospective clinical study was to evaluate the clinical outcome of fixed implant-supported complete prostheses on Astra or Brånemark implants when using either conventional cast frameworks or frameworks produced according to the Cresco Ti Precision method® (Cresco Ti Systems Sàri., Lausanne, Switzerland). Materials and Methods: Forty-six patients treated 3 years previously were divided into four groups according to implant system and framework design. Clinical examinations were performed and case records were scrutinized. The stability for each prosthesis retention screw was recorded as the torque profile and was monitored using the Osseocare® torque controller (Nobel Biocare AB, Göteborg, Sweden). Complications in association with implants and superstructures were registered. Patient opinions were recorded. The significance level was set to 5%. Results: The Astra-Cresco group demonstrated a lower degree of prosthesis retention screw stability compared with the Astra group. No differences among the four groups were seen regarding plaque, bleeding on probing, or marginal bone resorption. The Brånemark group (Brånemark System®, Nobel Biocare AB) demonstrated more mechanical complications than the Brånemark-Cresco group. Mobile prostheses were found in the Brånemark and the Astra-Cresco groups. Fracture of veneer was seen in 20% of the prostheses and was more frequently found in the groups with mobile prostheses. Sixty percent of the prostheses showed reactions in the surrounding soft tissues. The most common reaction was mucosal proliferation. No differences were detected in the patients' opinions. Conclusion: Within the limitations of this retrospective study, the following can be concluded: (1) compared with conventional frameworks, the Cresco distortion correction method does not provide a better clinical outcome after prosthesis connection in patients with fixed implant-supported complete prostheses; and (2) the two framework-producing methods behave differently on Astra implants compared with Brånemark implants concerning prosthesis retention screw stability, mechanical and biologic complications, and reactions in patients with fixed implant-supported complete prostheses. [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]


Teeth in a Day® for the Maxilla and Mandible: Case Report

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2003
Thomas J. Balshi DOS
ABSTRACT Background: A growing body of evidence indicates that successful osseointegration of dental implants can take place in the wake of immediate loading, providing that bone quality and quantity are adequate, and patients follow postsurgical instructions carefully. Purpose: The goal of this report is to demonstrate the efficient treatment protocol based on immediate loading for both the maxilla and mandible, including extraction site locations. Materials and Methods: Following extraction of the remaining anterior mandibular teeth, 18 Brånemark implants (Nobel Biocare AB, Gothenburg, Sweden), including two zygoma and two pterygoid implants, were installed in both arches in accordance with the Teeth in a Day protocol developed by the authors 9 years ago. This protocol uses an acrylic screw-retained prosthesis, with steel prosthetic copings embedded, supported by full-size Brånemark implants to prevent micromotion at the bone-to-implant interface. Results: Only 1 of the 18 immediately loaded implants failed to osseointegrate. Three years after completion of treatment, the patient reported functioning well with no complications. Conclusions: When appropriate subjects are selected, the Teeth in a Day protocol offers patients a number of significant advantages, including condensed treatment time, reduced postsurgical discomfort, and almost instantaneous improvement in speech and masticatory function, esthetics, and patient self-image. [source]


Clinical and Radiographic Evaluation of the 5-mm Diameter Regular-Platform Brånemark Fixture:2- to 5-Year Follow-up

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2002
DSc Odont, Georges Tawil DDS
ABSTRACT Purpose: The purpose of this study was to report the clinical results obtained with 5-mm diameter regular-platform Brånemark implants after 2 to 5 years of follow-up. A secondary aim was to compare the clinical outcome to that of adjacently placed standard 3.75-mm fixtures in the same patients under the same operative condition and in the same prosthetic construction. Materials and Methods: Sixty patients, with a mean age of 54 years, received a total of 97 5-mm diameter regular-platform fixtures. The majority of the implants were placed at molar sites. In 41 of the patients, 53 5-mm diameter implants were placed adjacent to 62 standard 3.75-mm diameter fixtures in the same prosthetic reconstruction. All implants were submerged for an average period of 4 to 6 months. Abutment connection was done according to standard protocol. The prosthetic treatment consisted of freestanding fixed bridges. Results: The cumulative survival rate of the 5-mm diameter implants loaded for a period of 2 to 5 years was 96.9%. Only three implants failed. They were placed in type 4 bone in the posterior maxilla. Bone loss over the first year was 0.70 mm and over a 3-year period 0.81 mm. Implants placed in type 4 bone showed significantly higher bone loss. No difference in the resorption rate could be found between the maxillary and the mandibular implants or between the various implant lengths. There was no significant difference between the bone loss around the 5-mm diameter fixtures and the adjacent 3.75-mm diameter standard fixtures. Conclusion: The present study demonstrated a high predictability of 5-mm diameter regular-platform implants when placed in the posterior maxilla and mandible. [source]


