| 11. |
- Davidson, Thomas, et al.
(författare)
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Reimbursement systems influence prosthodontic treatment of adult patients
- 2015
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 73:6, s. 414-420
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To evaluate the influence of reimbursement system and organizational structure on oral rehabilitation of adult patients with tooth loss. Materials and methods. Patient data were retrieved from the databases of the Swedish Social Insurance Agency. The data consisted of treatment records of patients aged 19 years and above claiming reimbursement for dental care from July 1, 2007 until June 30, 2009. Before July 1, 2008, a proportionately higher level of subsidy was available for dental care in patients 65 years and above, but thereafter the system was changed, so that the subsidy was the same, regardless of the patient's age. Prosthodontic treatment in patients 65 years and above was compared with that in younger patients before and after the change of the reimbursement system. Prosthodontic treatment carried out in the Public Dental Health Service and the private sector was also analyzed. Results. Data were retrieved for 722,842 adult patients, covering a total of 1,339,915 reimbursed treatment items. After the change of the reimbursement system, there was a decrease in the proportion of items in patients 65 years and above in relation to those under 65. Overall, there was a minimal change in the proportion of treatment items provided by the private sector compared to the public sector following the change of the reimbursement system. Conclusions. Irrespective of service provider, private or public, financial incentive such as the reimbursement system may influence the provision of prosthodontic treatment, in terms of volume of treatment.
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| 12. |
- Ekelund, Jan-Anders, et al.
(författare)
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Implant treatment in the edentulous mandible: a prospective study on Brånemark system implants over more than 20 years.
- 2003
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Ingår i: The International journal of prosthodontics. - 0893-2174. ; 16:6, s. 602-8
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: This prospective investigation studied the clinical and radiographic performance of mandibular fixed prostheses supported by osseointegrated implants over more than 20 years. MATERIALS AND METHODS: A total of 273 standard Brånemark implants (10 mm long) were placed in 47 patients between 1978 and 1982. Clinical and radiographic data collected at several examinations over the 20-year observation period have been reported previously. This study presents the outcome of the latest follow-up after 20 to 23 years. RESULTS: Thirty patients (64%; 75% of those still alive) attended the 20-year follow-up examination. Three implants were lost during the entire observation period, and the 20-year implant cumulative survival rate was 98.9%. All patients had continuous prosthesis function, but two had their mandibular prostheses remade during the 20 years. No implants or prostheses were lost or fractured during the last 5 years, and only a few prosthodontic complications were noted. The mean bone level was 1.6 mm (SD 0.90) below the reference point after 20 years, and mean bone loss was 0.2 mm (SD 0.22) between the 15- and 20-year follow-ups. Thirty-seven implants (24%) showed more than two exposed threads at the 15-year follow-up examination, but only four implants (3%) presented pain and/or bone loss exceeding one thread (0.6 mm) during the last 5 years. CONCLUSION: The successful treatment result after 15 years continued up to more than 20 years in function. During the last 5 years, a majority of the implants with several exposed implant threads could be maintained without any complications, and the frequency of implants showing signs of ongoing peri-implantitis was less than 3%.
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| 13. |
- Eliasson, Alf, 1959, et al.
(författare)
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The precision of fit of milled titanium implant frameworks (I-Bridge) in the edentulous jaw.
- 2010
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Ingår i: Clinical implant dentistry and related research. - : Wiley. - 1708-8208 .- 1523-0899. ; 12:2, s. 81-90
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: New computer numeric controlled (CNC)-milled frameworks for implant-supported prostheses have been introduced. However, no data are available on the precision of fit of these new frameworks. PURPOSE: The purpose of this study is to evaluate the precision of fit of a new CNC-milled framework technique (I-Bridge, Biomain AB, Helsingborg, Sweden) using Brånemark System (Nobel Biocare AB, Göteborg, Sweden) and NobelReplace (Nobel Biocare AB) system implants. MATERIALS AND METHODS: Ten test frameworks were fabricated for one master model for each implant system. Five additional frameworks were fabricated for five different models simulating clinical cases as controls (Brånemark System). The distortion of implant center point positions was measured in x-, y-, and z-axes and in three dimensions by using a contact-type coordinate measuring machine and a computer program developed specifically for this purpose. Mann-Whitney U-test was used to compare differences of distortion within and between the groups. RESULTS: The maximal distortion in arch width (x-axis) and curvature (y-axis) was within 71 and 55 microm for all frameworks, respectively. The mean distortion in absolute figures in x-, y-, z-axes and three dimensions was for "clinical control" frameworks 23, 26, 4, and 34 microm as compared with less than 12, 12, 2, and 17 microm for Brånemark and NobelReplace frameworks, respectively. Control frameworks showed significantly (p < .05) greater mean and range of distortions in x- and y-axes and in three dimensions compared with test frameworks. CONCLUSION: All measured frameworks presented signs of misfit, indicating that no framework had a "passive fit." Frameworks produced in a more routine clinical environment seem to present greater levels of distortion as compared with frameworks produced in a strict test situation. However, all measured frameworks presented levels of precision of fit within limits considered to be clinically acceptable in earlier studies of frameworks placed on abutments.
