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Sökning: LAR1:gu > Tidskriftsartikel > Jemt Torsten 1950

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41.
  • Jemt, Torsten, 1950, et al. (författare)
  • Bone Loss Before and After Peri-implantitis Surgery: A 7-Year Retrospective Observational Study
  • 2021
  • Ingår i: International Journal of Oral & Maxillofacial Implants. - : Quintessence Publishing. - 0882-2786. ; 36:6, s. 1199-1210
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: This study aimed to report changes in implant bone levels before and after peri-implantitis surgery (P-IS). Materials and Methods: Patients were treated with P-IS from 2003 to 2010 and thereafter followed up until the last available radiographic examination (study termination: October 2018). Bone loss was measured before and after P-IS, and the numbers of clinical examinations post-P-IS were determined. The Student t test was used to compare the bone loss between examinations and reference populations, and correlations between different variables were calculated using the Pearson correlation coefficient (r). Results: One hundred thirty-four consecutive patients (137 arches) underwent P-IS during the inclusion period (2.3%). A total of 122 patients (125 arches) were followed up fora mean period of 6.9 (SD: 5.54) and 7.3 (SD: 3.39) years from the first annual examination to before P-IS, and from the time of P-IS to after P-IS, respectively. The mean bone loss during the aforementioned durations was 0.18 (SD: 0.23) and 0.26 (SD: 0.28) mm/year, respectively (P < .05). Bone loss per year was also greater for unaffected implants after (0.29 [0.34] mm/year) compared with before P-IS (0.06 [0.10] mm/year; P < .05). No difference in bone loss was observed between peri-implantitis affected and unaffected implants or between implants with a turned or moderately rough surface after P-IS. A greater amount of bone loss was associated with increasing numbers of clinical examinations and shorter follow-up times after P-IS (P < .05). Conclusion: Average bone levels decreased from the time of prosthesis placement to termination of the study. Bone loss increased after P-IS in the total and unaffected group, and edentulous patients compared unfavorably with partially and single implant conditions. Increased bone loss was associated with higher numbers of clinical examinations per year of followup after P-IS (P < .05).
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42.
  • Jemt, Torsten, 1950, et al. (författare)
  • Bone response to implant-supported frameworks with differing degrees of misfit preload: in vivo study in rabbits.
  • 2000
  • Ingår i: Clinical implant dentistry and related research. - 1523-0899. ; 2:3, s. 129-37
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: To study the bone response around implants placed in tibia of rabbits that supported misfitting superstructures secured with different degrees of preload. MATERIALS AND METHODS: Twelve rabbits were provided with two terminal 10-mm and one intermediate 7-mm-long implant in each tibia. After an integration time of about 9 weeks, nine of the animals received one control framework each (n = 9), designed with good fit to all three implants. In the other tibia of these animals, and in both tibias in the remaining three rabbits, test frameworks (n = 15) were connected with a vertical misfit of about 1 mm to the intermediate implant. The intermediate set screws were tightened with a torque ranging from 15 Ncm to 26 Ncm in the different test frameworks. The fascia and skin was then sutured back over the implants. After a loading period of 2 to 3 weeks, the animals were sacrificed, and histomorphometric measurements were made and correlated to the different levels of preload of the central implant. RESULTS: The mean bone-to-metal contact for the three best consecutive threads of the central implant was 40% for both test and control sites (p > .05). Compared to the other regions of the implant thread, less bone-to-metal contact was found at the tip of the test implant threads in the low preload group (p < .05). However, the same relation was not observed in the high preload group. A significant correlation was observed between increasing degree of preload in the central screw joint and increasing bone-to-metal contact, most obviously noticed at the tip of the implant thread (p < .01). CONCLUSIONS: Misfit stress levels of clinical magnitudes do not seem to jeopardize osseointegration per se. On the contrary, clinical levels of preload stress seem to significantly promote bone remodeling at the tip of the implant thread.
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43.
