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Marginal Bone Resorption (marginal + bone_resorption)
Selected AbstractsTwo-Year Outcome with Nobel Direct® Implants: A Retrospective Radiographic and Microbiologic Study in 10 PatientsCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2009Tommie Van de Velde LA ABSTRACT Introduction: The Nobel Direct® implant (Nobel Biocare AB, Göteborg, Sweden) was developed to minimize marginal bone resorption and to result in "soft tissue integration" for an optimized aesthetic outcome. However, conflicting results have been presented in the literature. The aim of this present study was to evaluate the clinical and microbiologic outcomes of Nobel Direct implants. Materials and Methods: Ten partially edentulous subjects without evidence of active periodontitis (mean age 55 years) received 12 Nobel Direct implants. Implants were loaded with single crowns after a healing period of 3 to 6 months. Treatment outcomes were assessed at month 24. Routine clinical assessments, intraoral radiographs, and microbiologic samplings were made. Histologic analysis of one failing implant and chemical spectroscopy around three unused implants was performed. Paired Wilcoxon signed-rank test was used for the evaluation of bone loss; otherwise, descriptive analysis was performed. Results: Implants were functionally loaded after 3 to 6 months. At 2 years, the mean bone loss of remaining implants was 2.0 mm (SD ± 1.1 mm; range: 0.0,3.4 mm). Three out of 12 implants with an early mean bone loss >3 mm were lost. The surviving implants showed increasing bone loss between 6 and 24 months (p = .028). Only 3 out of the 12 implants were considered successful and showed bone loss of <1.7 mm after 2 years. High rates of pathogens, including Aggregatibacter actinomycetemcomitans, Fusobacterium spp., Porphyromonas gingivalis, Pseudomonas aeruginosa, and Tanerella forsythia, were found. Chemical spectroscopy revealed, despite the normal signals from Ti, O, and C, also peaks of P, F, S, N, and Ca. A normal histologic image of osseointegration was observed in the apical part of the retrieved implant. Conclusion: Radiographic evidence and 25% implant failures are indications of a low success rate. High counts and prevalence of significant pathogens were found at surviving implants. Although extensive bone loss had occurred in the coronal part, the apical portion of the implant showed some bone to implant integration. [source] A 3-Year Retrospective Study of Cresco Frameworks: Preload and ComplicationsCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2005Lars 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] Stability Measurements of Osseointegrated Implants Using Osstell in Partially Edentulous Jaws after 1 Year of Loading: A Pilot StudyCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2002Piero Balleri MD ABSTRACT Background: The introduction of resonance frequency analysis (RFA) as a commercially available technique has made it possible to measure implant stability in implant stability quotient (ISQ) units at any time during the course of implant treatment and loading. However, no information on normal ISQ levels can be found in the literature. Purpose: The aim of this pilot study was to measure the stability of clinically successful implants in partially edentulous patients after 1 year of loading and to study the influence of jaw, anterior/posterior position, implant length, and marginal bone level on implant stability. Materials and Methods: Fourteen partially edentulous patients previously treated with 45 implants were subjected to clinical and radiographie evaluations and RFA measurements using Osstell (Integration Diagnostics, Sävedalen, Sweden) after 1 year of loading. Results: All 45 implants were stable, and implant stability levels were in the range of 57 to 82 ISQ units with a mean of 69 ± 6.5 ISQ after 1 year of loading. Mandibular implants were more stable than were maxillary ones. There were no differences between anterior and posterior implants. No correlation could be found between implant length and stability. Only minor marginal bone resorption was observed. Conclusions: The results from this limited material showed that successfully integrated implants have ISQ levels from 57 to 82 ISQ with a mean of 69 ISQ after 1 year of loading. Mandibular implants are more stable than are maxillary ones. High implant stability can be achieved with short implants and placement in posterior regions. [source] Fixed Mandibular Restorations on Three Early-Loaded Regular Platform Brånemark ImplantsCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2001Hugo 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] In-patient comparison of immediate and conventional loaded implants in mandibular molar sites within 12 monthsCLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2008Güncü, M. Bar Abstract Objectives: The aim of this prospective clinical study was to evaluate the clinical outcomes of dental implants placed in the mandibular molar sites and immediately functionally restored compared with conventionally loaded controls in an in-patient study. Material and methods: Twenty-four dental implants were placed in 12 patients who had first molar loss bilaterally in the mandibular area. One site of the patient