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Sökning: LAR1:gu > Tidskriftsartikel > Jemt Torsten 1950

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  • Albrektsson, Tomas, 1945-, et al. (författare)
  • Is Marginal Bone Loss around Oral Implants the Result of a Provoked Foreign Body Reaction?
  • 2014
  • Ingår i: Clinical implant dentistry and related research. - 1708-8208. ; 16:2
  • Tidskriftsartikel (refereegranskat)abstract
    • Background When a foreign body is placed in bone or soft tissue, an inflammatory reaction inevitably develops. Hence, osseointegration is but a foreign body response to the implant, which according to classic pathology is a chronic inflammatory response and characterized by bone embedding/separation of the implant from the body. Purpose The aim of this paper is to suggest an alternative way of looking at the reason for marginal bone loss as a complication to treatment rather than a disease process. Materials and Methods The present paper is authored as a narrative review contribution. Results The implant-enveloping bone has sparse blood circulation and is lacking proper innervation in clear contrast to natural teeth that are anchored in bone by a periodontal ligament rich in blood vessels and nerves. Fortunately, a balanced, steady state situation of the inevitable foreign body response will be established for the great majority of implants, seen as maintained osseointegration with no or only very little marginal bone loss. Marginal bone resorption around the implant is the result of different tissue reactions coupled to the foreign body response and is not primarily related to biofilm-mediated infectious processes as in the pathogenesis of periodontitis around teeth. This means that initial marginal bone resorption around implants represents a reaction to treatment and is not at all a disease process. There is clear evidence that the initial foreign body response to the implant can be sustained and aggravated by various factors related to implant hardware, patient characteristics, surgical and/or prosthodontic mishaps, which may lead to significant marginal bone loss and possibly to implant failure. Admittedly, once severe marginal bone loss has developed, a secondary biofilm-mediated infection may follow as a complication to the already established bone loss. Conclusions The present authors regard researchers seeing marginal bone loss as a periodontitis-like disease to be on the wrong track; the onset of marginal bone loss around oral implants depends in reality on a dis-balanced foreign body response.
  • Albrektsson, Tomas, 1945-, et al. (författare)
  • Where are we coming from?
  • 2018
  • Ingår i: International Journal of Prosthodontics. - 0893-2174. ; 31, s. S11-S14
  • Tidskriftsartikel (refereegranskat)
  • Andersson, B., et al. (författare)
  • Long-Term Function of Single-Implant Restorations: A 17-to 19-Year Follow-Up Study on Implant Infraposition Related to the Shape of the Face and Patients' Satisfaction
  • 2013
  • Ingår i: Clinical Implant Dentistry and Related Research. - 1523-0899. ; 15:4, s. 471-480
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Various levels of infraposition of single-implant restorations have been observed in long-term follow-up studies, but little knowledge is available on the biological mechanism behind this pattern. Purpose: The primary aim of this study is to report the frequency and severeness of implant infraposition in the anterior single-implant application after 17 to 19 years in function and, secondly, to try to relate these observations to anatomical appearance of the shape of the face of the patient. Materials and Methods: The present study comprised of 57 patients who were provided with 65 CeraOne (TM) single-tooth restorations (Nobel Biocare AB, Gothenburg, Sweden) between 1989 and 1991. Altogether 46 of these patients were treated with single implants in the anterior region. Besides clinical and radiographic data, clinical photographs, study casts, and patient's assessment of the long-term aesthetic result (visual analog scale) was collected at the termination of the present study. The degree of implant crown infraposition was related to assessed facial shape and to patient and clinical assessment of the aesthetic result by means of Pearson's correlation test. To increase the numbers of patients, another group of 25 patients presented in another similar study were pooled with the present material for prevalence calculations. Results: Altogether 47 patients showed up for the final examination after an average of 18 years (82%). Two implants failed (18 years cumulative survival rates [CSR] - 96.8%) and eight original single-crown restorations were replaced (CSR 83.8%). Three of the replaced crowns were replaced because of infraposition of the crowns. About 40% of the patients showed signs of infraposition, similar in younger and older age groups, but more frequently observed in female patients at termination of the study (p < 0.05). There was a weak trend indicating an association between "long-face" appearance and infraposition of the crown restoration (p > 0.05), and patients were more satisfied with the aesthetic clinical result than the participating clinicians (p < 0.05). Conclusion: Single-implant restorations in the anterior upper jaw may present small degrees of infraposition in long-term perspectives. Female patients seem to be at a higher risk of infraposition (p < 0.05), but no clear relationship between age at implant placement or facial shape and degree of infraposition was possible to establish (p > 0.05). Patients were more satisfied with the aesthetic result, as compared with the clinicians (p < 0.05), and patients seemed to pay less attention to the degree of infraposition in their aesthetic assessments, as compared with most of the clinicians.
