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Radiographic Parameters (radiographic + parameter)
Selected AbstractsPosterior pedicle screws combined with shortening and release techniques for lumbar and thoracolumbar adolescent idiopathic scoliosisORTHOPAEDIC SURGERY, Issue 1 2009Su-xi Gu MD Objective:, To prospectively evaluate the clinical and radiographic effects of posterior surgery with wide posterior shortening release and segmental pedicle screws techniques in a consecutive group of patients with thoracolumbar /lumbar adolescent idiopathic scoliosis. Methods:, Between April 2002 and July 2005, 114 patients (86 women and 28 men) were enrolled in this study. There were 72 Lenke type 5, 32 Lenke type 6, and 10 Lenke type 3C curves. Radiographic parameters such as coronal plane Cobb angle; lordosis angle; lowest instrumented vertebrae (LIV) angulation; and the distances from the central sacral vertical line (CSVL) to the LIV, to the apical vertebra and to the C7 plumb line, were analyzed. Complication rates were also recorded during follow-up. Results:, The average coronal correction was from 61° to 13° (78.6%). In the sagittal plane, lumbar lordosis was normalized from 36° with a wide range (23°,67°) to 42° with a normal range (34°,55°). The LIV had 79% correction of coronal angulations. The center sacral line to LIV was improved from 2.3 cm to 0.5 cm, apex to center sacral line from 5.0 cm to 1.6 cm, and CSVL from 2.7 cm to 0.8 cm. A total of 1460 pedicle screws were placed safely, average 9.6 levels (5,14) were fused. The patients were followed up for an average of 30 months (range, 12,50). There was excellent maintenance of correction at final follow-up. Conclusion:, Wide posterior release and segmental pedicle screw instrumentation has excellent radiographic and clinical results with minimal complications. [source] Clinical and radiographic scores in haemophilic arthropathies: how well do these correlate to subjective pain status and daily activities?HAEMOPHILIA, Issue 6 2002T. Wallny Summary. Haemophilic patients who reached adulthood before the establishment of prophylactic treatment frequently show multiple and substantial arthropathies. The aim of this study was to determine to what extent haemophiliac's subjective impairment due to arthropathies correlates with objective clinical and radiographic parameters. By means of a questionnaire and a visual analogue scale, we consulted 79 haemophiliacs concerning their joint-pain status, how these were treated and to what extent their daily activities had been affected. Using a scoring system suggested by the Advisory Committee of the World Federation of Haemophilia, clinical evaluation was performed. Radiographs of 60 patients were assessed by means of the Petterson scale. The results were statistically compared. We found a significant correlation between pain intensity and clinical pathology as well as between pain intensity and radiographic joint damage for both knees and for the right ankle. The number of painful joints correlated well with the number of clinically/radiographically affected joints. The more pronounced the objective damage to joints, the more frequently patients claimed to have constant pain, depressive episodes and a dependency on pain-relieving medication. The more pronounced the objectively assessed damage to the knee and ankle joint, the higher the likelihood that the patient suffers from severe joint pain and reduction of activity. Treatment of painful symptoms from arthropathies is often insufficient. Scores and questionnaires may help to define the haemophiliacs pain status more clearly, thereby offering a possibility of assessment and long-term observation. [source] Mandibular overdentures supported by two Brånemark, IMZ or ITI implants: a ten-year prospective randomized studyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2009Henny J. A. Meijer Abstract Objectives: The aim of this prospective comparative study was to evaluate the survival rate, condition of peri-implant tissues, patient satisfaction and surgical and prosthetic aftercare of the IMZ-implant system (two-stage cylinder type), the Brånemark-implant system (two-stage screw type) and the ITI-implant system (one-stage screw type) supporting a mandibular overdenture during a 10-year follow-up period. Materials and Methods: Three groups of 30 edentulous patients were treated with two endosseous implants in the interforaminal region of the mandible. Clinical and radiographic parameters were evaluated immediately after completion of the prosthetic treatment and after 1, 5 and 10 years of functional loading. Prosthetic and surgical aftercare was scored during the evaluation period, as well as patient satisfaction. Results: The 10-year survival rate was 93% for the IMZ group, 98% for the