was determined as immediately loaded (IL) and the other side was conventionally loaded (CL). Resonance frequency analyses for implant stability measurements, radiographic examinations for marginal bone levels and peri-implant evaluations were performed during the clinical follow-up appointments within 12 months. Results: During the 12-month follow-up period, only one implant was lost in the IL group. The mean implant stability quotient values were 74.18±5.72 and 75.18±3.51 for Groups IL and CL at surgery, respectively, and the corresponding values were 75.36±5.88 and 75.64±4.84 at 1-year recall, respectively. The difference was not statistically significant between the two groups during the 12-month study period (P>0.05). When peri-implant parameters were evaluated, excellent peri-implant health was demonstrated during the 1-year observation period and all implants showed less than 1 mm of marginal bone resorption during the first year. Conclusions: In the present study, immediate functionally loading did not negatively affect implant stability, marginal bone levels and peri-implant health when compared with conventional loading of single-tooth implants. [source] Prosthetic treatment of maxillary lateral incisor agenesis with osseointegrated implants: a 24,39-month prospective clinical studyCLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2006Fernando Zarone Abstract Objectives: The present study aimed at evaluating the marginal bone resorption and the peri-implant tissue conditions around Narrow-Neck ITI implants in the implant,prosthetic treatment of the agenesis of maxillary lateral incisors. Material and methods: Thirty patients affected by monolateral or bilateral agenesis of the maxillary lateral incisors were selected. Thirty-four ITI-SLA Narrow Neck implants were inserted and loaded about 4 months after the surgical procedure. The final restorations were realized using Aureo Galvan Crowns veneered with feldspathic ceramics. The follow-up period ranged from 24 to 39 months. Both marginal bone resorption and soft tissue quality were evaluated. The data were statistically analysed using analysis of variance (ANOVA) for repeated measures, one-way ANOVA and Tukey's post hoc test (P=0.05). Results: During the 24,39-month follow-up period, no implant showed either pain and sensitivity or mobility. After 39 months of functional loading, a cumulative survival rate of 97.06% and a cumulative success rate of 94.12% were calculated. Conclusions: In case of maxillary lateral incisor agenesis, the implant,prosthetic approach has proved to be a reliable and predictable treatment for both re-establishment of function and aesthetics. Satisfactory values of marginal bone resorption over time and optimal conditions of peri-implant tissue around Narrow-Neck ITI implants were found. [source] Biomechanical aspects of marginal bone resorption around osseointegrated implants: considerations based on a three-dimensional finite element analysisCLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2004Eriko Kitamura Abstract Objectives: Although bone loss around implants is reported as a complication when it progresses uncontrolled, resorption does not always lead to implant loss, but may be the result of biomechanical adaptation to stress. To verify this hypothesis, a three-dimensional finite element analysis was performed and the influence of marginal bone resorption amount and shape on stress in the bone and implant was investigated. Material and methods: A total of nine bone models with an implant were created: a non-resorption (Base) model and eight variations, in which three different resorption depths were combined with pure vertical or conical (vertical,horizontal) resorption. Axial and buccolingual forces were applied independently to the occlusal node at the center of the superstructure. Results: Regardless of load direction, bone stresses were higher in the pure vertical resorption (A) models than in the Base model, and increased with resorption depth. However, cortical bone stress was much lower in the conical resorption models than in both the Base and A models of the same resorption depth. An opposite tendency was observed in the cancellous bone under buccolingual load. Under buccolingual load, highest stress in the implant increased linearly with the resorption depth for all the models and its location approached the void existing below the abutment screw. Conclusions: The results of this analysis suggest that a certain amount of conical resorption may be the result of biomechanical adaptation of bone to stress. However, as bone resorption progresses, the increasing stresses in the cancellous bone and implant under lateral load may result in implant failure. Résumé Bien que la perte osseuse autour des implants soit considérée comme une complication quand elle progresse de manière incontrôlée, la résoption ne se termine pas toujours par la perte de l'implant, mais peut être le résultat de l'adaptation biomécanique au stress. Pour vérifier cette hypothèse, une analyse d'éléments finis en trois dimensions a été effectuée et l'influence de l'aspect et de la quantité de résorption osseuse marginale au stress dans l'os et l'implant a été analysée. Neuf modèles osseux avec un implant ont été créés : un modèle (Base) sans résorption