| 1. |
- Henry, Patric, et al.
(författare)
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Osseointegrated implants for single-tooth replacement: a prospective 5-year multicenter study.
- 1996
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Ingår i: The International journal of oral & maxillofacial implants. - 0882-2786. ; 11:4, s. 450-5
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Tidskriftsartikel (refereegranskat)abstract
- One hundred seven Brånemark implants were placed in 92 patients participating in an international multicenter trial on single-implant restorations at seven centers. The patients were followed for 5 years in a prospective study focusing on implant success and crown function. Plaque and gingival indexes, as well as probing depths, were recorded around teeth and implants. The marginal bone level at implants was determined from intraoral radiographs. Only three implants (2.8%) had been lost at the final annual checkup. During the follow-up period, a total of 17 patients dropped out or were excluded because of nonconformity with the protocol. Based on the remaining patients, a total of 86 implants were clinically and radiographically evaluated at the 5-year follow-up period, resulting in a cumulative success rate of 96.6% (71 implants) in the maxillae and 100% (15 implants) in the mandibles. Plaque and gingival indexes showed a similar pattern of good health around both natural teeth and titanium abutments. The marginal bone loss during the 5-year period did not exceed 1 mm as a mean for all implants analyzed. The most frequent complication recorded during the follow-up was loosening of the abutment fixation screw. The outcome of this study indicated that safe and highly predictable results can be obtained for 5 years when Brånemark implants are used to support single-tooth restorations.
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| 2. |
- Jemt, Torsten, 1950, et al.
(författare)
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A 5-year prospective multicenter follow-up report on overdentures supported by osseointegrated implants.
- 1996
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Ingår i: The International journal of oral & maxillofacial implants. - 0882-2786. ; 11:3, s. 291-8
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Tidskriftsartikel (refereegranskat)abstract
- This report presents the results of a 5-year prospective multicenter study including nine centers worldwide. A total of 30 patients received 117 Brånemark implants in the maxillae, and 103 patients received 393 implants in the mandibles. According to the protocol, all integrated maxillary implants were to be loaded; however, only two of four mandibular implants were planned for support of the overdentures, leaving the remaining implants covered by mucosa as backup for possible implant failures. Thirty-five patients (26.3%) who were provided with 127 implants (24.9%) were withdrawn from the study. Six patients treated in the maxilla lost all their implants and resumed wearing complete dentures. The cumulative success rates for implants and for overdentures supported by two implants in the edentulous mandible were 94.5% and 100%, respectively. The corresponding cumulative success rates for implants and for overdentures supported by an optimal number of implants in the maxilla were 72.4% and 77.9%, respectively. Significantly better jawbone characteristics at the time of implant surgery were considered to contribute to the better cumulative success rates in the mandibles. Mean marginal bone loss was 0.8 mm (SD 0.8) and 0.5 mm (SD 0.8) for loaded implants during a 5-year period of time in the maxillae and mandibles, respectively. Measurements of the clinical height of the abutment cylinders indicated a mean recession (0.2 mm) of peri-implant mucosa during the follow-up period in the mandibles. Conversely, hyperplasia was observed in the maxillae.
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| 3. |
- Jemt, Torsten, 1950, et al.
(författare)
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Osseointegrated implants for single tooth replacement: a 1-year report from a multicenter prospective study.
- 1991
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Ingår i: The International journal of oral & maxillofacial implants. - 0882-2786. ; 6:1, s. 29-36
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Tidskriftsartikel (refereegranskat)abstract
- One hundred seven dental implants were inserted to support single tooth restorations in 92 patients participating in a prospective multicenter investigation. Only three implants (2.8%) were lost after 1 year of clinical function. Most of the remaining restorations were esthetically successful by using modified components. The gingival condition was healthy around the single crowns and coincided well with the clinical situation around the permanent teeth. The most obvious problem experienced during the first year was related to loose abutment screws. Twenty-six percent of the screws retaining crowns were retightened during the observation period, but the frequency of loose screws had a tendency to decrease as the study progressed.