Brånemark group and 100% for the ITI group (IMZ Periodontal conditions in patients with coronary heart disease: a case,control studyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 3 2008Carin Starkhammar Johansson Abstract Aim: This study examined periodontal conditions in patients with coronary heart disease (CHD) and subjects with no history of CHD. Material and Methods: Participants were 161 patients (40,75) with severe angina pectoris (diagnosed as CHD by coronary angiography) who subsequently underwent percutaneous coronary intervention and 162 control subjects with no history of CHD. Periodontal status was recorded. Bone loss was determined on radiographs. Periodontal disease experience was classified into five groups according to Hugoson & Jordan. Results: Periodontal disease experience groups 4 and 5 were more common in the CHD group (25%) compared with the control group (8%). The mean bone level (the distance from the CEJ to the most coronal level of the alveolar bone) was 3.0±1.0 mm in CHD subjects and 2.6±0.8 mm in controls. CHD patients had significantly lower numbers of natural teeth, higher numbers of periodontal pockets 4,6-mm and higher bleeding on probing (%). In a stepwise regression analysis, the factor periodontal disease experience groups 4+5 gave an odds ratio of 5.74 (2.07,15.90) for having CHD after controlling for smoking and age. Conclusion: Severe periodontal disease expressed by several clinical and radiographic parameters was more prevalent among subjects with CHD than among controls. Analysis, the factor periodontal disease experience groups 4+5 gave an odds ratio of 5.74 (2.07,15.90) for having CHD after controlling for smoking and age. [source] Intervertebral disc degeneration: New insights based on "skipped" level disc pathologyARTHRITIS & RHEUMATISM, Issue 8 2010Kenneth M. C. Cheung Objective Typically, age and abnormal physical loading ("wear and tear") have been associated with the development of intervertebral disc degeneration. In the past decade, various additional etiologic factors for disc degeneration have been sporadically reported in the literature; however, many investigators continue to place tremendous emphasis on the effects of age and biomechanics associated with disc degeneration. The aim of this study was to provide additional insight into the notion that age and biomechanics are key factors in the development of disc degeneration. To this end, we addressed the prevalence of and risk factors associated with a unique pattern of disc degeneration of the lumbar spine, "skipped" level (nonconsecutive) disc degeneration (SLDD). Methods As part of a large genetics-based study in southern Chinese individuals (n = 1,989), a cross-sectional analysis was performed in subjects exhibiting disc degeneration in ,2 levels (n = 838) who were then categorized as having SLDD (n = 174) or non-SLDD (contiguous, multilevel; n = 664). Various radiographic parameters were assessed based on T2-weighted magnetic resonance imaging (MRI). Subject demographics were assessed, and univariate and multivariate logistic regression analyses were performed. Results Overall, 8.7% of the whole population (n = 1,989) had SLDD, while it was present in 20.8% of subjects with multilevel disc degeneration (n = 838). SLDD was more prevalent in male subjects (adjusted odds ratio [OR] 1.48, 95% confidence interval [95% CI] 1.04,2.10, P = 0.028). SLDD was significantly associated with the presence of Schmorl's nodes (adjusted OR 2.72, 95% CI 1.78,4.15, P < 0.001), which also presented in levels with no disc degeneration. A history of disc bulge/extrusion (P = 0.004) and/or a history of back injury (P = 0.010) was significantly associated with non-SLDD, and a greater degree of overall severity of disc degeneration was also associated with non-SLDD. Other demographic and MRI findings did not significantly differ between groups. Conclusion To our knowledge, this report is the first to describe the prevalence and risk factors associated with SLDD. Our study challenges the paradigm that age and biomechanics are the key factors associated with the development of disc degeneration. Although age and biomechanical factors may play a role in the manifestation of disc degeneration, our novel findings of SLDD patterns provide further awareness of and support for the notion that additional etiologic factors may play a role in the development of disc degeneration. Such factors warrant further investigation to shed light on the cause of disc degeneration. [source] Clinical outcome of submerged vs. non-submerged implants placed in fresh extraction socketsCLINICAL ORAL IMPLANTS RESEARCH, Issue 12 2009Luca Cordaro Abstract Aim: The aim of this study was to compare the clinical outcome of submerged vs. non-submerged tapered implants placed into fresh