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- Albrektsson, Tomas, 1945, et al.
(författare)
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An Imbalance of the Immune System Instead of a Disease Behind Marginal Bone Loss Around Oral Implants: Position Paper
- 2020
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Ingår i: The International journal of oral & maxillofacial implants. - : Quintessence Publishing. - 1942-4434 .- 0882-2786. ; 35:3, s. 495-502
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of this paper is to present evidence that supports the notion that the primary reason behind marginal bone loss and implant failure is immune-based and that bacterial actions in the great majority of problematic cases are of a secondary nature. MATERIALS AND METHODS: The paper is written as a narrative review. RESULTS: Evidence is presented that commercially pure titanium is not biologically inert, but instead activates the innate immune system of the body. For its function, the clinical implant is dependent on an immune/inflammatory defense against bacteria. Biologic models such as ligature studies have incorrectly assumed that the primary response causing marginal bone loss is due to bacterial action. In reality, bacterial actions are secondary to an imbalance of the innate immune system caused by the combination of titanium implants and ligatures, ie, nonself. This immunologic imbalance may lead to marginal bone resorption even in the absence of bacteria. CONCLUSION: Marginal bone loss and imminent oral implant failure cannot be properly analyzed without a clear understanding of immunologically caused tissue responses.
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- Albrektsson, Tomas, 1945
(författare)
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Are Oral Implants the Same As Teeth?
- 2019
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Ingår i: Journal of clinical medicine. - : MDPI AG. - 2077-0383. ; 8:9
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Tidskriftsartikel (refereegranskat)abstract
- Osseointegration of oral implants was initially discovered by Brånemark [...].
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- Albrektsson, Tomas, 1945, et al.
(författare)
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Bone loss around oral and orthopedic implants: An immunologically based condition
- 2019
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Ingår i: Clinical Implant Dentistry and Related Research. - : Wiley. - 1523-0899 .- 1708-8208. ; 21:4, s. 786-795
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Tidskriftsartikel (refereegranskat)abstract
- Background Marginal bone resorption has by some been identified as a "disease" whereas in reality it generally represents a condition. Purpose The present article is a comparison between oral and orthopedic implants, as previously preferred comparisons between oral implants and teeth seem meaningless. Materials and Methods The article is a narrative review on reasons for marginal bone loss. Results and Conclusions The pathology of an oral implant is as little related to a tooth as is pathology of a hip arthroplasty to a normally functioning, pristine hip joint. Oral as well as orthopedic implants are recognized as foreign bodies by the immune system and bone is formed, either in contact or distance osteogenesis, to shield off the foreign materials from remaining tissues. A mild immune reaction coupled to a chronic state of inflammation around the implant serve to protect implants from bacterial attacks. Having said this, an overreaction of the immune system may lead to clinical problems. Marginal bone loss around oral and orthopedic implants is generally not dependent on disease, but represents an immunologically driven rejection mechanism that, if continuous, will threaten implant survival. The immune system may be activated by various combined patient and clinical factors or, if rarely, by microbes. However, the great majority of cases with marginal bone loss represents a temporary immune overreaction only and will not lead to implant failure due to various defense mechanisms.
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- Albrektsson, Tomas, 1945, et al.
(författare)
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Crestal Bone Loss and Oral Implants
- 2012
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Ingår i: Clinical Implant Dentistry and Related Research. - : Wiley. - 1523-0899 .- 1708-8208. ; 14:6, s. 783-791
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Tidskriftsartikel (refereegranskat)abstract
- Background: A consensus meeting was arranged to critically analyze whether the high figures of peri-implantitis at machined implants that recently have been reported in the literature are valid also for modern implants. Purpose: The aims of this paper were to present the outcomes from the consensus meeting and to evaluate recent long-term clinical studies on modern implants with regard to frequency of peri-implant infection. Materials and Methods: Ten different studies of three modern implant brands of moderately rough surfaces with 10-year or longer follow-up times were found through a PubMed and manual search. Results: It was concluded that bleeding on probing or probing depths are weak indicators of crestal bone loss (CBL); that CBL occurs for many other reasons than infection; that implant-, clinician-, and patient-related factors contribute to CBL; and that modern oral implants outperform older devices. Based on a literature search, the frequency of implants with reported peri-implant infection and significant bone loss leading to implant removal or other surgical intervention was on average 2.7% during 7 to 16 years of function. Conclusion: The summed frequency of peri-implantitis and implant failure is commonly less than 5% over 10 years of follow-up for modern implants when using established protocols.
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- Albrektsson, Tomas, 1945, et al.
(författare)
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Direct bone anchorage of oral implants: clinical and experimental considerations of the concept of osseointegration.
- 1990
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Ingår i: The International journal of prosthodontics. - 0893-2174. ; 3:1, s. 30-41
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Forskningsöversikt (refereegranskat)abstract
- The term osseointegration is analyzed in relation to its theoretical and clinical definitions, and comparisons are made to other implant modalities. The term osseointegration has a clear clinical meaning, but there is doubt about its precise usage in an experimental setting. Clinically, an implant can be described as osseointegrated if there is no discernable movement when force is applied to the fixture. This is in contrast to implants surrounded by fibrous connective tissue, which move within soft tissue. Newly developed laboratory techniques may be used in the future to precisely characterize osseointegration in the laboratory.
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