			Home About us Contact

Edentulous Mandible (edentulous + mandible)

Distribution by Scientific Domains

Medical Sciences	96%

Selected Abstracts

Laser-Welded Titanium Frameworks Supported by Implants in the Partially Edentulous Mandible: A 10-Year Comparative Follow-Up Study

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2008
Anders Örtorp DDS, PhD/Odont Dr
ABSTRACT Background: Comparative long-term knowledge of different framework materials in the partially edentulous implant patient is not available. Purpose: To report and compare 10-year data on free-standing implant-supported partial prostheses with laser-welded titanium (test) and conventional gold alloy (control) frameworks. Materials and Methods: Altogether, 52 partially edentulous patients were consecutively provided with laser-welded prostheses (n = 60) in the partially edentulous lower jaw (test group). A control group of 52 randomly selected patients with gold alloy castings (n = 60) was used for comparison. Clinical and radiographic 10-year data were retrospectively collected and evaluated for both groups. Results: The overall 10-year implant cumulative survival rate (CSR) was 93.0% (loaded implants, 96.4%), with a 10-year implant CSR of 91.5 and 94.7% for test and control implants, respectively (p > .05). Out of a total of 22 lost implants, 17 implants (77.3%) were shorter than 10 mm. The overall 10-year prosthesis CSR was 93.7%, with a corresponding 10-year CSR of 88.4 and 100% for test and control groups, respectively (p < .05). Average 10-year bone loss was 0.46 mm (SD 0.47) and 0.69 mm (SD 0.53) for the test and control groups (p < .001), respectively. Only 1% of the implants had >3 mm accumulated bone loss after 10 years. Altogether, 10 of the prostheses in both groups had implant component mechanical problems (8.3%). None of the frameworks or implants fractured, but more fractures of porcelain veneers were observed in the test group (p < .05). Conclusion: The protocol of implant treatment in the partially edentulous jaw functioned well during 10 years, although prosthodontic maintenance was required. However, laser-welded titanium frameworks presented more problems as compared with gold alloy frameworks. More loaded implants were lost (p < .05), and higher incidence of porcelain chipping was noted in the test group (p < .05). However, bone loss was on an average lower for the test group during the 10 years of follow-up (p < .001). [source]

Functional Restoration of Implants on the Day of Surgical Placement in the Fully Edentulous Mandible: A Case Series

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2005
Alexandre-Amir Aalam DDS
ABSTRACT Purpose: The purpose of this article is to report the clinical experience and outcome of a study of the functional rehabilitation of 16 completely edentulous mandibles with immediately loaded cross-arch screw-retained hybrid prostheses at the University of Southern California. Materials and Methods: After signing informed consent forms 16 patients (9 male, 7 female) aged 47 to 84 years (mean age, 62.6 ± 11.6 years) received 90 Brånemark System® Mk III dental implants (Nobel Biocare USA, Yorba Linda, CA, USA). Stability and radiographs of the dental implants were evaluated at the time of surgery, at 3 months, at 1 year, and at 3 years post loading. Results: Three implants failed to meet the criteria of success, bringing the cumulative success rate to 96.6%, with a 100% prosthetic success rate at 3 years. Thirty-nine (43.3%) of the dental implants placed were 15 mm in length. Seventy-seven (85.5%) of the dental implants were placed in high-density bone. At 3 years post loading, the average bone loss was ,1.2 ± 0.1 mm. Conclusion: Within the limitations of this study, restoration of implants by unreinforced hybrid prostheses at the time of placement provided satisfactory results. The outcome was stable at 3 years post restoration. Mandibular rehabilitation by functional loading of the implants on the day of the insertion requires the comprehension and proper application of surgical and restorative principles. [source]

One-Stage Operative Procedure Using Two Different Implant Systems: A Prospective Study on Implant Overdentures in the Edentulous Mandible