et huit variations dans lesquelles trois profondeurs de résorption différentes ont été combinées avec des résorptions verticales ou coniques (verticale-horizontale). Des forces axiales et vestibulo-linguales ont été appliquées de manière indépendante en occlusal au centre de la superstructure. Quelle que soit la direction de la charge, les stress osseux étaient plus importants dans la résorption verticale pure (A) que dans le modèle de base et augmentaient avec la profondeur de résorption. Cependant, le stress osseux cortical était beaucoup plus faible dans les modèles à résorption conique que dans les modèles Base et A de même profondeur de résorption. Une tendance opposée était observée dans l'os spongieux sous charge vestibulo-linguale. Sous charge vestibulo-linguale, le stress le plus important dans l'implant augmentait linéairement avec la profondeur de résorption pour tous les modèles et sa localisation approchait l'espace existant en-dessous du pilier. Les résultats de cette analyse suggèrent qu'une certaine quantité de résorption conique pourrait être le résultat d'une adaptation biomécanique au stress osseux. Cependant, quand la résorption osseuse progresse les stress s'amplifiant dans l'os spongieux et au niveau de l'implant sous une force latérale peuvent résulter en un échec implantaire. Zusammenfassung Ziel: Auch wenn ein Knochenverlust um Implantate, der unkontrolliert fortschreitet, als Komplikation beschrieben wird, führen solche Resorptionen nicht gezwungenermassen zu einem Implantatverlust. Sie könnten aber Ausdruck einer biomechanischen Adaptation auf die Belastungen sein. Um diese Hypothese zu überprüfen, führte man eine dreidimensionale "Finite-Element"-Analyse durch. Man untersuchte die Zusammenhänge von Ausmass und Form der marginalen Knochenresorption und den entstehenden Kräften im Knochen und Implantat. Material und Methode: Die Arbeitsgrundlage waren 9 Modelle mit je einem Implantat: eines diente als Kontrolle (ohne Resorptionserscheinungen), die anderen acht zeigten drei verschiedene Resortionstiefen in Kombination mit rein vertikalen oder konischen (vertiko-horizontal) Defektformen. Dann liess man, unabhängig von der Okklusionsgestaltung, axiale und buccolinguale Kräfte auf die Mitte der Suprastruktur auftreffen. Resultate: Unabhängig von der Belastungsrichtung war die Knochenbelastung bei den rein vertikalen Resorptionsmodellen (A) grösser als beim Kontrollmodell und sie nahmen mit der Tiefe der Resorption zu. Die Belastung im kortikalen Knochen war aber in den Modellen mit konischen Resorptionen viel geringer als beim Kontrollmodell und den A-Modellen mit denselben Resorptionstiefen. Eine genau umgekehrte Tendenz konnte man im spongiösen Knochen unter buccolingualer Belastung feststellen.Bei einer buccolingualen Belastung nahm die Belastungsspitze beim Implantat bei allen Modellen linear mit der Resorptionstiefe zu und der Ort dieser Belastungsspitze lag im Bereich des Leerraumes genau unterhalb der Schraube des Sekundärteils. Zusammenfassung: Die Resultate dieser Analyse lassen vermuten, dass die konische Resorption bis zu einem gewissen Ausmass das Resultat einer biomechanischen Adaptation auf die Belastung des Knochens ist. Wenn aber die Knochenresorption fortschreitet, können die zunehmenden Belastungen im spongiösen Knochen und im Implantat bei einer lateralen Belastung zum Implantatmisserfolg führen. Resumen Objetivos: Aunque la pérdida de hueso alrededor de los implantes se informa como una complicación cuando progresa incontroladamente, la reabsorción no siempre lleva a la pérdida del implante, pero puede ser el resultado de la adaptación biomecánica al estrés. Para verificar esta hipótesis, se llevó a cabo un análisis tridimensional de elementos finitos y se investigó la influencia de la cantidad de reabsorción de hueso marginal y la forma en el estrés en el hueso y el implante. Material y métodos: Se crearon un total de 9 modelos de hueso con un implante: Un modelo sin reabsorción (Base) y 8 variaciones, el las que se combinaron tres diferentes profundidades de reabsorción con reabsorciones verticales o cónicas puras (vertical,horizontal). Se aplicaron fuerzas axiales y bucolinguales independientemente al nodo oclusal en el centro de la superestructura. Resultados: A pesar de la dirección de la carga, los estreses óseos fueron más altos en los modelos de reabsorción vertical pura (A) que en los modelos Base y se incrementaron con la profundidad de reabsorción. De todos modos, el estrés cortical fue mucho menor en los modelos de reabsorción cónica que en los modelos Base y A con la misma profundidad de reabsorción. Se observó una tendencia opuesta en el hueso esponjoso bajo carga bucolingual. Bajo carga bucolingual, el estrés mas alto en el implante se incrementó linealmente con la profundidad de reabsorción para todos los modelos y su localización se aproximó al espacio existente bajo el tornillo del pilar. Conclusión: Los resultados de este análisis sugieren que cierta cantidad de reabsorción cónica puede resultar de la adaptación biomecánica del hueso al estrés. De todos modos, al progresar la reabsorción ósea, los estrés crecientes en el hueso esponjoso y en el implante bajo carga lateral puede resultar en un fracaso del implante. 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