Brånemark System (brånemark + system)

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Terms modified by Brånemark System

  • brånemark system implant

  • Selected Abstracts

    Bone reactions to longstanding functional load at implants: an experimental study in dogs

    T. Berglundh
    Abstract Objectives: The aims of the present investigation were (i) to study marginal bone level alterations following implant installation, abutment connection and functional loading and (ii) to analyse bone tissue reactions to functional load. Material and Methods: Six beagle dogs, about 1-year old, were used. All mandibular pre-molars were extracted. Three months later four implants of the Astra Tech Implants® Dental System were installed in one side of the mandible and four standard fixtures of the Brånemark System® were placed in the contralateral side of the mandible. Abutment connection was performed 3 months later and a plaque control programme was initiated. Three months after abutment connection fixed partial dentures (FPDs) made in gold were cemented to the maxillary canines and pre-molars. FPDs were also connected to the three posterior implants in each side of the mandible, while the mesial implant in each side was used as an unloaded control. Radiographs were obtained from all implant sites following implant installation, abutment connection and FPD placement. Ten months after the FPD placement the radiographic examination was repeated. The animals were sacrificed and biopsies from all implant sites were obtained and prepared for histological analysis. Results: The radiographic analysis revealed that largest amount of bone loss occurred following implant installation and abutment connection and that this loss was more pronounced at Brånemark than at Astra implants. The bone level alterations that were observed at implants exposed to 10 months of functional load in both implant systems were small and did not differ from control sites. The histological analysis revealed that implants exposed to functional load exhibited a higher degree of bone-to-implant contact than control implants in both implant systems. Conclusion: It is suggested that functional load at implants may enhance osseointegration and does not result in marginal bone loss. [source]

    Immunohistochemical characteristics of inflammatory lesions at implants

    Federico Gualini
    Abstract Objective: The aim of the present investigation was to study some immunohistochemical features of peri-implant mucositis and peri-implantitis lesions. Materials and methods: Two groups of subjects (Groups A and B) were included. Group A consisted of 10 partially edentulous subjects (eight females and two males; 45,72 years of age) who had been restored with implants (Brånemark System®, Nobel Biocare AB, Göteborg, Sweden). The implants had been in function between 2 and 5 years. In each subject, one implant site demonstrating signs of peri-implant mucositis, i.e. soft tissue inflammation but no bone loss, was selected. The site was anaesthetized and a soft tissue biopsy was collected. In Group B, six subjects were included. They had been restored with implants (Brånemark System®, Nobel Biocare AB, Göteborg, Sweden) between 5 and 11 years prior to the current study. In each individual ,,1 implant site exhibited signs of peri-implantitis and was selected for biopsy. All sites of peri-implantitis had (i) a history of continuous marginal bone loss (assessed in radiographs), (ii) clinical symptoms of soft tissue inflammation (bleeding on probing and suppuration) but (iii) no implant mobility. From each selected peri-implantitis site a 4 × 4 mm large soft tissue biopsy was obtained. All specimens were snap frozen and prepared for immunohistochemical analysis regarding the proportions of cells positive for the CD3, CD4, CD8, CD19 and elastase markers. Results: Peri-implantitis lesions were considerably larger and contained significantly greater proportions of B cells (CD19+) and elastase-positive cells than mucositis lesions. Peri-implantitis sites, in contrast to sites with mucositis, consistently displayed elastase-positive cells in the central portions of the infiltrate. Conclusion: It is suggested that peri-implantitis lesions exhibit properties that are different from mucositis lesions. [source]

    Three-dimensional force measurements on oral implants: a methodological study

    J. Duyck
    This paper describes a methodology that allows in vitro and in vivo quantification and qualification of forces on oral implants. Strain gauges are adapted to the outer surface of 5·5 and 7 mm standard abutments (Brånemark System®, Nobel Biocare, Sweden). The readings of the strain gauges are transformed into a numerical representation of the normal force and the bending moment around the X- and Y- axis. The hardware and the software of the 3D measuring device based on the strain gauge technology is explained and its accuracy and reliability tested. The accuracy level for axial forces and bending moments is 9.72 N and 2.5 N·cm, respectively, based on the current techniques for strain gauged abutments. As an example, an in vivo force analysis was performed in a patient with a full fixed prosthesis in the mandible. Since axial loads of 450 N and bending moments of 70 N·cm were recorded, it was concluded that the accuracy of the device falls well within the scope of our needs. Nevertheless, more in vivo research is needed before well defined conclusions can be drawn and strategies developed to improve the biomechanics of oral implants. [source]