Effects of Implant Design and Surface on Bone Regeneration and Implant Stability: An Experimental Study in the Dog Mandible

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2001
Lars Rasmusson DMD
ABSTRACT Background: Previous experimental studies have shown a higher degree of bone-implant contact for surface-enlarged implants compared with machined implants. Yet, there is insufficient evidence that such implants show higher stability and an increased survival rate. Purpose: The purpose of this investigation was to study the integration and stability of grit-blasted implants with retention elements on the implant neck, with and without marginal bone defects, compared with machined implants without retention elements. Materials and Methods: After tooth extraction of the mandibular premolars in six dogs, two grit-blasted, partly microthreaded Astra Tech implants and one standard Branemark implant were bilaterally placed in each dog. On one side, 3 ± 3 mm large buccal defects were created, to expose three to four implant threads. The contralateral side served as control, and no defects were made. The animals were sacrificed after 4 months of healing. Implant stability was measured using resonance frequency analysis at implant installation and after 4 months of healing. Histologic and histomorpho-metric evaluation was made after 4 months of healing. Results: Resonance frequency analysis indicated that all implants in the test and control groups were osseointegrated after 4 months, with a tendency toward higher implant stability for the Astra Tech implants. There was a statistically significant higher increase in resonance frequency for the Astra test implants compared with their corresponding controls. Histology and histomorphometry showed well-integrated implants with varying degrees of bone repair at the defect sites. The greater bone-implant contact for the Astra implants was statistically significant. No significant difference between the implants in amount of bone filling the threads was recorded. Conclusions: The Astra Tech implants tested showed a higher degree of bone,implant contact and higher level of bone regenerated at defect sites compared with the Brånemark implants. Resonance frequency analysis demonstrated a significantly higher increase in the Astra test implants compared with their control groups than did the Brånemark test implants versus their controls. [source]


One-Year Prospective Evaluation of the Early Loading of Unsplinted Conical Brånemark Fixtures with Mandibular Overdentures Immediately following Surgery

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2001
Alan G.T. Payne BDS, FCD(SA), MDent
ABSTRACT Background: Prospective evaluation of the early loading of unsplinted Branemark implants with mandibular over-dentures opposing conventional dentures is not evident in the implant-related literature. Purpose: To clinically evaluate progressive and early loading of 20 unsplinted conical Brånemark implants in edentulous mandibles with overdentures. Materials and Methods: Ten edentulous patients all had two conical Brånemark implants placed in the anterior mandible with mandatory primary stability with bicortical anchorage. Ball abutment connection was performed simultaneously. Previously constructed conventional mandibular dentures were temporarily relined with tissue conditioner postoperatively and worn with moderation for the first 2 weeks to allow progressive loading. Early loading of the implants followed after 2 weeks, with inclusion of the respective matrices in the mandibular dentures, using a definitive reline procedure. Results: All patients successfully functioned with their mandibular implant overdentures from 2 to 52 weeks postoperatively. Mean marginal bone loss was within established criteria for success:0.22 mm (SD = 0.48 mm) mesially and 0.30 mm (SD = 0.39 mm) distally on the conical implants. Mobility tests using the Periotest instrument became more negative, although not at statistically significant levels. Difficulties in the management of the peri-implant mucosa between surgery and loading at 2 weeks were observed in 40% of the patients. Conclusions: These preliminary 1-year results show that successful early loading of unsplinted conical Brånemark implants with mandibular overdentures is possible. [source]


Long-term Follow-up of Severely Atrophic Edentulous Mandibles Reconstructed with Short Branemark Implants

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2000
Bertil Friberg DDS
ABSTRACT Background: Oral implant treatment (Brånemark System) of edentulous mandibles has been presented in numerous studies. However, with regard to the severely atrophic lower jaw, no long-term follow-up studies with solely short implants are available. Purpose: The purpose of the present investigation was to retrospectively follow the long-term treatment outcome of patients with severely resorbed edentulous mandibles being subjected to oral implant placement with short (6,7 mm) Brånemark implants. Materials and Methods: A total of 247 standard (7 mm long, 3.75 mm) and 13 wide (6 mm long, 5 mm) implants were inserted in 49 patients, all of whom exhibited severe resorption of edentate mandibles. Fixed implant-supported prostheses were manufactured for 45 patients, whereas 4 patients received overdentures. The patients were followed for a mean period of 8 years (range, 1,14 yr). Results: Seventeen implants failed during the study period (cumulative implant survival rate 95.5% at 5-yr and 92.3% at 10-yr follow-up). Implant-supported constructions were worn continuously throughout the investigation by all study subjects. Marginal bone loss, measured after 1, 5, and 10 years of function, concurred with studies of Brånemark implants placed in more voluminous mandibles. No major clinical or construction complications occurred in the followed patients. Conclusions: The outcome of the present study showed that placement of short Brånemark implants without the use of bone grafting procedures for reconstruction of severely atrophic edentulous mandibles is a highly predictable treatment procedure. [source]