  • Antoun, H., et al. (författare)
  • A retrospective study on 1592 consecutively performed operations in one private referral clinic. Part I: Early inflammation and early implant failures
  • 2017
  • Ingår i: Clinical Implant Dentistry and Related Research. - 1523-0899. ; 19:3, s. 404-412
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundFew large-scale follow-up studies are reported on routine implant treatment. PurposeTo report retrospective data on early inflammatory and early implant failures in a large number of routine patients at one private referral clinic. Materials and MethodsA total of 1017 patients were consecutively provided with 3082 implants with an anodized surface (Nobel Biocare AB) at 1592 implant operations between 2000 and 2011. All patients reported with mucosa inflammation and bone loss and/or implant failures to the first annual examination were identified. A logistic multivariate data analysis was performed to identify possible factors with an association to the two events. ResultsAltogether 33 patients/operations presented early inflammation (2.1% operations). History of periodontitis (OR 3.91; 95% CI: 1.86-8.21), numbers of implants (OR1.33; 95% CI:1.07-1.67 per implant), two stage surgical technique (OR 3.70; 95% CI: 1.75-7.85), and lower jaw treatment (OR 4.73; 95% CI: 2.12-10.57) increased the risk for early mucositis with bone loss (P<.05). Highest risk for early inflammation was observed for patients at an age of 50-55 years at surgery (P<.05). Smoking habits (OR 2.08; 95% CI: 1.06-4.10) Immediate implant placement (OR 2.09; 95% CI: 1.23-3.54), and immediate grafting procedures (OR 2.09; 95% CI: 1.04-4.19) had a significant association to early implant failures (P<.05). Furthermore, risk for an early failure decreased with 22% per year of inclusion (2000 >2011; OR 1.22; 95% CI;1.08-1.39). ConclusionHistory of periodontitis and two-stage surgery protocols with bone grafts in the (posterior) lower jaw increased the risk for early inflammatory problems after surgery (P<.05), with the highest risk for mid-aged patients (P<.05). Preventable factors related to the patient (smoking) and experience of surgeon showed to have a significant association to early implant failures in routine clinical practice (P<.05).
  • Bergenblock, Sibel, 1973-, et al. (författare)
  • Long-Term Follow-Up of CeraOne Single-Implant Restorations: An 18-Year Follow-Up Study Based on a Prospective Patient Cohort.
  • 2012
  • Ingår i: Clinical implant dentistry and related research. - 1708-8208. ; 14:4
  • Tidskriftsartikel (refereegranskat)abstract
    • ABSTRACT Background: Knowledge on long-term clinical performance of more than 5 years on the single-implant CeraOne (Nobel Biocare AB, Gothenburg, Sweden) concept is limited. Purpose: The aim of this study is to report the long-term clinical performance of the first CeraOne single-implant restorations, installed 17 to 19 years ago. Materials and Methods: The group comprised 57 patients provided with 65 CeraOne single-tooth restorations. Sixty-two all-ceramic and three metal-ceramic crowns were cemented between 1989 and 1991. Patients were followed up clinically and with intraoral radiographs at placement, after 1, 5, and between 17 and 19 years after placement. Results: Data were available for altogether 48 patients, followed up on an average time of 18 years. Excluding deceased patients (n = 2) and failed implant patients (n = 2), only five patients were lost to follow-up (8.8%). Two implants failed, resulting in an 18-year implant cumulative success rate (CSR) of 96.8%, and altogether eight original single-crown restorations were replaced (CSR 83.8%). The most common reason for crown replacement was infra-position of the implant crown (n = 3). Many of the remaining original crowns showed various signs of implant crown infraposition at the termination of the study. In general, the soft tissue at the restorations was assessed to be healthy and comparable with the gingiva at the adjacent natural teeth. Bone levels were on an average stable with only few patients exhibiting bone loss of more than 2 mm during 18 years in function. Conclusion: This long-term follow-up study of single-implant restorations shows encouraging results with few implant failures and minimal bone loss over an 18-year period. Original single-crown restorations were replaced more frequently, because of, for example, implant crown infraposition and veneer fractures. The CeraOne concept proved to be a highly predictable and safe prosthodontic treatment.
