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- Göthberg, Catharina, 1960, et al.
(författare)
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Bone and soft tissue outcomes, risk factors, and complications of implant-supported prostheses: 5-Years RCT with different abutment types and loading protocols
- 2018
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Ingår i: Clinical Implant Dentistry and Related Research. - : Wiley. - 1523-0899 .- 1708-8208. ; 20:3, s. 313-321
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundData on risk factors and complications after long-term implant treatment is limited. The aims were to evaluate the role of various fixation modes and to analyze complications and risks that affect long-term use of implant-supported partial fixed dental prostheses. Materials and MethodsFifty partially edentulous subjects received three Branemark TiUnite implants. Superstructures were attached directly at implant level (IL) or via abutments: machined surface (AM) and an oxidized surface (AOX, TiUnite). Implants were immediately loaded (test) or unloaded for 3 months (control). Examinations occurred over a 5-year period. ResultsForty-four subjects were re-examined after 5 years. Cumulative survival rates in test and control groups were 93.9% and 97.0%, respectively. Marginal bone loss (MBL; Mean [SEM]) was significantly lower at superstructures connected to AM (1.61 [0.25] mm) than at sites with no abutment IL (2.14 [0.17] mm). Peri-implantitis occurred in 9.1% of subjects and in 4.0% of implants. Multiple linear regression indicated that increased probing pocket depth (PPD), periodontal disease experience, deteriorating health, and light smoking (10 cigarettes/day) predict greater MBL, whereas increased buccal soft tissue thickness and higher ISQ predict lower MBL. ConclusionsThe results show that MBL was influenced by the connection type. A machined abutment, instead of connecting the superstructure directly at the implant level, was beneficial. The following factors influenced MBL: PPD, periodontal disease experience, deteriorating health, light smoking, buccal soft tissue thickness, and ISQ. The results on peri-implantitis underscore the need for long-term maintenance care. Further, the abutment material surface properties constitute additional target for strategies to minimize MBL.
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| 4. |
- Göthberg, Catharina, 1960, et al.
(författare)
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Immediately Loaded Implants with or without Abutments Supporting Fixed Partial Dentures: 1-Year Results from a Prospective, Randomized, Clinical Trial.
- 2014
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Ingår i: Clinical implant dentistry and related research. - : Wiley. - 1708-8208 .- 1523-0899. ; 16:4, s. 487-500
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To evaluate 1-year implant survival and marginal bone loss around implants that support fixed partial dentures loaded immediately or after 3 months, and effects from abutment usage. MATERIALS AND METHODS: In this 2005 to 2009 randomized, parallel-group, clinical trial, 50 partially edentulous patients each received three Brånemark TiUnite™ implants (Nobel Biocare®, Göteborg, Sweden), mostly in the posterior maxilla. Two implants were fitted with abutments: a TiUnite™ surface and a machine-milled surface; the suprastructure was attached directly at implant level for the third implant. After randomized allocation, implants were immediately loaded with a fixed temporary bridge (test group) or left unloaded for 3 months (control group). A permanent fixed suprastructure replaced the temporary bridge after 6 months (test). Hard and soft tissues were examined during pretreatment and surgery plus 2 days, 14 days, 4 weeks, 3 months, and 1 year after surgery. RESULTS: After 1 year, four implants were lost in the test and two in the control groups (1-year survival rates of 94.9% [test] and 97.2% [control], with no significant intergroup difference). Resonance frequency analysis values indicated a similar pattern in both groups, with implant stability quotient (ISQ) reduction between 2 and 4 weeks. The test group had a significantly lower ISQ than the control group at these appointments. After 1 year, marginal bone losses around the implants were, on average, 1.32mm (test, standard error of the mean [SEM] 0.08) and 1.24mm (control, SEM 0.08), with no significant intergroup difference. Significantly larger marginal bone loss was observed at implants without abutment compared with implants with abutment. CONCLUSIONS: For both groups, this study showed similar implant survival rates and marginal bone loss. Larger bone loss was found at implants loaded without attached abutments.
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| 5. |
- Göthberg, Catharina, 1960
(författare)
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On loading protocols and abutment use in implant dentistry. Clinical studies.