  • Jemt, Torsten, 1950 (författare)
  • Cemented ceraone® and porcelain fused to tiadapt ™ abutment single-implant crown restorations: A 10-year comparative follow-up study
  • 2009
  • Ingår i: Clinical Implant Dentistry and Related Research. - : Wiley. - 1523-0899. ; 11:4, s. 303-310
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Long-term data comparing cemented and noncemented single-implant restorations has not been reported. Aim: To compare clinical and radiographic performance of single-implant crown restorations made by either directly baked porcelain to custom-made TiAdapttrade mark titanium abutments (Nobel Biocare AB, Göteborg, Sweden) (test) or cement crowns onto CeraOne(R) (Nobel Biocare AB) abutments (control) after 10 years in function. Materials and Methods: Altogether, 35 consecutive patients were provided with 41 turned single Brånemark System(R) implants (Nobel Biocare AB) in the partially edentulous upper jaw. By random, 15 and 20 patients were provided with 18 test and 23 control implant crowns, respectively. Thereafter, clinical and radiographic data were collected and compared between the two groups. Results: None of the implants were found loose during the follow-up period (100%). Few clinical problems were observed, and the overall average marginal bone loss was 0.26 mm (SD 0.64) during 10 years in function. After the final tightening of the crowns, no significant differences were observed between the test and control groups (p > .05). The head of the implants was placed on an average 6.3 mm (SD 2.24) below the cement/enamel junction of the adjacent teeth (range 2.5-10.0 mm). Implants with reported mechanical and/or mucosal problems or placed more apically in relation to the adjacent teeth did not present more bone loss as compared with implants with no problems or placed more coronally, respectively (p > .05). Conclusions: There seems to be no obvious clinical or radiographic differences between the test and control single-implant restorations during 10 years of follow-up. Occasionally, some restorations presented loose abutment screws and/or fistulas during follow-up. This implies a certain need for maintenance where a one-piece single-implant protocol (test) allows both for a simple clinical procedure at placement without cementation problems, as well as for an easy and simple maintenance of installed single implant crowns in long-term function.
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44.
  • Jemt, Torsten, 1950, et al. (författare)
  • Changes of anterior clinical crown height in patients provided with single-implant restorations after more than 15 years of follow-up.
  • 2006
  • Ingår i: The International journal of prosthodontics. - 0893-2174. ; 19:5, s. 455-61
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: To measure the long-term changes of clinical crown height in patients treated with single-implant crowns and compare them to those of an adult population with normal dentition. MATERIALS AND METHODS: The test group comprised 23 patients, consecutively restored with a total of 48 single-implant crowns in the anterior maxilla. Mean age was 26.1+/-11.4 years at inclusion. Original master casts were stored after treatment, and patients were recalled for new study casts an average of 15.8+/-0.74 years later. The control group comprised 141 dental students with a mean age of 22.9 +/-1.20 years at inclusion. Study casts were made at inclusion and after 10 (n = 141) and 20 years (n = 60). Clinical crown height was measured for maxillary anterior teeth, and data were pooled and compared regarding clinical crown height and changes in height. RESULTS: Implant clinical crowns were an average of 0.6+/-1.04 mm longer than the contralateral teeth (P < .05). Central and lateral incisors showed mucosal recession at an average of 0.4+/-0.53 mm (P < .05) and 0.6+/-0.58 mm (P < .01), respectively. In the control group, only minor insignificant changes (+/-0.1 mm) in mean clinical crown height could be observed during the follow-up period. However, obvious individual variations of changes could be found in the control group, and were more pronounced for women. Altogether, 15% and 9% of measured teeth showed > or = 1.0 mm increase or decrease of clinical crown height during 20 years, respectively. Initially, shorter teeth presented a trend (P < .05 to .001) of more mucosal recession than longer teeth. CONCLUSION: Mean values of clinical crown height disguise significant individual variations of changes. To perform a risk evaluation for potential future mucosal recession, it could be suggested that greater changes in clinical crown height may occur in patients provided with implant-supported crowns than in untreated control subjects, possibly more for women than men, and more for initially shorter teeth than for longer adjacent teeth.
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45.