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2001
Andrew Tawse-Smith DDS, Cert Perio (Göteborg)
ABSTRACT Background: Evidence-based reports are needed to support the application of a one-stage surgical protocol for unsplinted implants supporting mandibular overdentures. Purpose: To examine the feasibility and success of using two different dental implant systems (originally designed for two-stage operative technique) using a one-stage operative procedure in patients being rehabilitated with implant mandibular overdentures. Materials and Methods: The study sample involved 24 edentulous subjects (aged 55,80 yr) randomly allocated to two different implant systems, one with a machined titanium implant surface (Steri-Oss, Nobel Biocare, Göteborg, Sweden) and the other with a roughened titanium surface (Southern Implants, Ltd., Irene, South Africa). Two unsplinted implants to support implant overdentures were placed in the anterior mandible of all patients, using a standardized one-stage surgical and prosthodontic procedure. Primary stability and bicortical anchorage of the implants was mandatory before healing abutments were connected at the time of implant placement. Implant overdentures and their respective matrices were inserted following a standard 12-week healing period. Data relating to mobility tests, radiographs, and peri-implant parameters were documented at 12, 16, and 52 weeks after surgery. Results: A success rate of 95.8% for the Steri-Oss and 100% for the Southern Implants was found, without any statistically significant differences in the marginal bone loss. Significant changes in Periotest values were observed for both types between 12 and 52 weeks (p <.001). Minor changes were observed in the peri-implant parameters evaluated. Conclusions: These preliminary findings show a successful application of this one-stage approach for unsplinted implants supporting mandibular overdentures with Steri-Oss and Southern Implant Systems. [source]

Prospective Follow-Up Study of 95 Patients with Edentulous Mandibles Treated According to the Branemark Novum Concept

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2003
Per Engstrand DDS
ABSTRACT Background: The long-term predictability reported with the traditional two-staged Brånemark method has led to developments aimed at simplifying the technique and reducing healing time. Results from a pilot study using the Brånemark Novum concept are promising, and it has been shown possible to fabricate and deliver an implant-supported fixed prosthesis to the patient on the day of surgery. Purpose: The objective of this study is to report clinical and radiographic outcomes in a group of patients treated according to the Brånemark Novum concept. Materials and Methods: Ninety-five patients with edentulous mandibles were consecutively included in the study. Three specially designed fixtures were placed in each patient (285 fixtures in total) using drilling templates. The fixtures were immediately splinted with a prefabricated substructure, and fixed prostheses were delivered the same day in 67% of the patients. For the rest, prosthesis delivery ranged from 1 to 40 days (mean 5.6 d). Clinical and radiographic examinations were performed after 3 months, 6 months, 1 year, and then annually. The follow-up time was 1 to 5 years (mean 2.5 yr). Results: The cumulative prosthesis survival rate was 99%. Eighteen fixtures (6.3%) failed in 13 patients. Kaplan-Meier survival estimates demonstrated a probability implant survival at 1 year of 95.0% (94 patients), at 3 years of 93.3% (47 patients), and at 5 years of 93.3% (9 patients). The mean bone loss was 0.73 mm between the examinations at 3 months and 1 year, 0.16 mm during the second year, and 0.13 mm annually during years 3 to 5. Conclusions: Comparable results, related to continuous prosthesis stability, were shown for the Novum approach compared with the traditional two-staged procedure. Survival of individual fixtures is lower when immediate loading is applied. [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]

IMMEDIATE LOADING OF IMPLANTS IN THE ESTHETIC ZONE

JOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 5 2005
Saj Jivraj DDS
The predictability of dental implants using the traditional Branemark protocol has been well documented. Since its inception, this protocol has been progressively challenged to decrease treatment time, minimize the number of surgical procedures, and maximize esthetic outcomes. Today, in specific clinical situations, implants may be placed and immediately loaded with provisional restorations. Immediate loading in the edentulous mandible has been well documented. There are also good data to show that immediate loading of the edentulous maxilla is also feasible if bone quality is suitable. The focus now has shifted toward immediate loading of implants placed in the esthetic zone. Clinicians have recognized that the challenge of providing anterior tooth replacements is in preserving the hard and soft tissue components that exist around natural teeth. The advantages of immediate restoration are obvious; however, the application of immediate or early load may pose an increased risk of implant failure in single-tooth situations. The prerequisites for achieving and maintaining acceptable results are not fully known. This review examines some of the literature concerning the reliability of early or immediate loading of implants placed in the esthetic zone. [source]