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- ABSTRACT Research questions: The influence of immediate or delayed loading and the use of abutments in implant dentistry with regard to peri-implant tissues and the effect of risk parameters. Methodology: Fifty partially edentulous patients each received three Brånemark TiUnite™ implants. The patients were randomly assigned to a test group (immediate loading) or a control group (delayed loading). The test patients received a temporary prosthesis within 48h. The prosthesis was attached directly at implant level (IL) or via abutments: a machine-milled surface (AM) or an oxidized surface (AOX, TiUnite™). Clinical examinations and intraoral radiographs were performed during a 5-year period. For a subgroup, crevicular fluid was analyzed with qPCR. Results: Up to 1-year, six implants were lost. Thereafter, no implants were lost, resulting in 5-year cumulative survival rates of 93.9% and 97.0%, for test and control groups, respectively. After 5 years, significantly lower marginal bone loss (MBL) was found at superstructures connected to AM than at sites with superstructures attached to IL. Soft tissues retracted mostly during the first year and thereafter minor changes were seen. With time, proximal probing pocket depth, plaque and bleeding increased, whereas a minor decrease for bleeding was found between 3 and 5 years. Similar bleeding-on-probing levels were seen at 3 and 5 years for various connections. The prevalence of peri-implantitis was 4.0% and 9.1% at implant and patient level, respectively, after 5 years. Technical complications were scarce after the first year; the most common was porcelain chipping. In a multiple linear regression model, the independent variables – health change, medication for high blood pressure, periodontal disease experience, smoking (≤10 cigarettes per day), and proximal pocket depth – explained about 27% of MBL variations. The gene study demonstrated correlation between some genes and clinical findings, but there is need for more research. Conclusions: The results demonstrated similar implant survival and marginal bone loss, irrespective of loading protocol. The use of a machined abutment should be preferred regarding marginal bone stability over time. There is still a lack of scientific support for placing superstructures directly on the implant. Factors related to systemic health and medications as well as periodontal disease experience and smoking, are associated with marginal bone loss. Peri-implantitis was found in 9.1% of the patients, indicating the need for supportive maintenance. Keywords: abutment design; clinical studies; dental implants; dental prosthesis, implant-supported; gene expression; health; immediate implant loading; marginal bone loss; osseointegration; prosthodontics; risk factors; smoking; treatment outcome.
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| 6. |
- Hugoson, Anders, et al.
(författare)
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Oral health of individuals aged 3-80 years in Jönköping, Sweden during 30 years (1973-2003) : I. Review of findings on dental care habits and knowledge of oral health
- 2005
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 29:4, s. 125-138
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to compare data on dental care habits and knowledge of oral health in four cross-sectional epidemiological studies carried out in 1973,1983,1993, and 2003. The 1973 study constituted a random sample of 1,000 individuals evenly distributed in the age groups 3, 5, 10, 15, 20, 30, 40, 50, 60, and 70 years. The same age groups with addition of a group of 80-year-olds were included in the 1983, 1993 and 2003 studies, which comprised 1,104, 1,078, and 987 individuals, respectively. A questionnaire about dental care habits and knowledge of oral health was used in connection with a clinical and radiographic examination. The same questions were used in all the four studies. An addition to the 1993 and 2003 investigations were questions concerning ethnic background. In 2003 approximately 90-95 per cent of all individuals were visiting the dentist on a regular basis every or every second year. The 30- and 40-yea r-olds, however, did not visit a dentist as regularly in 2003 as in 1993. In these age groups 21-24 per cent of the individuals, respectively, reported that they had not visited a dentist in the last 2 years. Almost all children 3-15 years old received their dental care within the Public Dental Service (PDS). During the period 1973-2003 an increase in percentage of individuals aged 20-50 years treated by the PDS was seen compared to private practice, while among 60-80 year-olds there were only minor changes. Most so-year-olds and older received their dental care by private practitioners. About 70-80 per cent of all adults in 2003 were enrolled in a recall system on the dentist's initiative while in 1973 most appointments were based on the patient's own initiative. The number of individuals who were frightened, 5-17 per cent, or felt discomfort at the prospect of an appointment with the dentist was more or less the same during the whole period. The knowledge of the etiology of dental diseases did not changed much between 1973 and 2003. The frequency of toothbrushing increased since 1973 and in 2003 more than 90 per cent of all individuals brushed their teeth twice or once a day. The use of dental floss and toothpicks decreased in 2003 compared to 1983 and 1993. Almost all individuals in 2003 used fluoride toothpaste. It was obvious that the dental team constituted the main source of dental health information. For the age groups 20 and 30 years information from friends and relatives was also important. In the age groups 3-20 years up to 45 per cent of the individuals were consuming soft drinks every day or several times a week.
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| 7. |
- Hugoson, Anders, et al.