    Turned Brånemark System® Implants in Wide and Narrow Edentulous Maxillae: A Retrospective Clinical Study

    Bertil Friberg DDS
    ABSTRACT Background: The available jawbone volume is regarded as one of the most important factors when assessing the prognosis of oral implants in the rehabilitation of the edentulous maxilla. Purpose: The aim of the current investigation was to retrospectively evaluate and compare the outcome of implants placed in edentulous maxillae with either wide or narrow jaw shapes. The marginal bone loss and implant cumulative survival rates (CSRs) were calculated and analyzed with special reference to smoking habits. Materials and Methods: The study included 75 individuals with edentulous maxillae, of which 33 patients exhibited wide (group A) and 42 patients exhibited narrow jaw shapes (group B). A total of 506 turned Brånemark System® (Nobel Biocare AB, Göteborg, Sweden) implants were inserted (226 in group A and 279 in group B) and followed clinically up to 7 years. Smoking habits were recorded. Radiographs were obtained at connection of prostheses, and at the 1- and 5-year follow-up visit. The marginal bone loss was calculated for the groups and analyzed using t -test. Results: Twenty-eight implants were lost during the study period, revealing implant CSRs at 7 years of 94.6% (11/226) and 93.6% (17/279) for wide and narrow crests, respectively. No difference in marginal bone loss was seen between the two groups, although a trend toward more bone loss was recorded for patients with wide crests. Smoking habits were more common in group A (45%) than in group B (31%). During the first year of function, smokers lost significantly more marginal bone than nonsmokers (p = .0447), albeit this difference did not prevail (p > .05) at the end of the study period. Conclusions: The implant CSRs at 7 years were equally good for the two groups of patients with various jaw shapes. Initially, smokers showed significantly more marginal bone loss than nonsmokers. [source]

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

    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]

    Bone Reformation and Implant Integration following Maxillary Sinus Membrane Elevation: An Experimental Study in Primates

    Vinicius C Palma DDS
    ABSTRACT Background:, Recent clinical studies have described maxillary sinus floor augmentation by simply elevating the maxillary sinus membrane without the use of adjunctive grafting materials. Purpose:, This experimental study aimed at comparing the histologic outcomes of sinus membrane elevation and simultaneous placement of implants with and without adjunctive autogenous bone grafts. The purpose was also to investigate the role played by the implant surface in osseointegration under such circumstances. Materials and Methods:, Four tufted capuchin primates had all upper premolars and the first molar extracted bilaterally. Four months later, the animals underwent maxillary sinus membrane elevation surgery using a replaceable bone window technique. The schneiderian membrane was kept elevated by insertion of two implants (turned and oxidized, Brånemark System®, Nobel Biocare AB, Göteborg, Sweden) in both sinuses. The right sinus was left with no additional treatment, whereas the left sinus was filled with autogenous bone graft. Implant stability was assessed through resonance frequency analysis (OsstellTM, Integration Diagnostics AB, Göteborg, Sweden) at installation and at sacrifice. The pattern of bone formation in the experimental sites and related to the different implant surfaces was investigated using fluorochromes. The animals were sacrificed 6 months after the maxillary sinus floor augmentation procedure for histology and histomorphometry (bone-implant contact, bone area in threads, and bone area in rectangle). Results:, The results showed no differences between membrane-elevated and grafted sites regarding implant stability, bone-implant contacts, and bone area within and outside implant threads. The oxidized implants exhibited improved integration compared with turned ones as higher values of bone-implant contact and bone area within threads were observed. Conclusions:, The amount of augmented bone tissue in the maxillary sinus after sinus membrane elevation with or without adjunctive autogenous bone grafts does not differ after 6 months of healing. New bone is frequently deposited in contact with the schneiderian membrane in coagulum-alone sites, indicating the osteoinductive potential of the membrane. Oxidized implants show a stronger bone tissue response than turned implants in sinus floor augmentation procedures. [source]

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

    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]

    Short Implants in the Severely Resorbed Maxilla: A 2-Year Retrospective Clinical Study