extraction sockets. Materials and methods: A prospective, controlled, multicenter, randomized, clinical trial has been performed in two centers in Rome and Torino (Italy). Thirty healthy patients were recruited according to the following inclusion criteria: need for an immediate post extraction implant, ages between 18 and 70, horizontal defect depth <2 mm, smokers <10 cigarettes/day and absence of any circumstance or condition that could represent contraindications to implant surgery. The patients were randomly allocated to submerged or non-submerged treatment groups immediately after flap elevation and tooth extraction. Submerged implants were exposed 8 weeks after the first surgery; all implants were loaded with provisional restorations 12 weeks after the first surgery and with definitive restoration 12 weeks thereafter. Clinical and radiographic parameters were evaluated at baseline, at implant loading and at the 1-year follow-up visit. Results: The results showed statistically significant differences between the two groups in the mean value of keratinized tissue (KT) height after surgery that was significantly reduced for submerged implants when compared with transmucosal implants (mean reduction of KT at year follow-up: T group 0.2 mm, S group 1.3 mm; P=0.007). Conclusion: Similar outcomes were found for submerged and non-submerged implants placed in fresh extraction sockets with a horizontal peri-implant defect smaller than 2 mm, except for a reduction of KT in the submerged group. Either with a submerged or a non-submerged procedure, 1 mm of mean soft tissue recession is seen after 1 year when compared with the pre-extraction situation. [source] Soft and hard tissue assessment of immediate implant placement: a case seriesCLINICAL ORAL IMPLANTS RESEARCH, Issue 2 2007Gintaras Juodzbalys Abstract Objectives: The aim of this prospective study was to evaluate clinically and radiographically the success and esthetic result of immediate implant placement at the time of extraction. Material and methods: Twelve patients with 14 titanium screw-shaped implants (13,16 mm length and 4.3 or 5 mm diameters) were placed in the extraction sockets. Defects after implant placement were recorded, and then filled up with deproteinized bovine bone mineral, bioabsorbable collagen membrane, and absorbable pins. The defect was again re-evaluated at second-stage surgery. Clinical and radiographic parameters of the peri-implant conditions were assessed at the moment of prosthesis placement and at 1-year follow-up. Results: The cumulative implant survival and success rate was 100% after a 1-year observation period. Analysis of the esthetic result showed that the mean pink esthetic score (PES) was 11.1 (SD 1.35) at 1-year follow-up. At 1 year, 64.3% papillae had a score of 2 and the remaining 35.7% score 3 according to the Jemt (1997) papillary index. Optimal value of width of the keratinized mucosa was recorded in 13 (92.9%) implant cases in both periods of follow-up. At 1-year follow-up, the linear distance between implant-shoulder to the bone peaks remains stable with a mean of 2.62±0.2 mm at the mesial and 2.9±0.58 mm at the distal aspect. Conclusion: Careful evaluation of potential extraction sites before immediate implant installation promotes optimal implant esthetics. [source] Mandibular overdentures supported by two or four endosseous implantsCLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2005A 5-year prospective study Abstract Objective: The aim of this 5-year prospective comparative study was to evaluate treatment outcome (survival rate, condition of hard and soft peri-implant tissues, patient satisfaction, prosthetic and surgical aftercare) of mandibular overdentures supported by two or four implants. Material and methods: Sixty edentulous patients with a mandibular height between 12 and 18 mm participated. Thirty patients were treated with an overdenture supported by two IMZ implants (group A) and 30 patients were treated with an overdenture supported by four IMZ implants (group B). Standardised clinical and radiographic parameters were evaluated 6 weeks after completion of the prosthetic treatment and after 1, 2, 3, 4 and 5 years of functional loading. Prosthetic and surgical aftercare was scored during the evaluation period. Results: One implant was lost (group A) during the healing period. There were no significant differences with regard to any of the studied clinical or radiographic parameters of the peri-implant tissues between the groups. None of the patients reported sensory disturbances in the lip or chin region. No differences in satisfaction were observed between the groups. With regard to aftercare, there was a tendency of a greater need of prosthetic interventions in group A, while correction of soft-tissue problems was restricted