Early load mandibular hybrid prosthesis using the Ohio State University acrylic frame requiring no final impression

AUSTRALIAN DENTAL JOURNAL, Issue 3 2009
I Turkyilmaz
Abstract Background:, Although immediate/early loading protocols for dental implants have presented encouraging outcomes, immediate loading procedures may cause discomfort to the patient and may increase the possibility of damage to the surgical site during the impression procedures. The aim of this study was to describe an alternative technique to fabricate a mandibular hybrid prosthesis in three or four days without making any final impression and to evaluate the outcomes of this technique. Methods:, Seven patients aged 41 to 71 years (mean age, 58 ± 11) were considered for this study. Each patient received five implants for the reconstruction of the edentulous mandible. These implants were placed in the anterior region of an edentulous mandible and restored with a final mandibular hybrid prosthesis in four days using the Ohio State University (OSU) acrylic frame requiring no final impression procedure. The patients were followed up to 19 months after implant placement. Results:, No implants were lost, no technical complications were observed and only minor marginal bone loss was noted after an average 15 months. Conclusions:, This clinical study shows that the OSU acrylic frame, which can easily be customized and accommodates variability in arch form, may be an alternative method to restore any edentulous mandible with an early load mandibular hybrid prosthesis. [source]

Syncrystallization: A Technique for Temporization of Immediately Loaded Implants with Metal-Reinforced Acrylic Resin Restorations

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2006
Marco Degidi MD
ABSTRACT Background, Rigid temporization has been recognized to have a significant impact on the peri-implant tissue response in immediate implant loading since it reduces the mechanical stress exerted on each implant. Purpose, A successful protocol for immediate loading of multiple implants depends on an adequate fixation and immobility of the implants to prevent the risk of micromovements in relation to the surrounding bone. The objective of this article was to evaluate a prosthetic concept for an accelerated rigid splinting of multiple implants for same-day immediate loading with metal-reinforced provisional restorations using a technique of welding temporary implant abutments with a prefabricated titanium bar directly in the oral cavity (syncrystallization). Materials and Methods, Between June 2004 and January 2005, immediate loading of threaded implants with a metal- reinforced acrylic resin provisional restoration at stage 1 surgery was evaluated in 40 consecutive patients. A total of 192 implants were placed in selected edentulous or partially edentulous patients using the syncrystallization technique. Once the titanium bar was welded intraorally to the abutments, opaque was applied and the provisional restoration was relined and screw-retained the same day. In addition, a comparison of deformations and stress distributions in implant-supported, metal-reinforced and nonmetal-reinforced resin provisional restorations was analyzed in the edentulous mandible by a three-dimensional finite element model (FEM). Results, All of the 192 rigidly temporized immediately loaded implants osseointegrated. An implant success rate of 100% was achieved over a period of 6 months postplacement. No fracture or luting cement failure of the provisional restoration occurred during the observation time. Compared to mere acrylic superstructures, a significant reduction of deformation and strain within metal-reinforced provisional restorations was detected by FEM analysis. Conclusion, The results of this study indicate that the syncrystallization technique allows an expedite and adequate rigid splinting of multiple immediately loaded implants. The advantages of the technique are: (1) reduction of treatment time for immediate temporization at stage 1 surgery; (2) predictable fixation and immobility of implants in the early stages of bone healing; and (3) less time for repairing provisional restorations as a result of no or rare fracture. [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]

Early Loading of Four or Five Astra Tech Fixtures with a Fixed Cross-Arch Restoration in the Mandible