  • Book, K, et al. (författare)
  • Functional adaptation to full-arch fixed prosthesis supported by osseointegrated implants in the edentulous mandible.
  • 1992
  • Ingår i: Clinical oral implants research. - 0905-7161. ; 3:1, s. 17-21
  • Tidskriftsartikel (refereegranskat)abstract
    • The objective of the present study was to assess possible adaptive functional changes in the masticatory system after insertion of fixed prostheses supported by osseointegrated implants in the edentulous mandible. Registrations of mandibular movement characteristics and maximal biteforce were performed at insertion and after 1 week, 3 months and 1 year after connection. The duration of the opening and closing phase decreased and maximal biteforce increased significantly (p < or = 0.05-0.001) from connection of the prostheses to the annual check-up. However, the process of functional adaptation implied 2 identified stages. An immediate phase that occurred within the 1st week, probably due to altered impact from mechano-sensitive receptors and a later more time-dependent phase, based on learning and new cortical engrams. Accordingly, the process of adaptation will continue over a long period of time.
  • Carlsson, Gunnar E, 1930-, et al. (författare)
  • Long-term marginal periimplant bone loss in edentulous patients.
  • 2000
  • Ingår i: The International journal of prosthodontics. - 0893-2174. ; 13:4, s. 295-302
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: The aim of this study was to examine the long-term periimplant bone loss in patients treated with implant-supported fixed prostheses in both jaws. MATERIALS AND METHODS: The participants comprised 44 edentulous patients who have been followed for a 15-year period after treatment with a fixed implant-supported prosthesis in the mandible. Thirteen of them also received an implant-supported fixed prosthesis in the maxilla, on average 4.5 years after the mandibular treatment. The periimplant bone level was measured on intraoral radiographs. RESULTS: The long-term results of the implant treatment were successful, and only 1% (3/273) of the implants were lost in the mandible and 7% (5/75) in the maxilla. All but one of the failures occurred before the connection of the prostheses. The mean marginal bone loss around the implants was small (less than 1 mm for a 10-year period after implant placement), and was of similar magnitude in both jaws. However, the individual variation was relatively great. There was no significant difference in marginal bone loss between those who had a maxillary complete denture during the entire observation period and those who had received a fixed implant-supported maxillary prosthesis. Smokers lost more periimplant bone than did the nonsmokers; the difference was significant in the mandible but small and nonsignificant in the maxilla. CONCLUSION: The long-term periimplant bone loss was small and of similar magnitude in the mandible and the maxilla in subjects who had received implant-supported fixed prostheses in both jaws. The prosthetic status in the maxilla, i.e., complete denture or fixed implant-supported prosthesis, had no significant influence on the mandibular periimplant bone loss.
  • Ekelund, Jan-Anders, et al. (författare)
  • Implant treatment in the edentulous mandible: a prospective study on Brånemark system implants over more than 20 years.
  • 2003
  • Ingår i: The International journal of prosthodontics. - 0893-2174. ; 16:6, s. 602-8
  • 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%.
  • Eliasson, Alf, 1959-, et al. (författare)
  • The precision of fit of milled titanium implant frameworks (I-Bridge) in the edentulous jaw.
  • 2010
  • Ingår i: Clinical implant dentistry and related research. - 1708-8208. ; 12:2, s. 81-90
  • 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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