A Clinical, Radiographic, and Microbiologic Comparison of Astra Tech and Brånemark Single Tooth Implants

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2000
Lorena Puchades-Roman BDS, M Clin Dent
ABSTRACT Background: The soft tissues around single tooth implants differ fundamentally from the gingiva around natural teeth. There are very limited data comparing soft tissues around different implant systems. Aim: To assess whether the design characteristics of dental implants, particularly the implant-abutment junction, may affect the dimensions and health of the peri-implant soft tissues and radiographic bone levels. Subjects and Method: Fifteen Astra Tech and 15 Brånemark single tooth implants that had been in function for a minimum of 2 years in 30 partially dentate subjects were examined for plaque accumulation, probing depth, and bleeding on probing and compared to contralateral healthy teeth. Standardized radiographs were taken to measure the most coronal bone to implant contact on the mesial and distal surfaces. In addition, samples of subgingival plaque were taken on paper points and examined by darkfield microscopy. Results: Significantly higher mean probing depths (p < .001) and higher mean percentage of spirochetes (p= .003) were found at implants compared to teeth. In this sample, the Brånemark implants had significantly higher probing depths than the Astra Tech implants (median and interquartile range: Astra Tech 2.7 mm [2,3], Brånemark 3.3 mm [3,3.7] p= .026) and the most coronal bone to implant contact was closer to the implant,abutment junction in the Astra Tech implants (Astra Tech 0.6 mm [0.2,0.9], Brånemark 1.6 mm [1.4,2.0]. p < .001). Conclusion: Although there were statistically significant differences between the two implant systems, the clinical differences were small and probably reflect differences in the biologic width in relation to the location and design of the implant-abutment junction. [source]


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]


Influence of implant taper on the primary and secondary stability of osseointegrated titanium implants

CLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2004
Dominic O'Sullivan
Abstract Objectives: The study presented was designed to analyse the mechanical performance and the primary and secondary stability characteristics of endosseous titanium implants with 1° (EXP1) and 2° (EXP2) of taper when compared with the standard Brånemark design (Nobel Biocare AB, Gothenburg, Sweden). Materials and methods: One pair of 10 mm EXP1 and control implants were placed in the femoral condyles of six rabbits. Paired 6 mm EXP1 and control implants and 6 mm EXP2 and control implants were placed in the tibial metaphysis. The control implants used were 4 mm diameter standard Brånemark implants, the same length as the test implants. At placement, insertion torque (IT) and resonance frequency analysis (RFA) measurements were performed. Six weeks postoperatively when the animals were killed, RFA and removal torque (RT) measurements were made. Results: At placement, significantly higher IT was needed to insert the EXP implants compared with the controls. RFA values were significantly higher for EXP1 implants placed in the tibia but not in the femur. In pooling data from the femur and tibia there was a significant difference. The EXP2 implants failed to insert fully and demonstrated a lower RFA value than may have been expected due to the exposed threads, although this difference was not statistically significant. Conclusions: The results from the present study showed that 1° of taper results in a better primary stability compared with the standard Brånemark design. There was no evidence that the tapered design caused negative bone tissue reactions. All the implants gained in stability during the healing period. Résumé L'étude présente a été effectuée pour analyser la performance mécanique et les caractéristiques de stabilité primaire et secondaire d'implants endoosseux en titane avec un taper (fuselé) 1° (EXP1) et 2 (EXP 2) comparés au modèle ad modum Branemark® standard. Une paire d'implants contrôles et un EXP1 de 10 mm ont été placés dans les condyles fémoraux de six lapins. Des paires d'implants contrôles et EXP1 de 6 mm et des implants contrôles et EXP2 de 6 mm ont été placés dans les métaphyses tibiales. Les implants contrôles utilisés avaient un diamètre standard de 4 mm, la même longueur que les implants tests. Lors du placement, des mesures de force d'insertion (IT) et d'analyse de fréquence de résonnance (RFA) ont été effectuées. Six semaines après l'opération lorsque les animaux ont été euthanasiés, les mesures RFA et les forces d'enlèvement (RT) ont été relevées. Lors du placement un IT significativement plus important a été nécessaire pour insérer les implants EXP1 comparé au contrôle. Les valeurs RFA étaient significativement plus importantes pour les implants EXP1 placés dans le tibia mais pas dans le fémur. En rassemblant les données du fémur et du tibia il y avait une différence significative. Les implants EXP2 ne parvenaient pas àêtre insérés à fond et ont montré une valeur RFA inférieure qui n'était pas inattendue vu les filetages exposés bien que ces différences n'étaient pas statistiquement significatives. Les résultats de l'étude présente ont montré que le taper 1 résultait en une stabilité primaire supérieure comparé au modèle ad modum Branemark® standard. Il n'y avait aucun signe que ce nouveau modèle causait des réactions tissulaires osseuses négatives. Tous les implants ont gagné en stabilité durant leur période de guérison. Zusammenfassung Ziele: Die hier vorgestellte Studie hatte zum Ziel, das mechanische Verhalten und die Charakteristika von Primär- und Sekundärstabilität bei enossalen Implantaten mit einer Gewindeneigung von 1° (EXP1) und von 2° (EXP2) zu untersuchen. Man verglich die Daten mit dem Standarddesign von Brånemark (Nobel Biocare AB, Gothenburg, Schweden). Material und Methode: Man implantierte ein Päärchen von 10mm-Implantaten (EXP1 und Kontrollimplantat) in die Femurkondylen von 6 Kaninchen. Zwei weitere Päärchen von 6mm-Implantaten (EXP1 und Kontrollimplantat, sowie EXP2 und Kontrollimplantat) implantierte man in die Metaphyse der Tibia. Bei den Kontrollimplantaten handelte es sich um Standardtypen von Brånemark mit einem Durchmesser von 4 Millimetern und derselben Länge wie die Testimplantate. Bei der Implantation mass man die Kraft, die es zu Eindrehen der Implantate brauchte (IT) und führte Messungen mit der Resonanzfrequenzanalyse (RFA) durch. Sechs Wochen nach der Operation wurden die Tiere geopfert, die RFA erneut durchgeführt und anschliessend der Ausdrehwiderstand (RT) bestimmt. Resultate: Bei der Implantation brauchte es signifikant grössere IT um die EXP-Implantate einzusetzen, als bei den Kontrollimplantaten. Die RFA-Werte waren bei den EXP1-Implantaten, die in die Tibia geschraubt worden waren, signifikant höher. Dies gilt aber nicht für die in den Femur geschraubten Implantate. Wurden die Daten vom Femur mit denen der Tibia verglichen, so erkannte man signifikante Unterschiede. Die EXP2-Implantate konnten nicht vollständig inseriert werden und zeigten auch tiefere RFA-Werte, als man den freiliegenden Schraubenwindungen entsprechend erwarten könnte. Diese Unterschiede waren aber nicht statistisch signifikant. Zusammenfassung: Die Resultate dieser Studie zeigten, das Schraubenwindungen mit 1° Steigung verglichen mit dem Standarddesign von Brånemark eine bessere Primärstabilität erzielten. Man fand andererseits keine Beweise, dass sich dieses neue Design der Schraubenwindungen negativ auf die Reaktion des Knochengewebes auswirkt. Alle Implantate gewannen während in der Heilphase an Stabilität dazu. Resumen Objetivos: El estudio presentado se diseñó para analizar el rendimiento mecánico y las características de estabilidad primaria y secundaria de implantes endoóseos de titanio con 1o (EXP1) y 2o (EXP 2) de autoroscado al compararlos con el diseño estándar de Brånemark (Nobel Biocare AB, Gothenburg, Suecia). Material y Métodos: Se colocó una pareja de implantes de 10 mm EXP1 y de control en los cóndilos femorales de 6 conejos. Se colocaron pareja de implantes de 6 mm EXP1 y de control y de 6 mm EXP2 y de control en la metáfisis tibial. Los implantes de control utilizados fueron Brånemark estándar de 4 mm de diámetro. A la colocación, se llevaron a cabo mediciones del torque de inserción (IT) y del análisis de la frecuencia de resonancia (RFA). Los animales se sacrificaron a las seis semanas de la operación, y se tomaron medidas del torque de remoción (RT). Resultados: Al colocarse, se necesitó un IT significativamente mas alto para insertar los implantes EXP en comparación con los de control. Los valores RFA fueron significativamente mas altos para implantes EXP1 colocados en la tibia pero no en el fémur. Confrontando los datos del fémur y de la tibia apareció una diferencia significativa. Los implantes EXP2 fracasaron en insertarse completamente y demostraron un menor valor de RFA del que se podía esperar debido a la exposición de las roscas, aunque esta diferencia no fue estadísticamente significativa. Conclusiones: Los resultados del presente estudio mostraron que 1o de autoroscado resultan en una mejor estabilidad primaria comparada con el diseño estándar de Brånemark. No hubo evidencia de que el diseño de autoroscado causara reacciones negativas en el tejido óseo. Todos los implantes ganaron estabilidad durante el periodo de cicatrización. [source]