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2002
Bruno Collaert DDS
ABSTRACT Background: A change in implant placement has emerged recently from two-stage to one-stage surgery and to earlier and even immediate loading of the fixtures. Purpose: The aim of this study was to verify whether four or five fixtures installed in the edentulous mandible were suitable for early loading with a cross-arch fixed restoration. Materials and Methods: In 25 consecutively treated patients (28,88 yr), four or five Astra Tech fixtures (Mölndal, Sweden) were installed in edentulous mandibles. During the same surgical procedure, the abutments were connected. An impression was taken immediately after surgery. All patients received a fixed prosthetic rehabilitation of 10 to 12 teeth made of a cast metal framework and acrylic teeth/gingiva within a month. The fixtures were followed up clinically and radiographically for 7 to 24 months. Bone level was measured from the most coronal point of the vertical part of the fixture to the most apical bone level mesially or distally. Results: No fixtures were lost during follow-up. No postoperative complications occurred. Radiographic analysis showed a mean bone level of 0.6 mm after 7 to 12 months. Fixtures followed up from 13 to 18 and 19 to 24 months showed a mean bone level of 0.7 mm. Around two fixtures, the bone level was found at the first implant thread. All other fixtures showed the bone level somewhere along the vertical unthreaded part of the fixture. Conclusions: Early loading within 1 month of four or five Astra Tech fixtures in the edentulous mandible is a predictable procedure for a follow-up period of 6 to 24 months. [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]

Five-year results of fixed implant-supported rehabilitations with distal cantilevers for the edentulous mandible

CLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2009
German O. Gallucci
Abstract Objectives: The purpose of this study was to evaluate the survival rate, success rate and primary complications associated with mandibular fixed implant-supported rehabilitations with distal cantilevers over 5 years of function. Material and methods: In this prospective multi-center trial, 45 fully edentulous patients were treated with implant-supported mandibular hybrid prostheses with distal extension cantilevers. Data were collected at numerous time points, including but not limited to: implant placement, abutment placement, final prosthesis delivery, 3 months and 5 years post-loading. Biological, implant and prosthetic parameters defining survival and success were evaluated for each implant including: sulcus bleeding ndex (SBI) at four sites per implant, width of facial and lingual keratinized gingiva (mm), peri-implant mucosal level (mid-facial from the top of the implant collar, measured in mm), modified plaque index (MPI) at four sites per implant, mobility and peri-implant radiolucency. Survival was defined as implants or prostheses that did not need to be replaced. Success rate was defined as meeting well-established criteria that were chosen to indicate healthy peri-implant mucosa osseointegration, prostheses success and complications. Results: A total of 237 implants in 45 completely edentulous patients were included in the study. In each patient, four to six implants were placed to support hybrid prostheses with distal cantilevers. Cantilevers ranged in length from 6 to 21 mm, with an average length of 15.6 mm. The ages of the patients ranged from 34 to 78 with a mean age of 59.5 years. The survival rate of implants was 100% (237/237) and for prostheses 95.5% (43/45). The overall treatment success rate was calculated as 86.7% (39/45). Of the six patients that have not met the criteria for success, two patients required replacement of the entire prosthesis and four patients presented >four complications events. Conclusion: Fixed implant-supported rehabilitation with distal cantilever resulted in a reliable treatment modality over the 5-year observation period. Although biological parameters of MPI, SBI, keratinized tissue and peri-implant mucosal levels showed statistically significant differences over time, the mean values for each patient remained within the normal limits of oral health. Complications were categorized as biological or technical. The majority of complications were technical complications (54/79) and of these most involved fracture of the acrylic teeth and base (20/54). While the survival rate was 100% for implants and 95.5% for prostheses, the application of strict criteria for treatment success resulted in an overall treatment success rate of 86.7%. [source]

Immediate functional loading of TiOblast dental implants in full-arch edentulous mandibles: a 3-year prospective study