    Franck Renouard DDS
    ABSTRACT Background: Although the predictability of endosseous dental implants is well documented, the restoration of the posterior region of the maxilla remains a challenge. The placement of short implants is one therapeutic option that reduces the need for augmentation therapy. Purpose: The purpose of this retrospective study was to assess the survival rates of 6 to 8.5 mm-long implants in the severely resorbed maxilla following a surgical protocol for optimized initial implant stability. Materials and Methods: The study included 85 patients with 96 short (6,8.5 mm) implants (Brånemark System®, Nobel Biocare AB, Göteborg, Sweden) supporting single-tooth and partial reconstructions. The implants had a machined (54) or an oxidized (TiUniteÔ, Nobel Biocare AB) (42) surface. A one-stage surgical protocol with delayed loading was used. The patients were followed for at least 2 years after loading (average follow-up period 37.6 months). The marginal bone resorption was assessed by radiographic readings. Results: Five implants were lost during the first 9 months, and four implants were lost to follow-up. The cumulative survival rate was 94.6%. Four of the failed implants had a machined surface, and one had an oxidized surface. The mean marginal bone resorption after 2 years in function was 0.44 ± 0.52 mm. Conclusion: This study demonstrates that the use of short implants maybe considered for prosthetic rehabilitation of the severely resorbed maxilla as an alternative to more complicated surgical techniques. [source]

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

    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]

    Immediate Provisional for Single-Tooth Implant Replacement with Brånemark System: Preliminary Report

    Edward Hui MDS, FDSRCS, FRCDC
    Abstract: Background: The success of osseointegrated implants ad modum Brånemark for single-tooth restorations is documented. Future developments should aim at improving the benefits to patients by decreasing treatment time, minimizing surgical stages, and maximizing esthetic outcomes. Using knowledge from studies of immediate implant placement, one-stage, immediate loading protocols, the authors developed the immediate provisional. Purpose: The purpose of this study was to develop a protocol to provide an immediate solution for restoring a single missing tooth in the esthetic zone. The protocol should be simple, predictable, cost effective, and allow the use of other techniques to improve esthetic outcome. Materials and Method: This prospective clinical study included 24 patients treated from August 1999 to October 2000. Single-tooth implant replacement was done according to immediate provisional protocol. Thirteen of the 24 patients had immediate implant placement after tooth extraction. All implants were placed in the esthetic zone. During surgery, emphasis was placed on obtaining primary stability by achieving bicortical anchorage and maximum insertion torque of at least 40 Ncm. CeraOne (Nobel Biocare) abutments were used, and provisional crowns were fabricated immediately before wound closure. The occlusion was protected by adjacent teeth. Results: Within the follow-up period of between 1 month and 15 months, all fixtures in the 24 patients were stable. Crestal bone loss greater than one thread-width was not detected. The esthetic result was considered satisfactory by all patients. Conclusions: The implant placement and restoration protocol used in this study showed promising initial results for both the immediate implant and healed extraction site groups. The desirable goals of patient satisfaction, excellent esthetic outcomes, and no increase in treatment cost were achieved in this protocol. Further studies to elucidate the potential of the immediate provisional protocol are justified. [source]

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

    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]

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

    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]

    Outcome of Oral Implant Treatment in Partially Edentulous Jaws Followed 20 Years in Clinical Function

    Odont Dr/PhD, Ulf Lekholm DDS
    ABSTRACT Background:, Most long-term follow-up studies of implants in partially edentulous jaws present their outcomes as mean values of implant survival and follow-up time, and few address the fate of the remaining teeth. Purpose:, The aim of this study was to investigate the results of oral implant treatment in partially edentulous jaws after 20 years, and simultaneously to assess what happens to teeth present at the time of implant placement. Materials and Methods:, Seventeen partially edentulous patients, of 27 originally treated individuals, were retrospectively reviewed after receiving implants from 1983 to 1985. The parameters studied were implant survival, prosthesis stability, marginal bone loss at teeth and implants, treatment complications, need for dental treatment, and patient's satisfaction with the outcome. Results:, The cumulative survival rate was 91%, when all 27 patients were assessed, that is, including the 10 dropouts. Of the 69 inserted and followed implants (Brånemark system®; Nobel Biocare AB, Göteborg, Sweden), six failed (8.7%) during the 20-year period, four during the first decade, and the remaining two during the second. A majority (n=4) of the losses were due to implant fractures, two after 8 years, and two after 17 years. In all, 10 of the original fixed bridges being followed (n=24) remained in function during the entire investigation period, whereas 12 were exchanged for new constructions after an average of 7 years. The mean marginal bone loss at teeth was 0.7 mm, and at implants it was 1.0 mm. The major complication observed during the second decade was veneer material fractures, which occurred 14 times in six patients. Component loosening and abutment- and bridge-locking screw fractures were the second most common problems seen, indicating material/component fatigue. Most patients were satisfied with their treatment and many mentioned that they did not think of the constructions as anything but a part of their own body. Conclusion:, Over the decades, treatment of partially edentulous jaws with turned titanium implants seems to function well and to provide patients with good support for fixed short-span bridge constructions. [source]