(författare)
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Oral health of individuals aged 3-80 years in Jönköping, Sweden during 30 years (1973-2003) : II. Review of clinical and radiographic findings
- 2005
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 29:4, s. 139-155
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this epidemiological study was to analyze various clinical and radiographic data on oral health and compare the results to those of three cross-sectional studies carried out in 1973 and 1983, and 1993. In 1973, 1983, 1993, and 2003 a random sample of 1,000; 1,104; 1,078; and 987 individuals, respectively, were studied. The individuals were evenly distributed in the age groups 3, 5, 10, 15, 20, 30, 40, 50, 60, 70, and 80 years. In 1973 80-year-olds were not included. All subjects were inhabitants of the City of Jönköping, Sweden. The clinical and radiographic examination assessed edentulousness, removable dentures, implants, number of teeth, caries, restorations and overhangs, oral hygiene, calculus, periodontal status, endodontic treatment, and periapical status. The number of edentulous individuals in the age groups 40-70 years was reduced from 16 per cent in 1973 to 8 per cent in 1993, and to 1 per cent in 2003. The mean number of teeth increased, and up to the age of 60 years, individuals had more or less complete dentitions. During the 30-year period,the number of carious lesions and restorations decreased in general. In the 15-year-olds the decrease in number of restored tooth surfaces was 900 per cent and the corresponding figure for 30-year-olds was 79 per cent. The age groups 60-800 years showed an increase in number of restored tooth surfaces and had as a mean 50 filled tooth surfaces. The oral health among 3-5-year-olds improved markedly between 1973 and 1993. In 2003, however, there was no further improvement in 3- and 5-year-olds compared to 1993. Generally, restorations in 2003 exhibited a high quality and 90-95 per cent had no proximal overhangs. In 1973 this figure was about 60 per cent. In the age groups 20-50 years there were continuously fewer teeth fitted with crowns or bridges during the 30-year period. In 1973 the 50-year-olds had a mean of 24.5 per cent of the teeth crowned and in 2003 6.8 percent. Compared to data from 1973 there was a reduction by half concerning occurrence of plaque and gingivitis in 2003. The frequency of individuals with one or more periodontal pockets (> or = 4 mm) increased with age. In 2003 the bone level at the age of 60 years corresponded to the bone level at the age of 40 years in 1973. The percentage of endodontically treated teeth was lower in 2003 in all age groups compared to 1973, 1983, and 1993. The percentage of endodontically treated teeth with periapical orjuxtaradicular destructions was generally lower in 2003 than in the earlier surveys, about 20 per cent in 2003 compared to 25-30 per cent in 1973,1983, and 1993. The comparison of the four studies shows that there has been a great overall improvement in oral health over this 30-year period.
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| 9. |
- Slotte, Christer, 1954, et al.
(författare)
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Gene Expression of Inflammation and Bone Healing in Peri-Implant Crevicular Fluid after Placement and Loading of Dental Implants. A Kinetic Clinical Pilot Study Using Quantitative Real-Time PCR.
- 2012
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Ingår i: Clinical implant dentistry and related research. - : Wiley. - 1708-8208 .- 1523-0899. ; 14:5, s. 723-736
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Early detection of healing complications after placement of dental implants is a pressing but elusive goal. This paper proposes a non-invasive diagnostic tool for monitoring healing- and peri-implant disease specific genes, complementary to clinical evaluations. Material and Methods: Eighteen partially edentulous patients were recruited to this pilot study. Three Brånemark TiUnite® implants/patient (Nobel Biocare) were placed in a one-stage procedure. Abutments with smooth or rough (TiUnite®) surface were placed. The test group (n=9) received fixed bridges (immediate loading), whereas the control group (n=9) implants were loaded 3 months after surgery. In addition to clinical measurements, crevicular fluid was collected using paper strips at the implant abutments 2, 14, 28, and 90 days postoperative. mRNA was extracted, purified, and converted to cDNA. Quantitative PCR assays for IL-1β, TNF-α, Osteocalcin (OC), Alkaline Phosphatase (ALP), Cathepsin K, Tartrate Resistant Acid Phosphatase, and 18S ribosomal RNA were designed and validated. Relative gene expression levels were calculated. Results: One implant was lost in the control group and three in the test group. In one test patient, one implant showed lowered stability after 2 to 4 weeks and was unloaded. Later implant stability improved which allowed for loading after 3 to 4 months. TNF-α and ALP most commonly showed correlation with clinical parameters followed by IL-1β and OC. The strongest correlation was found for TNF-α with clinical complications at 2 and 14 days (p=.01/r=-048, and p=.0004/r=-0.56, respectively; test and control groups together). In some cases, gene expression predicted clinical complications (TNF-α, ALP, CK). Conclusion: This study is based on samples from few individuals; still, some genes showed correlation with clinical findings. Further studies are needed to refine and optimize the sampling process, to find the appropriate panel, and to validate gene expression for monitoring implant healing.
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