CLINICAL ORAL IMPLANTS RESEARCH, Issue 7 2008
H. De Bruyn
Abstract Introduction: Implant-prosthetic rehabilitation of the completely edentulous mandible has evolved to a simplified procedure with shorter treatment time and survival rates of 95,100% depending on the implant system used. Purpose: The aim was to evaluate the 3-year clinical success of Astra Tech TiOblast implants, functionally loaded on the day of surgery with a fixed full-arch bridge in the mandible. Materials and methods: One hundred and twenty-five implants of 3.5,4 mm width and 11,17 mm length were installed in 25 edentulous mandibles of 15 female and 10 male patients. Implants were functionally loaded on the day of surgery with a provisional, acrylic, glassfibre reinforced, 10 unit bridge. After 3,4 months, the final 12-unit bridge was constructed. Radiographical bone loss was measured on peri-apical radiographs after 3, 12, 24 and 36 months. Results: All implants were functional during the whole study period yielding a survival rate of 100%. None of the fixtures showed pain or mobility after manual torque with 20 N cm at the 3-month control. Mean radiographical bone loss after 3 months and 1, 2 and 3 years was 0.6 mm (SD 0.7), 0.8 mm (SD 0.8), 1 mm (SD 0.8) and 1.3 (SD 1) respectively, which was statistically significantly increasing up to 1 year. Conclusion: Immediate loading of full-arch mandibular bridgework on five TiOblast implants offers a long-lasting clinical result with 100% fixture survival and stable bone-to-implant contact up to 3 years. [source]

Evaluation by quantitative magnetic resonance imaging of trabecular bone quality in the dentate and edentulous mandible

CLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2008
Cetin Celenk
Abstract Objective: To quantify the differences in mandibular trabecular bone quality between edentulous and dentate patients using quantitative magnetic resonance imaging (QMRI). Methods: The patients in this study had been referred to our clinic for QMRI examination for various reasons. A total of 40 male patients (18 dentate, 22 edentulous), 45,55 years of age, were examined. Mandibular T2* axial cross-sections were performed following receipt of consent from each patient. T2* relaxation time values (RTVs) were determined in the trabecular area. Results: The mean mandibular T2* RTVs of dentate and edentulous patients were 181 and 182, respectively. There were no significant differences between the two groups (P=0.929) (Student's t -test). Conclusions: Mandibular trabecular bone quality may not be influenced by edentulousness according to QMRI. [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]