to patients of group B. Conclusion: There is no difference in clinical and radiographical state of patients treated with an overdenture on two or four implants during a 5-year evaluation period. Patients of both groups were as satisfied with their overdentures. Résumé Le but de cette étude comparative et prospective de cinq années a été d'évaluer la guérison (taux de survie, condition des tissus paroïmplantaires mous et durs, satisfaction du patient, prothèse et chirurgie) de prothèses mandibulaires sur deux ou quatre implants. Soixante édentés avec une hauteur mandibulaire entre douze et 18 mm ont participé. Trente patients ont été traités avec une prothèse ancrées sur deux implants IMZ (groupe A) tandis que les trente autres ont été traités avec une prothèse ancrée sur quatre implants IMZ (groupe B). Les paramètres radiographiques et cliniques standards ont étéévalués six semaines après la mise en place de la prothèse et ensuite une, deux, trois, quatre et cinq années après la mise en charge fonctionnelle. Le suivi chirurgical et prothétique a étéévalué durant cette période. Un implant a été perdu dans le groupe A durant la période de guérison. Il n'y avait aucune différence significative en ce qui concerne aucun des paramètres radiographiques et cliniques étudiés des tissus paroïmplantaires entre les deux groupes. Aucun des patients n'a rapporté d'ennuis sensoriels au niveau de la lèvre ou du menton. Aucune différence dans la satisfaction n'a été observée entre les deux groupes. En ce qui concerne le maintien, une nécessité plus importante d'intervention au niveau des prothèses était constatée dans le groupe A tandis que la correction des problèmes des tissus mous n'a dûêtre effectuée que chez les patients du groupe B. Il n'y a donc aucune différence radiographique ou clinique chez les patients traités avec une prothèse ancrée sur deux ou quatre implants durant un suivi de cinq années. Les patients des deux groupes étaient autant satisfaits de leurs prothèses. Zusammenfassung Ziel: Das Ziel dieser prospektiven vergleichenden Studie über 5 Jahre war, das Behandlungsresultat (Ueberlebensrate, Zustand der peri-implantären Hart- und Weichgewebe, Patientenzufriedenheit, prothetische und chirurgische Nachsorge) von Hybridprothesen im Unterkiefer, welche von 2 oder 4 Implantaten getragen werden, zu untersuchen. Material und Methoden: An der Studie nahmen 60 zahnlose Patienten mit einer Unterkieferhöhe zwischen 12 und 18 mm teil. 30 Patienten wurden mit einer Hybridprothese getragen von 2 IMZ Implantaten versorgt (Gruppe A), und 30 Patienten erhielten eine Hybridprothese auf 4 IMZ Implantaten (Gruppe B). Standardisierte klinische und radiologische Parameter wurden 6 Wochen nach Eingliederung der Rekonstruktion und nach 1,2,3,4 und 5 Jahren funktioneller Belastung ausgewertet. Die prothetische und chirurgische Nachsorge wurde während der Beobachtungsperiode aufgezeichnet. Resultate: 1 Implantat ging während der Einheilphase verloren (Gruppe A). Es bestanden keine signifikanten Unterschiede in Bezug auf die untersuchten klinischen und radiologischen Parameter der peri-implantären Gewebe zwischen den zwei Gruppen. Keiner der Patienten beklagte Gefühlsstörungen im Bereich der Lippe oder des Kinns. Zwischen den zwei Gruppen bestanden keine Unterschiede bezüglich Zufriedenheit. Bei der Nachsorge bestand eine Tendenz eines grösseren Bedarfs an prothetischen Interventionen in Gruppe A, während Korrekturen von Weichteilproblemen auf Patienten der Gruppe B beschränkt waren. Schlussfolgerung: Es bestehen keine Unterschiede in den klinischen und radiologischen Befunden bei Patienten, welche für eine Beobachtungsperiode von 5 Jahren mit Hybridprothesen auf 2 oder 4 Implantaten versorgt worden waren. Die Patienten beider Gruppen waren mit ihren Hybridprothesen zufrieden. Resumen Objetivo: La intención de este estudio fue prospectivo comparativo de 5-años fue evaluar los resultados del tratamiento (índice de supervivencia, condiciones de los tejidos duros y blandos periimplantarios, satisfacción del paciente, mantenimiento postquirúrgico y postprotesico) de sobredentaduras mandibulares soportadas por 2 o 4 implantes. Material y Métodos: Participaron 60 pacientes edéntulos con una altura mandibular entre 12 y 18 mm. Se trataron 30 pacientes con una sobredentadura soportada por 2 implantes IMZ (grupo A) y 30 pacientes se trataron con una sobredentadura soportada por 4 implantes IMZ (grupo B). Se evaluaron parámetros clínicos y radiológicos a las 6 semanas tras conclusión del tratamiento protésico y tras 1, 2, 3, 4 y 5 años de carga funcional. Se tomó nota del mantenimiento prostético y quirúrgico durante el periodo de evaluación. Resultados: Se perdió un implante (grupo A) durante el periodo de cicatrización. No hubo diferencias significativas respecto a