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| 14. |
- Engfors, Ingela, et al.
(författare)
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Fixed implant-supported prostheses in elderly patients: a 5-year retrospective study of 133 edentulous patients older than 79 years.
- 2004
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Ingår i: Clinical implant dentistry and related research. - 1523-0899. ; 6:4, s. 190-8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: An increasing number of elderly patients are treated with implants, but results for the elderly patient in terms of implant success and adaptation to implant prostheses are contradictory. OBJECTIVE: To retrospectively study the 5-year clinical and radiologic performances of fixed implant-supported prostheses placed in edentulous elderly patients and to compare those results with the results of using similar prostheses in a control group of younger patients. MATERIALS AND METHODS: The study group comprised 133 edentulous patients who were 80 or more years of age and who were consecutively treated with fixed implant-supported prostheses between January 1986 and August 1998. Altogether 761 Brånemark System implants (Nobel Biocare AB, Göteborg, Sweden) were placed in 139 edentulous jaws. The control group comprised 115 edentulous patients who were younger than 80 years and who were treated consecutively from March 1996 to November 1997 with similar prostheses. In this group 670 implants were placed in 118 edentulous jaws. Information was collected from all postinsertion visits, including the fifth annual checkup, and changes of marginal bone levels were analyzed from intraoral radiographs. RESULTS: The 5-year cumulative survival rate (CSR) for implants in the maxilla was 93.0% in the study group and 92.6% in the control group; the corresponding CSRs for implants in the mandible were 99.5% and 99.7%. The most common complications for patients in the study group were soft tissue inflammation (mucositis) and cheek and lip biting (p < .05) whereas resin veneer fractures were the most common complications for the control group. Overall 5-year marginal bone loss for the study group was 0.7 mm (standard deviation [SD], 0.45) in the upper jaw and 0.6 mm (SD, 0.50) in the lower jaw. Differences in bone levels and bone loss between the two groups did not reach significant levels (p > .05). CONCLUSIONS: Implant treatment in the elderly patients showed treatment results comparable to those observed in younger age groups. However, indications of more problems with adaptation could be observed and were reflected in more postinsertion problems. Cleaning problems and associated soft tissue inflammation (mucositis) as well as tongue, lip, and cheek biting were significantly more often observed among the elderly patients (p < .05).
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| 15. |
- Fransson, Christer, 1956, et al.
(författare)
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Prevalence of subjects with progressive bone loss at implants.
- 2005
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Ingår i: Clinical oral implants research. - : Wiley. - 0905-7161. ; 16:4, s. 440-6
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of the present study was to assess the prevalence of subjects with progressive bone loss at implants with a function time of at least 5 years. MATERIAL AND METHODS: Radiographs of 1346 patients who had attended annual follow-up visits at the Brånemark Clinic, Public Dental Services, Gothenburg, Sweden were retrieved. Six hundred and sixty-two subjects fulfilled the inclusion criteria. Thus, they all had been provided with implant-supported (Brånemark System) Nobel BioCare, Gothenburg, Sweden) fixed partial or complete dentures or single-tooth replacements with a documented function time in radiographs of at least 5 years. Implants that demonstrated progressive bone loss to a level of > or =3 threads of an implant were detected. The number of subjects who exhibited one or more implants with progressive bone loss to the threshold level was recorded. RESULTS: Twenty-eight percent of 662 included subjects had one or more implants with progressive bone loss. A logistic regression analysis revealed that the individuals in this group carried a significantly larger number of implants than the subjects in whom no implants with progressive loss were detected (6 vs. 4.8). Furthermore, >30% of the subjects in the group with progressive bone loss had > or =3 identified implants and that about 33% of all such implants in this group exhibited extensive bone loss. Out of the total 3413 implants included in the study, 423 implants (12.4%) demonstrated progressive bone loss. CONCLUSION: It is suggested that the prevalence of progressive bone loss at implants assessed from subject-based data is higher than that evaluated from implant-based data.
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| 16. |
- Friberg, Bertil, 1950, et al.
(författare)
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Clinical experience of TiUnite implants: a 5-year cross-sectional, retrospective follow-up study.