Immediate occlusal loading of Osseotite implants in the lower edentulous jaw

CLINICAL ORAL IMPLANTS RESEARCH, Issue 3 2004
A multicenter prospective study
Abstract Objective: This paper reports the results of a prospective multicenter clinical study on immediately fully occlusally loaded full-arch screw-retained prostheses with distal extensions (hybrid prostheses) supported by Osseotite implants inserted in edentulous lower jaws. Method and material: Sixty-two patients were enrolled in four clinical centers. Three hundred and twenty-five Osseotite implants were inserted and occlusally loaded according to an immediate loading protocol. The temporary prosthesis was delivered 4 h from surgery. The final prosthesis was delivered after 6 months. Marginal bone loss was monitored from periapical radiographs using a computerized technique. Results: Two implants failed to integrate within 2 months of occlusal loading. A cumulative implant success rate of 99.4% was achieved for a period of 12,60 months postplacement (mean 28.6±14.1 (SD) months). Crestal bone loss around the immediately loaded implants was similar to that reported for standard delayed loading protocols. Conclusion: The results of this study suggest that the rehabilitation of the edentulous mandible by an immediate occlusally loaded hybrid prosthesis supported by five to six Osseotite implants represents a viable alternative treatment to classic delayed loading protocols. Résumé Cette étude rapporte les résultats d'une étude clinique multicentrique prospective sur la charge occlusale complète immédiate de l'ensemble de la mâchoire sur des prothèses retenues par des implants-vis avec une extension distale supportée par des implants Osséotite insérés dans la mandibule de patients édentés. Soixante-deux patients ont été inclus dans quatre centres cliniques et 325 implants Osséotite ont été insérés et mis en charge occlusale suivant le protocole de charge immédiate. La prothèse temporaire était placée quatre heures après la chirurgie. La prothèse finale était placée après six mois. La perte osseuse marginale était enregistrée à partir de radiographies périapicales via l'utilisation d'une technique informatisée. Deux implants ne se sont pas intégrés dans les deux mois de la mise en charge occlusale. Un taux de succès cumulatif des implants de 99,4% a été atteint pendant une période de douze à soixante mois après le placement (moyenne 28±14,1 mois). La perte osseuse crestale autour des implants mis en charge immédiatement était semblable à celle rapportée pour les protocoles de mise en charge retardée. Les résultats de cette étude suggèrent que la réhabilitation de la mandibule chez l'édenté par des prothèses placées sur des implants immédiatement mis en charge placées sur cinq ou six implants Osséotite représente un traitement alternatif au protocole classique avec une mise en charge retardée. Zusammenfassung Ziele: Diese Arbeit präsentiert die Daten einer longitudinalen klinischen Multizenterstudie über sofort mit Kaukräften belastete und verschraubte Totalprothesen mit distalen Extensionen (Hybridprothesen). Als Verankerung dienten Osseotiteimplantate in einem zahnlosen Unterkiefer. Methode und Material: Für diese Studie behandelte man in vier klinischen Zentren 62 Patienten. Gemäss einem vorgegebenen Protokoll setzte man 325 Osseotite-Implantate und belastete sie sofort mit Kaukräften. Die provisorischen Prothesen konnten vier Stunden nach der Chirurgie eingegliedert werden. Die definitiven Hybridprothesen setzte man sechs Monate später ein. Den marginalen Knochenverlust beurteilte man mit periapicalen Röntgenbildern, die komputerunterstützt vermessen wurden. Resultate: Bei zwei Implantaten kam es in den ersten zwei Monaten der okklusalen Sofortbelastung zu Misserfolgen. Daraus errechnete sich zwischen dem zwölften und 60. Monat nach Implantation eine kumulative Erfolgsrate aller Implantate von 99.4% (Mittelwert/SD 28.6±14.1 Monate). Der crestale Knochenverlust um die sofortbelastete Implantate war ähnlich wie in anderen Arbeiten mit standartmässig verzögert belasteten Implantaten. Schlussfolgerung: Die Resultate dieser Arbeit lassen vermuten, dass die Rekonstruktion eines zahnlosen Unterkiefers mit okklusal sofortbelasteten Hybridprothesen, abgestützt auf 5 bis 6 Osseotite-Implantaten, eine brauchbare Alternative zu den klassischen Protokollen mit einer verzögerten Belastung darstellt. Resumen Intención: Este trabajo informa sobre los resultados de un estudio prospectivo multicéntrico de prótesis de arco completo implantorretenidas inmediatamente cargadas con extensiones distales (prótesis híbridas) soportadas por implantes Osseotite insertados en mandíbulas edéntulas. Método y Material: Se enroló a 62 pacientes en cuatro centros clínicos. Se insertaron 325 implantes Osseotite y se cargaron oclusalmente de acuerdo con un protocolo de carga inmediata. La prótesis temporal se suministró a las cuatro horas de la cirugía. La prótesis definitiva se suministró a los seis meses. La pérdida de hueso marginal se monitorizó de radiografías periapicales usando una técnica computarizada. Resultados: Dos implantes fracasaron al integrarse dentro de los dos meses de carga oclusal. Se logró un índice de éxito acumulado de implantes del 99.4% durante un periodo de 12 a 60 meses tras el tratamiento (media 28.6±14.1 (SD) meses). La pérdida de hueso crestal alrededor implantes cargados inmediatamente fue similar a aquellos informados para protocolos de carga diferida estándar. Conclusión: Los resultados de este estudio sugieren que la rehabilitación de la mandíbula edéntula por medio de una prótesis híbrida de carga oclusal inmediata soportada por 5,6 implantes Osseotite representa una alternativa viable de tratamiento frente a los protocolos clásicos de carga diferida. [source]

Anisotropic elastic properties of cancellous bone from a human edentulous mandible

CLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2000
Aisling M. O'Mahony
The elastic moduli have not been reported for cancellous bone from the edentulous mandible. Accurate values are needed for finite element modeling of the mandible. The aim of this study was to determine elastic modulus values in three orthogonal directions for cancellous bone taken from an edentulous jaw and to relate these values to apparent density and volume fraction. Seven samples were obtained from the edentulous mandible of a 74-year-old female. Young's modulus was determined by compression testing of cubes cut with the faces aligned with the anatomic axes. Bone volume fraction averaged 0.33 (SD 0.14) and apparent density averaged 0.55 g/cc (SD 0.29). Young's modulus was greatest in the mesio-distal direction (mean 907 MPa, SD 849 MPa), followed by the bucco-lingual (mean 511 MPa, SD 565 MPa) and infero-superior direction (mean 114 MPa, SD 78 MPa). The infero-superior direction was less than the bucco-lingual (P=0.03) and mesio-distal (P=0.002). The mesio-distal and bucco-lingual directions could not be shown to be different (P=0.32). This suggests a model of transverse isotropy for cancellous bone in the jaw, where the symmetry axis is along the infero-superior (weakest) direction. [source]

Radiological trace of mandibular primary growth center in postnatal human mandibles

THE ANATOMICAL RECORD : ADVANCES IN INTEGRATIVE ANATOMY AND EVOLUTIONARY BIOLOGY, Issue 12 2006
Young Joon Lee
Abstract The mandibular primary growth center (MdPGC) of human fetus was conspicuously defined in the soft X-ray view of fetal mandibles. As the peripheral adaptive growth of mandible advances during the postnatal period, the MdPGC image became overshadowed by condensed cortical bones in soft X-ray view. In this study, we traced a sclerotic sequela of MdPGC during the postnatal period. Panoramic radiograms of 200 adults and soft X-ray views of 30 dried adult mandibles were analyzed by statistical methods. The former clearly showed an MdPGC below the middle portion of apices of canine and first premolar, which was distinguishable from mental foramen, and the latter also showed the MdPGC at the same area as a radiating and condensed radiopaque image, measuring 0.5,1.0 cm in diameter. This MdPGC position was seldom changed in the elderly people, even in the edentulous mandibles. Additionally, in the radiological examination, the benign tumors including odontogenic cysts hardly involved the MdPGC, while the malignant tumors of both primary and metastatic cancer frequently destroyed the MdPGC. Anat Rec Part A, 2006. © 2006 Wiley,Liss, Inc. [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]

Functional Restoration of Implants on the Day of Surgical Placement in the Fully Edentulous Mandible: A Case Series

A Comparative Study of Computed Tomography and Magnetic Resonance Imaging for the Detection of Mandibular Canals and Cross-Sectional Areas in Diagnosis prior to Dental Implant Treatment

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2004
Hideyuki Imamura DDS
ABSTRACT Background: Computed tomography (CT) is effective in the diagnosis of dental implants. However, it has the disadvantage of exposing patients to high doses of x-rays, and the mandibular canals cannot be detected by CT in some clinical cases. Purpose: The purpose of this study was to examine the detectability of the anatomic morphology of the molar region in the lower jaw (where implantation is common) by CT and magnetic resonance imaging (MRI), to compare the data, and to determine the usefulness of MRI in diagnosis prior to dental implant treatments. Materials and Methods: Eleven female subjects (average age, 59 years) who had partially edentulous mandibles (total of 19 sites) were included in the study. CT and MRI were performed with the same subjects, and the degrees of identification of the mandibular canal in the first and second molar regions were compared. Dimensional accuracy in the second molar region was also compared. Results: With CT, the canals of the first molar regions were not identified in 11 of 19 sites; however, MRI identified the canals in all 19 sites. Using the kappa index, we found that the inter- and intraobserver identification reliabilities (0.84 and 0.87, respectively) were excellent, especially for MRI. Dimensional positioning of the canal in the second molar region was almost the same with MRI as with CT. Conclusions: MRI is an alternative method in diagnosis prior to dental implant treatment in the mandibular molar region. [source]

Prospective Follow-Up Study of 95 Patients with Edentulous Mandibles Treated According to the Branemark Novum Concept

Early Loading of Four or Five Astra Tech Fixtures with a Fixed Cross-Arch Restoration in the Mandible

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]