  • Jemt, Torsten, 1950, et al. (författare)
  • Changes of Marginal Bone Level in Patients with "Progressive Bone Loss" at Branemark System (R) Implants: A Radiographic Follow-Up Study over an Average of 9 Years
  • 2015
  • Ingår i: Clinical Implant Dentistry and Related Research. - : Wiley. - 1523-0899. ; 17:4, s. 619-628
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundPatients have in many studies been identified with progressive bone loss and peri-implantitis problems, but few studies are available where these groups of patients have been followed up. PurposeThe purpose of this paper is to study further progression of bone loss in a cohort of 182 patients that have been reported to suffer from progressive bone loss and peri-implantitis. Materials and MethodsAltogether, 182 patients that have earlier been identified to suffer from progressive bone loss formed the present study group. Data from patients' files have been retrieved, and intraoral radiographs have been analyzed for further bone level changes. Bone loss has been measured from time of inclusion into the present group to last available radiographs. Within each patient, one or several implants were diagnosed to suffer from progressive bone loss (affected), whereas others are not (unaffected). ResultsAltogether, 145 patients (80%) were radiographically followed up on an average of 9.1 years (SD 3.77) after inclusion. Twenty-four implants (3.1%) were lost in 16 patients (11%). Marginal bone loss was on an average 0.3mm (SD 0.75) at stable implants with only small differences between affected and unaffected implants. In total, 67 implants (8.6%) presented an annual bone loss of >0.2mm. Oral hygienist treatment and/or peri-implantitis surgery did not neither reduce implant failure rate nor marginal bone loss in 88 treated patients as compared with untreated patients. ConclusionsLess than one-third of the patients identified with progressive bone loss showed one or more implants as failures or with high annual bone loss (>0.2mm) during follow-up (11.6% of implants). Treated patients (oral hygienist and/or surgery) did not perform better than untreated patients with regard to bone loss or implant failure.
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46.
  • Jemt, Torsten, 1950, et al. (författare)
  • Could Age at Surgery Be Associated with Early Mortality After Implant Surgery? A Retrospective Study of 3,877 Edentulous Patients
  • 2022
  • Ingår i: International Journal of Oral & Maxillofacial Implants. - : Quintessence Publishing. - 0882-2786. ; 37:1, s. 128-134
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: Knowledge of the early mortality patterns in edentulous implant patients is limited. This study aimed to report patient mortality within the first year after surgery and compare the cause of death with preexisting conditions reported before surgery. Materials and Methods: In this retrospective cohort study, data from the Swedish National Death Register on patients, consecutively treated in the edentulous arch between 1986 and 2013, were compared with information from the patient files regarding the preexisting health conditions of the deceased patients. One-year survival rates were calculated and compared with expected mortality in a Swedish reference population based on three age groups: young ( 45 years of age), middle-aged (45 to 64 years of age), and old patients ( 64 years of age). Proportions of mortality between study groups and reference populations were tested by means of a log-rank test, and agreement between diagnoses before surgery and cause of death was tested by means of kappa test. Results: Altogether, 3,877 patients were included, of whom 60 patients died within 1 year after implant surgery (1.5%). The expected mortality in the Swedish reference population was 2.1% (P < .05). Mortality was higher for middle-aged (P = .02) but lower for old patients (P = .0001) compared with the Swedish reference populations. Eight of the deceased patients (13%) had no preexisting conditions, while 48 patients reported a health diagnosis before implant surgery. The most common of these were related to the circulatory system (ICD 10-I), which was the cause of death for 30 patients. A "none to slight agreement" between presurgical diagnoses and cause of death was observed in the population (kappa: 0.152). Conclusion: Edentulous implant patients presented overall lower mortality than expected in the general population during the first year after surgery. However, middle-aged patients showed a higher proportion of deceased patients compared with control people of the same age. Cardiovascular diseases were the cause of death in 50% of the group, and the agreement between presurgical and cause of death diagnoses was poor.
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47.
  • Jemt, Torsten, 1950, et al. (författare)
  • Could Future Implant Failures be Predicted Based on Observed Bone Levels and Bone Loss After 5 Years? A Retrospective Investigation on Patients Presented in Previous Studies
  • 2023
  • Ingår i: International Journal of Oral & Maxillofacial Implants. - 0882-2786. ; 38:2, s. 259-267
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: To evaluate the diagnostic accuracy of bone loss/bone levels, as detected after 5 years of implant function, in identifying patients who suffered implant failures in the following 5 years. Materials and Methods: Data on radiographic measurements of marginal bone levels at prosthesis placement and after 5 years of function were retrospectively retrieved from 11 previous publications. Included patients were allocated into different subgroups with regard to bone loss/bone level during/after 5 years in function, respectively. A diagnostic test was used to estimate the accuracy of finding patients/jaws/implants at risk for a future implant failure by calculating sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs) in different subgroups, respectively. Results: Altogether, 749 treated jaws (723 patients/3,363 implants) were included in the study group. Treated jaws in the high-level subgroups presented an overall higher risk of implant failures from 5 to 10 years in function (P < .05). Many treated jaws/implants were allocated into the high-level groups, but the proportions of implant failures were low in these groups. The diagnostic test comparing high-and low-level groups with and without implant failures showed low accuracy to predict implant failures; the PPV ranged from 4% to 33%. Lower PPVs were observed for diagnostic tests for individual implants (range: 4% to 6%). Conclusion: More severe bone loss was associated with higher risk of future implant failure. However, many patients/ implants with obvious bone loss in the study group and low prevalence of implant failures at the 10-year examination resulted in poor accuracy in identifying individual patients or implants at risk for failure. This suggests that it is difficult to predict future implant failures based only on radiographic measurements. Int J Oral Maxillofac Implants 2023;38:259-267. doi: 10.11607/jomi.10042
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48.