- 2010
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Ingår i: Clinical implant dentistry and related research. - : Wiley. - 1708-8208 .- 1523-0899. ; 12:Supplement s1, s. e95-103
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Tidskriftsartikel (refereegranskat)abstract
- Background: Little is known of the long-term clinical and radiographic performance of moderately rough surface implants. Purpose: The aim of the present retrospective investigation was to study two pioneer cohorts of patients, that is, the first patients to receive Brånemark System® implants with a moderately rough surface (TiUnite™, Nobel Biocare AB, Göteborg, Sweden) at the present clinic. TiUnite implants were inserted either in compromised bone sites in a mixed-mouth concept together with turned implants or used solely. Patients were followed up over a period of 5 years with regard to implant survival and the marginal bone response. Materials and Methods: Patients who received both implant types (mixed group) comprised 41 subjects, and the second group (TiUnite group) comprised 70 subjects. A total of 110 turned and 68 TiUnite implants were placed in the mixed group, and 212 TiUnite implants in the TiUnite group. Follow-up radiographs were obtained at prosthesis placement and at the 1- and 5-year check-ups, and examined by independent observers. Results: One turned (0.9%) and two TiUnite (2.9%) implants failed in the mixed group, and three implants (1.6%) failed in the TiUnite group, indicating no significant differences between surfaces or groups (p < .05). The mean marginal bone loss at 5 years was 0.6 mm to 0.8 mm, also indicating no significant differences for the two implant types tested in the mixed group. Conclusions: Cumulative survival rates for the two implant surfaces were favorable at 5 years, and the marginal bone loss was low and similar for both implant surfaces.
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| 17. |
- Friberg, Bertil, 1950, et al.
(författare)
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Early failures in 4,641 consecutively placed Brånemark dental implants: a study from stage 1 surgery to the connection of completed prostheses.
- 1991
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Ingår i: The International journal of oral & maxillofacial implants. - 0882-2786. ; 6:2, s. 142-6
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Tidskriftsartikel (refereegranskat)abstract
- This study comprised 4,641 Brånemark dental implants, which were retrospectively followed from stage 1 surgery to completion of the prosthetic restorations. The implants were placed during a 3-year period (1986 to 1988) in 943 jaws, representing 889 patients with complete and partial edentulism. The jaw and sex distribution revealed a predominance of mandibles (564/943) and females (534/943). The mean age of the patients was 57.5 years (range 13 to 88 years) at implant placement. Only 69 (1.5%) fixtures failed to integrate, and most losses were seen in completely edentulous maxillae (46/69), in which the jaw bone exhibited soft quality and severe resorption. A preponderance of failures could also be seen among the shortest fixtures (7 mm). A majority of the mobile implants were recorded at the abutment connection (stage 2) operation (48/69).
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| 18. |
- Friberg, Bertil, 1950, et al.
(författare)
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Rehabilitation of edentulous mandibles by means of 5 TiUnite™ implants after one-stage surgery: A 1-year retrospective study of 90 patients
- 2008
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Ingår i: Clinical Implant Dentistry and Related Research. ; 10:1, s. 47-54
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Tidskriftsartikel (refereegranskat)abstract
- Background: Recently the present team reported the 1-year data of one-stage surgery and mainly early loading performed in edentulous mandibles using 750 turned Brånemark System R implants in 152 patients. Purpose: The aim of the present investigation was to retrospectively evaluate the 1-year results of the same treatment technique, using Brånemark System R implants with an oxidized surface (TiUnite TM). The outcome was compared with that of the former study (control) on turned implants. Materials and Methods: The present study involved 90 individuals with 450 TiUnite TM implants of mainly the Brånemark System R Mark III design, placed in edentulous mandibles and using one stage surgery. The prosthetic procedure was commenced as a mean 8 days after teh surgical intervention. Intraoral radiographs were obtained at prosthesis insertion and at the 1-year annual check-up. Failure rates of test and control groups were compared by means of the Chisquare test. Results: No implants were found to be mobile up to and including the first annual check-up, resulting in an implant cumulative survival rate (CSR) of 100%. The corresponding CSR for the control group was 97.5% and this difference in implant survival was statistically significant, when analyzed with the chi-square test (p<.001). A statistical significant difference was also demonstrated (p<.01) when conducting the same statistical analysis on the patient level. The mean marginal bone resorption during the first year of function was 0.49 mm (SD 0.56) and the corresponding figures for the control study were 0.39 mm (SD 0.46). The central TiUnite TM implant, i.e. the one placed in or in close relation to the symphyseal region showed significantly more bone loss (p<.05) than the corresponding central turned implant of the control study. Distally positioned test implants demonstrated less marginal bone loss than the corresponding central one. Conclusions: The outcome of 450 TiUnite TM implants placed in 90 patients with edentulous manidbles, of which 380 implants in 76 patients were followed for one year, showed an implant CSR of 100%. The figure was significantly different from the control study result of 97.5% on turned surface implants. The levels of marginal bone were close to identical for test and control implants at the 1-year check-up.