ninguno de los parámetros clínicos y radiográficos estudiados de los tejidos periimplantarios entre los grupos. Ninguno de los pacientes informó sobre molestias sensoriales en el labio o la región del mentón. No se observaron diferencias entre los grupos respecto a la satisfacción. Respecto al mantenimiento, hubo una tendencia a una mayor necesidad de intervenciones prostéticas en el grupo A, mientras que las correcciones en los tejidos blandos se circunscribieron al grupo B. Conclusiones: No hay diferencias en el estado clínico y radiográfico de los pacientes tratados con una sobredentadura en 2 o 4 implantes durante un periodo de evaluación de 5 años. Los pacientes de ambos grupos estaban satisfechos con sus sobredentaduras. [source] Early loading (2 or 6 weeks) of sandblasted and acid-etched (SLA) ITI® implants in the posterior mandibleCLINICAL ORAL IMPLANTS RESEARCH, Issue 2 2004A 1-year randomized controlled clinical trial Abstract: The aim of this 1-year prospective controlled clinical trial was to evaluate the effect of early loading of ITI® solid screw titanium implants with a sandblasted and acid-etched (SLA) surface on clinical and radiographic parameters. Material and methods: Twenty-seven consecutively admitted patients presenting bilateral edentulous posterior mandibular areas and in need of prosthetic reconstruction were recruited. Sixty-seven ITI® standard solid screw implants with an SLA surface, a diameter of 4.1 mm and a length of 8, 10 or 12 mm were installed bilaterally in molar and premolar areas according to a one-stage surgical protocol. One week (test) and 5 weeks (control) after implant placement, solid ITI® prosthetic abutments were connected using a torque of 35 N cm. No provisional restoration was fabricated. Two weeks (test) and 6 weeks (control) after implant placement, porcelain-fused-to-metal single-tooth crowns were cemented. Clinical measurements were obtained at day 0 and 2, 6, 12, 24 and 52 weeks thereafter. Periapical radiographs were taken immediately after implant placement, after 6 weeks and at the 1-year examination. Results: After 1 year, implant survival was 100%. Two test and one control implants rotated at the time of abutment connection and were left unloaded for 12 additional weeks. At the 1-year examination, no statistically significant differences were found between the test and control sites with respect to pocket probing depths (2.6 mm±0.5 vs. 2.7 mm±0.5), mean clinical attachment levels (3.1 mm±0.4 vs. 3.2 mm±0.5), mean percentages of sites bleeding on probing (9.7% vs. 8.3%), mean widths of keratinized mucosa (1.8 mm±0.4 vs. 1.9 mm±0.5), mean PerioTest® values (,1.4 PTV±0.9 vs. ,1.6 PTV±0.8) or mean crestal bone loss measurements (0.57 mm±0.49 vs. 0.72 mm±0.50). Conclusion: Based on these results, loading of titanium implants with an SLA surface as early as 2 weeks did not appear to jeopardize the osseointegration healing process in the posterior mandible. Furthermore, implants rotating at 35 N cm, if left unloaded for additional 12 weeks, did not negatively affect clinical and radiographic outcomes. Résumé Le but de cet essai clinique contrôlé prospectif d'une année a été d'évaluer l'effet de la mise en charge précoce d'implants en titane vis solide ITI® avec une surface sablée et mordancée (SLA) sur des paramètres cliniques et radiographiques. Vingt-sept patients présentant des aires bilatérales mandibulaires postérieures édentées et nécessitant donc une reconstruction prothétique ont été recrutés. Soixante-sept implants ITI® d'un diamètre de 4,1 mm et d'une longueur de 8, 10 ou 12 mm ont été placés bilatéralement dans les zones molaires et prémolaires suivant le processus chirurgical en une étape. Une semaine (test) et cinq semaines (contrôle) après leur placement des piliers prothétiques ITI® ont été serrés avec une force de 35 Ncm. Aucune restauration provisoire n'a été fabriquée. Deux semaines (test) et six semaines (contrôle) après le placement des implants des couronnes céramo-métalliques indépendantes ont été cimentées. Des mesures cliniques ont été obtenues aux jours 0 et deux, et aux semaines 6, 12, 24 et 52. Des radiographies périapicales ont été prises immédiatement après le placement des implants, après six semaines et une année. Après une année, le taux de survie implantaire était de 100%. Deux implants tests et un contrôle pivotaient au moment de la connexion du pilier et ont été laissés non-chargés pour 12 semaines supplémentaires. Après une année, aucune différence statistique n'a été trouvée entre les sites tests et contrôles en ce qui concerne les profondeurs de poches au sondage (2,6 ±0,5 mm vs 2,7± 0,5 mm), les niveaux d'attache clinique moyens (3,1±0,4 vs 3,2±0,5 mm,) les pourcentages moyens de sites saignant au sondage (9,7% vs 8,3%), les largeurs moyennes de