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| 4. |
- Bergqvist, Karin, et al.
(författare)
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The role of chloramines in treatment of diabetic foot ulcers: an exploratory multicentre randomised controlled trial
- 2016
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Ingår i: Clinical Diabetes and Endocrinology. - : Springer Science and Business Media LLC. - 2055-8260. ; 2:6
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Tidskriftsartikel (refereegranskat)abstract
- Background Chronic foot ulcers in diabetes are serious, costly and frequently difficult to heal. Recent guidelines conclude that new dressings and treatments generally fail to show superiority compared with standard of care. Several mechanisms are probably responsible for impaired healing of chronic foot ulcers, including inflammation and infection. Chloramines have presumed antiseptic and antibacterial properties, and have shown to be a useful treatment in odontology. Methods In an explorative open randomised controlled multi-centre study, we compared chloramine-based treatment with current standard of care for 12 weeks and follow-up for 24 weeks. Seventeen patients in each group, mean age about 70, duration of diabetes > 20 years and foot ulcers about 1.5 years, completed the 12 weeks study. Results After 5 weeks, the difference between the groups in relative reduction in ulcer area was statistically significant (p=0.016). Absolute change in ulcer area was first statistically significant within the chloraminetreated group after 2 weeks (p=0.026), after 8 weeks in the control group (p=0.0023), with significant difference between groups after 5 weeks (p=0.024). The approximate relative decrease per week was 19.4% (95%CI 12.2, 26.0; p<0.0001) in the chloramine-treated group and 11.7% (95%CI 6.4, 16.7; p<0.0001; between-group difference p=0.083). After 9 weeks 7 patients had healed in the chloraminetreated group, but only one in the control group (p=0.039). There were no statistically significant differences in wound healing at 12 or 24 weeks, and no marked differences in signs of infection, pain, quality of life (EQ-5D), or incidence of adverse events. Conclusions Chloramine-based treatment seems to be efficacious, particularly in the early phase of the care of infected diabetic foot ulcers. It is safe and easy to use, and could prove to be a valuable addition in the treatment arsenal, providing non-surgical debridement. Future studies will evaluate its role in wound care.
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| 5. |
- Herrmann, Irene, 1950, et al.
(författare)
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A study on variances in multivariate analyses of oral implant outcome.
- 2007
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Ingår i: Clinical implant dentistry and related research. - : Wiley. - 1523-0899 .- 1708-8208. ; 9:1, s. 6-14
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Elaborate studies have shown that interdependency exists between implants being placed in the same patient/jaw. Therefore, interdependency ought to be an important aspect to address, whenever performing statistical analyses of oral implant outcomes. A Jackknife method could be an option when conducting statistical evaluations of oral implant failure prognoses. PURPOSE: The aim of this study was to evaluate whether a statistical difference can be detected by using the Jackknife method in conjunction with life table analyses and/or a log rank test of four different combinations of jaw density and quantity. MATERIALS AND METHODS: Four multicenter studies were pooled and adjusted in order to create a research database consisting of 486 patients and 1,737 implants in preparation for the Jackknife resampling method. Combinations of jaw shapes and bone qualities were constructed to select at-risk patients. STATISTICAL METHODS: Life tables with confidence intervals were calculated and a log rank test was used to determine whether a statistical difference between the combinations could be established. RESULTS: Both statistical analyses, after the Jackknife resampling method, showed that patients with poor bone quality and resorbed jaws (combination IV) had a statistically higher risk of implant failure. CONCLUSION: By rearranging data using the Jackknife method, standardized statistical tests seem to work well even when the study population tested was affected by interdependency.
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| 6. |
- Herrmann, Irene, 1950, et al.
(författare)
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Evaluation of patient and implant characteristics as potential prognostic factors for oral implant failures.