  • Jemt, Torsten, 1950 (författare)
  • Data on implant failures will show different results depending on how patients are compiled and analyzed: A retrospective study on 3902 individual patients treated either with one single implant or implants in the edentulous upper jaw
  • 2020
  • Ingår i: Clinical Implant Dentistry and Related Research. - : Wiley. - 1523-0899 .- 1708-8208.
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose The basic aim of the present study was to analyze the results of implant failures in two different implant populations, and how these results may vary depending on how the data are compiled and analyzed. Materials and Methods Two groups of consecutively treated patients were included who had been provided with either one single implant in a partially edentulous upper jaw (1881 patients) or four to eight implants in an edentulous upper jaw (2031 patients/12 454 implants). The risk of implant failure in the two groups separately and in combination was statistically compared by using uni- and multivariable analyses. Results The two groups showed significant differences in inclusion, surgical treatment protocols, and the risk of implant failures (P < .05). Overall, 25-year patient-level cumulative survival rates (CSRs) were 75.8% and 96.3% for edentulous and single implant treatment, respectively. "Dental condition" was the variable associated with the greatest risk of implant failure (HR 6.00; edentulous). Only one variable was significantly associated with the risk of implant failure in all tested groups ("time after surgery"; a decreased risk was observed over time), and more variables were statistically associated with implant failures in the edentulous group than in the single implant group. Conclusions Edentulous patients present a significantly and substantially higher risk of implant failures than patients provided with a single implant. When patients with different clinical conditions are pooled into the same group, patients with the most common condition in the total group have greatest impact on the result of the total group. Based on the present observations, risk patterns for a certain oral condition are not necessarily comparable with the implant treatment received by other patients, and the external validity may be limited in small, homogeneous groups of patients.
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49.
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50.
  • Jemt, Torsten, 1950, et al. (författare)
  • Early complete failures of fixed implant-supported prostheses in the edentulous maxilla: a 3-year analysis of 17 consecutive cluster failure patients.
  • 2006
  • Ingår i: Clinical implant dentistry and related research. - : Wiley. - 1523-0899 .- 1708-8208. ; 8:2, s. 77-86
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Clusters of implant failures in the edentulous maxilla seem to occur in some patients. To create groups for analysis with higher numbers of these patients implies large original groups for inclusion. PURPOSE: The aim of this study was to retrospectively describe and compare a group of "cluster failure patients" with randomly selected patients treated in the edentulous maxilla. MATERIALS AND METHODS: From a group of 1,267 consecutively treated patients in one clinic, all patients presenting failing fixed implant-supported prostheses within the first 3 years of follow-up were included. All patients were treated with turned titanium implants using two-stage surgery. A control group of equal number of patients were created for comparison. Data on patients were retrospectively retrieved from their records, and compared. RESULTS: Seventeen patients (1.3%) met the inclusion criteria in the entire group. The bone resorption index revealed less bone quantity in the study group (p < .05) during implant placement, but there was no difference regarding primary implant stability at first-stage surgery. The distribution of short and long implants showed relatively higher number of short implants in the study group (p < .05), and more patients had a presurgical discussion on the risk of implant failure prior to treatment in this group (p < .05). Only 5 out of 102 implants (4.9%) were lost before prosthesis placement as compared to 38 and 25 lost implants during the following two years in the study group. Smoking habits and signs of bone loss related to periodontitis in the lower dentition were more frequent in the study group, but did not reach a significant level (p > .05). CONCLUSION: The results indicate that bone quantity, reflected in fixture length, has a significant impact on increased implant failure risk. Other factors of interest as predictors for implant failures could be smoking habits and also possibly signs of periodontitis in the opposing dentition.
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