muqueuse attachée (1,8±0,4 mm vs 1,9±0,5 mm), les valeurs Periotest moyennes (,1,4±0,9 PTV vs ,1,6 ±0,8 PTV) ou les mesures de perte osseuse crestale moyennes (0,57 ± 0,49 mm vs 0,72±0,52 mm). La charge d'implants en titane avec surface SLA aussitôt que deux semaines après leur placement ne semblait pas mettre en danger le processus d'ostéoïntégration dans la partie postérieure de la mandibule. De plus, les implants pivotant à 35 Ncm, si laissés non-chargés pour douze semaines supplémentaires, n'affectaient pas de manière négative les mesures cliniques et radiographiques. Zusammenfassung Material und Methoden: Es wurden siebenundzwanzig Patienten mit beidseits zahnlosem Seitenzahnbereich im Unterkiefer, welche eine prothetische Versorgung benötigten, in die Studie aufgenommen. Es wurden 67 ITI® Standard Vollschraubenimplantate mit einem Durchmesser von 4.1 mm und einer Länge von 8, 10 oder 12 mm beidseits in der Molaren- und Prämolarenregion transmukosal eingesetzt. Eine Woche (Test) und 5 Wochen (Kontrolle) nach Implantation wurden ITI® Massivsekundärteile mit einem Drehmoment von 35 Ncm eingesetzt. Es wurde keine provisorische Versorgung angefertigt. Zwei Wochen (Test) und 6 Wochen (Kontrolle) nach Implantation wurden Gold-Porzellan Einzelkronen einzementiert. Klinische Messungen wurden am Tag 0 und nach 2, 6, 12, 24, und 52 Wochen aufgenommen. Periapikale Röntgenaufnahmen wurden sofort nach der Implantation, nach 6 Wochen und anlässlich der 1 Jahreskontrolle angefertigt. Resultate: Nach einem Jahr betrug die Implanta-tüberlebensrate 100%. Zwei Test- und ein Kontrollimplantat drehten sich beim Einschrauben der Sekundärteile und wurden für zusätzliche 12 Wochen unbelastet belassen. Bei der 1 Jahresuntersuchung konnten zwischen Test- und Kontrolli-mplantaten keine statistisch signifikanten Unterschiede bezüglich Sondierungswerten (2.6mm+/,0.5 gegenüber 2.7mm +/,0.5), mittlerem klinischem Attachmentniveau (3.1mm +/,0.4 gegenüber 3.2mm +/,0.5), mittlerem Prozentanteil beim Bluten auf Sondieren (9.7% gegenüber 8.3%), mittlerer Breite der keratinisierten Mukosa (1.8mm +/,0.4 gegenüber 1.9mm +/,0.5), mittleren Periotest® Werten (,1.4 PTV +/,0.9 gegenüber ,1.6 PTV +/,0.8) oder mittlerem marginalem Knochenverlust (0.57mm +/,0.49 gegenüber 0.72mm +/,0.50) gefunden werden. Schlussfolgerung: Gemäss dieser Resultate schien die Belastung von Titanimplantaten mit SLA Oberfäche bereits nach 2 Wochen den Heilungsprozess der Osseointegration im posterioren Unterkiefer nicht zu beeinträchtigen. Implantate, die bei 35Ncm rotierten und daraufhin für weitere 12 Wochen unbelastet blieben, beeinflussten die klinischen und radiologischen Resultate nicht negativ. Resumen La intención de este ensayo clínico prospectivo controlado fue evaluar el efecto de una carga temprana sobre implantes macizos roscados de titanio con una superficie pulverizada con arena y gravada con ácido (SLA) sobre parámetros clínicos y radiográficos. Material y Métodos: Se reclutaron veintisiete pacientes consecutivamente admitidos que presentaron áreas edéntulas bilaterales en la mandíbula posterior y necesitando reconstrucción protésica. Se instalaron bilateralmente en las áreas molar y premolar sesenta y siete implantes ITI® estándar macizos roscados de titanio con una superficie SLA, un diámetro de 4.1 mm y una longitud de 8, 10 o 12 mm de acuerdo con un protocolo quirúrgico de una sola fase. Una semana (prueba) y 5 semanas (control) tras la colocación del implante, se conectaron pilares prostéticos macizos ITI usando un torque de 35 Ncm. No se fabricaron restauraciones provisionales. Dos semanas (prueba) y 6 semanas (control) tras la colocación de los implantes, se cementaron coronas unitarias metalocerámicas. Se obtuvieron medidas clínicas en el día 0 y tras 2, 6, 12, 24 y 52 semanas. Se tomaron radiografías periapicales inmediatamente tras la colocación del implante, a las 6 semanas y en el examen de 1 año. Resultados: Tras 1 año, la supervivencia de los implantes fue del 100%. Dos implantes de prueba y uno de control rotaron en el momento de la conexión del pilar y se dejaron sin carga durante 12 semanas más. En el examen de 1 año, no se encontraron diferencias significativas entre los lugares de prueba y los de control respecto a las profundidades de sondaje (2.6 mm±0.5 vs. 2.7 mm±0.5), niveles medios de inserción clínica (3.1±mm±0.4 vs. 3.2 mm±0.5), porcentaje medio de lugares con sangrado al sondaje (9.7% vs. 8.3%), anchura media de mucosa queratinizada (1.8 mm±0.4 vs. 1.9 mm±0.5), valores medios de Perio Test® (,1.4 PTV±0.9 vs. ,1.6 PTV±0.8) o a las medidas medias de perdida de hueso crestal (0.57 mm±0.49 vs. 0.72 mm±0.50). Conclusiones: Basándose en estos resultados, la carga de implantes de titanio con superficie SLA tan pronto como a las 2 semanas no pareció comprometer el proceso