- 2005
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Ingår i: The International journal of oral & maxillofacial implants. - 0882-2786. ; 20:2, s. 220-30
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of this study was to evaluate patient, implant, and treatment characteristics to identify possible prognostic factors for implant failure. MATERIALS AND METHODS: Out of a database with different dental implant treatment protocols, a research database of 1 randomly selected implant per patient was created. The database consisted of 487 implants. Of these, 80 were withdrawn, 36 failed, and 371 remained successful during a 5-year follow-up period. Potential risk factors were evaluated by chi-square tests and post hoc analyses. RESULTS: Significant or strongly significant differences were found regarding implant failures as a result of jawbone quality, jaw shape, implant length, treatment protocol, and combinations of jawbone-related characteristics. Responsible clinics and number of implants supporting the restoration were factors that could not be associated with implant failure. DISCUSSION: Implant failures in this study were more often seen when negative patient-related factors were present. Approximately 65% of the patients with a combination of the 2 most negative bone-related factors (jawbone quality 4 and jaw shape D or E) experienced implant failure. However, only 3% of the patients had this combination. Implant length, the only implant-related factor evaluated, was also significantly correlated with the success rate, but implant length could also be regarded as a result of the jawbone volume available. Another negative patient-related factor was the treatment protocol; however, in most cases this was also indirectly or partly related to the status of the jawbone available for implant placement. CONCLUSION: Patient selection appears to be of importance for increasing implant success rates.
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| 7. |
- Herrmann, Irene, 1950
(författare)
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Influences of Statistical Analyses on Result Presentations of Oral Implant Treatment
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Abstract Evaluation of oral implants involves at least three major components: statistical methods, study design and success criteria. The aims of the current thesis were to investigate how different statistical methods affect the outcome of oral implant treatment and to statistically determine if any dependence among implants placed in the same jaw exists. If so - how would that affect the outcome and the type and amount of missing data (withdrawn patients)? Furthermore, the aims were to evaluate patient, implant and treatment characteristics to find possible prognostic factors for implant failure and to study the impact of variances with or without handling dependence using the Jackknife technique. Four prospective multi-centre studies, involving 487 patients and 1738 implants, were pooled to create a database for these elaborations. The database was divided into subgroups based on significant different outcomes regarding implant failures. Four jaw-bone combinations (Combination I-IV) were established, and in study IV - Combinations I-III were pooled and compared with Combination IV. Statistical methods used were: life table analyses, confidence intervals, chi2 tests, step by step multivariate analyses, post hoc analyses, log rank tests and the Jackknife technique. The result of the current statistical investigations demonstrated that dependence among implants placed in the same jaw existed. The impact of missing data was shown to depend on, if the patients were selectively or randomly withdrawn. A random selection could reach at the most 50% without affecting the CSR. However, if the selection was based on e.g. treated jaw, the outcomes were significantly different. Patient characteristics such as jaw, jaw-bone quality, jaw-shape and combination of these factors, and also on implant length and treatment protocol, showed significant differences. Patients with jaw shape D or E and bone-quality 4 were e.g. identified with a significantly higher risk for implant failure than all of the other combinations. Both life table analyses, using CI and log rank tests, demonstrated after the variances were calculated via the Jackknife technique significantly lower success rates for Combination IV. The p-values were ?inadequately? stronger, however, when using a log rank test and ignoring the established dependence. Based on these results it was stated that, following established dependence among implants within the same jaw, this should never be ignored when evaluating oral implant outcomes. Two methods were found possible to use to handle this dependence, the ?one implant per patient? or the Jackknife technique if variances are part of the evaluation. Missing data is inevitable and will affect the outcome, and therefore a description of the characteristics of withdrawn patients should be presented. Jaw-combination IV showed the lowest success rate and would therefore be the most appropriate population to use, when evaluating new improved oral implant systems in order to prove significantly different follow-up outcome.
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