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| 19. |
- Friberg, Bertil, 1950, et al.
(författare)
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Rehabilitation of edentulous mandibles by means of four TiUnite implants after one-stage surgery: a 1-year retrospective study of 75 patients.
- 2010
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Ingår i: Clinical implant dentistry and related research. - : Wiley. - 1708-8208 .- 1523-0899. ; 12:Suppl 1 s1, s. e56-62
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Tidskriftsartikel (refereegranskat)abstract
- Background: Recently, the present team reported the 1-year data of a one-stage surgery and mainly early loading with five supporting implants in completely edentulous mandibles, indicating more bone loss at the central implant, placed in the midline of the jaw. Purpose: The aim of the present retrospective investigation was to evaluate the 1-year results of the same treatment technique with four instead of five supporting implants in completely edentulous mandibles. The outcome was compared with that of a former study (control) on five implants per patient during first year of function. Materials and Methods: The present study comprised 75 patients with a total of 300 TiUnite™ implants (Nobel Biocare AB, Göteborg, Sweden) of mainly the Brånemark System ≥ Mark III design. The prosthetic procedure started and was completed on an average of 9.1 days (standard deviation [SD] 4.47) and 33.2 days (SD 16.09) after the surgical intervention, respectively. Intraoral radiographs were obtained at prosthesis insertion and at the 1-year follow-up visit. Failure rates of test and control groups were compared by means of the chi-squared test. Results: All four implants in one patient were found to be mobile at the first annual check-up, resulting in an implant cumulative survival rate (CSR) of 98.5%. The corresponding CSR for the control group was 100% (p > 0.05). The mean marginal bone resorption during the first year of function was 0.3 mm (SD 0.74) as compared with 0.5 (SD 0.56) mm for the control group (p > 0.05). Conclusions: The outcome of 300 TiUnite™ implants placed in 75 patients with edentulous mandibles, of which 268 implants in 67 patients were followed for 1 year, showed an implant CSR of 98.5%. The implant survival was not significantly different from that of the control study result of 100%, in which five instead of four supporting implants were used. The levels of marginal bone were close to identical for the corresponding test and control implants at the 1-year check-up.
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| 20. |
- Friberg, Bertil, 1950, et al.
(författare)
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Rehabilitation of Edentulous Mandibles by Means of Osseointegrated Implants: A 5-Year Follow-Up Study on One or Two-Stage Surgery, Number of Implants, Implant Surfaces, and Age at Surgery
- 2015
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Ingår i: Clinical Implant Dentistry and Related Research. - : Wiley. - 1523-0899. ; 17:3, s. 413-424
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn three former reports, the present team has presented the 1-year outcome of four different treatment procedures handling the edentulous mandible; that is, two-stage and one-stage surgery with turned Branemark System (R) (Nobel Biocare AB, Gothenburg, Sweden) implants (Group 1 and 2) and one-stage surgery using either 5 or 4 TiUnite (Nobel Biocare AB, Gothenburg, Sweden) implants (Group 3 and 4). PurposeThe aim of the present investigation was to follow up these patients for a period of 5 years with regard to implant/prosthesis cumulative survival rates, marginal bone loss calculations, clinical complications, and results related to age at surgery. Materials and MethodsA total of 385 patients, provided with 1,838 implants, were originally included in the four patient groups. All patients received fixed prostheses. The overall majority of patients had each five implants placed. Radiographs were obtained at prosthesis delivery, at the 1 and 5-year follow-up. ResultsA total of 1,230 implants in 259 patients (67%) were possible to follow up for 5 years. Implant Cumulative Survival Rates (CSR) in 5 years for Groups 1-4 were 99.7, 97.0, 98.5, and 98.6%. The corresponding prosthesis treatment CSR was 100, 99.3, 98.5, and 98.6%, respectively. Significantly, more patients (p<.05) lost turned implants after one-stage surgery (Group 2). Frequency distributions of implants revealed that >1.2mm bone loss was observed around 75 implants (6.4%). The moderately rough central (midline) implant showed more bone loss than other placed implants (Group 3; p<.05). The youngest half of included patients at surgery (Youngest(50%); n=193) presented significantly higher mortality than older patients as well as compared to normal population (p<.05). Patients in the Younger(50%) group showed also an association to patients with complete loss of all implants and patients with most implants with obvious bone loss after 5 years. ConclusionsAll four treatment procedures served well during the 5 years of follow-up and only eight patients (2.1%) were complete failures or showed obvious bone loss (>1.8mm) at several implants (>2 implants), mostly observed in younger patients. The few complications in relation to implant failure and/or obvious bone loss could be associated to both local impact factors (surface, implant site, surgical protocol) as well as to host response factors (systemic health).
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