de cicatrización de la osteointegración en la mandíbula posterior. Mas aun, los implantes que rotaron a 35 Ncm, si se dejan sin carga durante 12 semanas más, no afectaron negativamente los resultados clínicos y radiográficos. [source] Effect of implant design on survival and success rates of titanium oral implants: a 10-year prospective cohort study of the ITI® Dental Implant SystemCLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2004Ioannis K. Karoussis Abstract Aim: The aim of this 10-year study (observation time 8,12 years, mean: 10 years) was to compare the survival rates, success rates and incidences of biological complications using three different implant designs of the ITI® Dental Implant System. Material and methods: In 89 dental patients treated comprehensively, a total of 112 hollow screw (HS), 49 hollow cylinder (HC) and 18 angulated hollow cylinder (AHC) implants were installed depending on the available bone volume and according to prosthetic needs. One and 10 years after surgical placement, clinical and radiographic parameters were assessed. The incidences of peri-implantitis according to various thresholds were registered over 10 years of maintenance. Results: Success criteria at 10 years were set at: pocket probing depth (PPD)5 mm, bleeding on probing (BoP),, bone loss < 0.2 mm annually. The survival rate for HS was 95.4%, for HC 85.7% and for AHC 91.7%. Ninety percent of all the HS, 71% of the HC and 88% of the AHC did not present with an incidence of peri-implantitis over the 10 years, HC having significantly higher incidence of peri-implantitis than HS (P< 0.004). With the success criteria set above, a success rate for HS of 74%, for HC of 63% and for AHC of 61% was identified at 10 years. However, including a definition of PPD6 mm, BoP , and bone loss < 0.2 mm annually for success, the rates for HS were 78%, for HC 65% and for AHC 67%, respectively. Basing success criteria purely on clinical parameters (without radiographic analysis), such as: PPD5 mm and BoP,, the success rates increased to 90%, 76% and 89%, respectively. With PPD6 mm and BoP , as success criteria chosen, the respective rates were 94%, 82% and 94% for HS, HC and AHC implants, respectively. Conclusions: A significantly higher survival rate as well as a significantly lower incidence of peri-implantitis was identified for hollow screw design ITI® Dental Implants after 10 years of service when compared to hollow cylinder design ITI® Dental Implants (95.4% vs. 85.7%; 10% vs. 29%). Depending on the setting of the threshold criteria for success, success rates are highly variable and hence, reporting of success rates with elaboration on the criteria set appears crucial for comparison of different studies. Résumé Le but de ce suivi d'une décennie a été de comparer les taux de survie, les taux de succès et les incidences des complications biologiques de l'utilisation de trois modèles implantaires différents du système ITI® Dental Implant. Chez 89 patients, 112 vis creuses (HS), 49 cylindres creux (HC) et 18 cylindres creux angulés (AHC) ont été placés suivant le volume osseux disponible et les nécessités prothétiques. Une et dix années après leur placement, des paramètres cliniques et radiographiques ont été définis. Les incidences de paroïmplantite relatives aux différents seuils ont été enregistrées durant ces dix années de maintenance. Les succès des critères à dix ans étaient placés à : PPD5 mm, BoP-, perte osseuse <0,2 mm/an. Le taux de survie pour HS était de 95,4%, pour HC de 86% et pour AHC de 92%. Nonante pour cent de tous les HS, 71% des HC et 88% des AHC ne présentaient pas d'incidences de paroïmplantite durant ces dix années, HC ayant une plus importante incidence de paroïmplantite que HS (p<0,004). Grace aux critères de succès indiqués, un taux de succès de 74% pour HS, de 63% pour HC et de 61% pour AHC a été identifié après dix ans. Cependant, en définissant le succès avec PPD6mm, BoP- et perte osseuse <0,2mm/an, les taux étaient de 78% pour HS, de 65% pour HC et de 67% pour AHC. En basant les taux de succès uniquement sur les paramètres cliniques (sans l'analyse radiographique) tels que PPD5 mm et BoP-, les taux de succès augmentaient respectivement à 90, 76 et 89%. Avec PPD6mm et BoP- comme critères de succès, les taux s'élevaient respectivement à 94, 82 et 94%. Un taux de survie significativement plus important ainsi qu'une incidence significativement plus faible de paroïmplantite étaient constatés au niveau des implants vis creuses après dix ans de mise en fonction comparés aux cylindres creux. Suivant l'établissement du seuil pour les critères du succès, les taux de ce succès sont extrêmement variables et rapporter les taux de succès suivant l'élaboration des critères est donc crucial pour comparer différentes études. Zusammenfassung Ziel: Das Ziel dieser 10-Jahresstudie (Beobachtungszeit 8,12 Jahre, Mittelwert: 10 Jahre) war es, bei ITI® -Implantaten mit drei verschiedenen Designs, die Erfolgs- und Überlebensrate zu vergleichen, und das Auftreten von biologischen Zwischenfällen zu untersuchen. Material und Methode: Bei 89 synoptisch behandelten Patienten implantierte man in Abhängigkeit des vorhandenen Knochenvolumens und der prothetischen Anforderungen insgesamt 112 Hohlschraubenimplantate (HS), 49 Hohlzylinderimplantate (HC) und 18 abgewinkelte Hohlzylinderimplantate (AHC). Ein und zehn Jahre nach der Implantation nahm man die klinischen und radiologischen Parameter auf. Eine Periimplantitis registrierte während der 10-jährigen Erhaltungsphase anhand verschiedener Grenzwerte. Resultate: Die Kriterien für einen Erfolg nach 10 Jahren legte man bei den folgenden Werten fest: PPD <5mm, BOP-, jährlicher Knochenverlust <0.2mm. Die Überlebensrate für ein HS lag bei 95.4%, für ein HC bei 85.7% und für ein AHC bei 91.7%. 90% aller HS, 71% aller HC und 88% aller AHC zeigte während den 10 Jahren nie Anzeichen einer Periimplantitis, wobei die HC signifikant häufiger Periimplantitis hatten, als die HS (p<0.004). Mit den oben festgelegten Erfolgskriterien ergab sich nach 10 Jahren für die HS eine Erfolgsrate von 74%, für die HC eine von 63% und für die AHC eine von 61%. Veränderte man die Definition auf "PPD<6mm, BOP -, jährlicher Kochenverlust <0.2mm", so betrugen die Erfolgsraten für die HS 78%, für die HC 65% und für die AHC 67%. Basierten die Erfolgskriterien rein auf klinischen Parametern (PPD <5mm, BOP-, keine röntgenologische Anlyse), so stiegen die Erfolgsraten auf 90%, 76% und 89% an. Wählte man die Erfolgskriterien "PPD <6mm und BOP -", so betrugen die Erfolgsraten für die HS 94%, für die HC 82% und für die AHC 94%. Zusammenfassung: Verglich man nach 10-jähriger Funktion die Hohlschrauben des ITI® -Implantat-Systems mit den Hohlzylindern desselben Systems, so ergab sich für die HS sowohl eine signifikant höher Überlebensrate, wie auch ein selteneres Auftreten von Periimplantitis (95.4% vs. 85.7%; 10% vs. 29%). Die Erfolgsraten variieren in Abhängigkeit der in der Definition eines Erfolges festgelegten Grenzwerten enorm stark. Dies erweist sich im Vergleich von verschiedenen Studien als hinderlich, weil die Definition der Erfolgsraten meist auf verschiedenen Kriterien beruhen. Resumen Intención: La intención de este estudio de 10 años (tiempo de observación 8,12, media: 10 años) fue comparar los índices de supervivencia, índices de éxito e índices de complicaciones biológicas usando tres diferentes diseños de implantes del Sistema de Implantes Dentales ITI®. Material y Métodos: Se instalaron en 89 pacientes dentales tratados completamente un total de 112 tornillos huecos (HS), 49 cilindros huecos (HC) y 18 cilindros huecos angulados (AHC) dependiendo de la disponibilidad de volumen óseo y de acuerdo con las necesidades protésicas. Se valoraron parámetros clínicos y radiográficos uno y diez años tras la colocación quirúrgica. Se registraron las incidencias de periimplantitis de acuerdo con varios umbrales a lo largo de 10 años de mantenimiento. Resultados: Los criterios de éxito a los 10 años se situaron en PPD5mm, BoP-, pérdida ósea < 0.2mm por año. El índice de supervivencia para los HS fue del 95.4%, para los HC del 85.7% y para los AHC del 91.7%. El 90% de los HS, el 71% de los HC y el 88% de los AHC no presentaron ninguna incidencia de periimplantitis a lo largo de los 10 años, HC tuvo una significativamente mayor incidencia de periimplantitis que HS (p< 0.004). Con los criterios de éxito antes mencionados, se identificó un índice de éxito para HS del 74%, para HC del 63% y para AHC del 61% a los 10 años. De todos modos, incluyendo una definición de PPD6mm, BoP, y pérdida ósea <0.2mm al año para tener éxito, los índices para HS fueron del 78%, para HC 65% y para AHC 67%, respectivamente. Basando los criterios de éxito puramente en parámetros clínicos (sin análisis radiográficos), tales como: PPD5mm y BoP-, los índices de éxito subieron hasta el 90%, 76% y 89%, respectivamente. Con el PPD6mm y BoP , como criterios de éxito elegidos, los índices respectivos fueron del 94%,82% y 94% para implantes HS, HC y AHC, respectivamente. Conclusiones: Se identificó un significativamente mayor índice de supervivencia al igual que una menor incidencia de periimplantitis para el diseño de tornillo hueco Implante Dental ITI®. (95.4% vs. 85.7; 10% vs. 29%). Dependiendo de la definición del criterio del umbral de éxito, los índices de éxito son altamente variables y por tanto, los informes de los índices de éxito con elaboración de la definición de criterios parece ser crucial para la comparación de los diferentes estudios. [source]
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