| 1. |
- Chrcanovic, Bruno, et al.
(författare)
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A retrospective study on clinical and radiological outcomes of oral implants in patients followed up for a minimum of 20 years
- 2018
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Ingår i: Clinical Implant Dentistry and Related Research. - : John Wiley & Sons. - 1523-0899 .- 1708-8208. ; 20:2, s. 199-207
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Tidskriftsartikel (refereegranskat)abstract
- Background: Very long-term follow-up of oral implants is seldom reported in the literature. Purpose: To assess oral implant failure rates and marginal bone loss (MBL) of patients followed up for a minimum of 20 years. Materials and Methods: Implants placed in patients followed up for 20+ years were included. Descriptive statistics, survival analyses, generalized estimating equations were performed. Three-hundred implants were randomly selected for MBL. Results: 1,045 implants (227 patients) were included. Implant location, irradiation, and bruxism affected the implant survival rate. Thirty-five percent of the failures occurred within the first year after implantation, and another 26.8% in the second/third year. There was a cumulative survival rate of 87.8% after 36 years of follow-up. In the last radiological follow up, 35 implants (11.7%) had bone gain, and 35 implants (11.7%) presented at least 3 mm of MBL. Twenty-six out of 86 failed implants with available radiograms presented severe MBL in the last radiological register before implant failure. Conclusions: Most of the implant failures occurred at the first few years after implantation, regardless of a very long follow up. MBL can be insignificant in long-term observations, but it may, nevertheless, be the cause of secondary failure of oral implants in some cases.
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| 2. |
- Chrcanovic, Bruno, et al.
(författare)
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Bruxism and dental implant treatment complications: a retrospective comparative study of 98 bruxer patients and a matched group.
- 2017
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Ingår i: Clinical oral implants research. - : Wiley. - 1600-0501 .- 0905-7161. ; 28:7
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To analyze the complications of dental implant treatment in a group of patients with bruxism in comparison with a matched group of non‐bruxers. Material and methods Patients being diagnosed as bruxers were identified within a group of patients consecutively treated with implant‐supported prostheses at one specialist clinic, based on the most recent listed sign and symptoms of bruxism according to the International Classification of Sleep Disorders. A diagnostic grading system of “possible,” “probable,” and “definite” sleep or awake bruxism was used, according to a recent published international consensus. A case–control matching model was used to match the bruxers with a group of non‐bruxers, based on five variables. Implant‐, prosthetic‐, and patient‐related data were collected, as well as 14 mechanical complications, and compared between groups. Results Ninety‐eight of 2670 patients were identified as bruxers. The odds ratio of implant failure in bruxers in relation to non‐bruxers was 2.71 (95% CI 1.25, 5.88). Considering the same number of patients with the same total number of implants equally distributed between groups, the bruxers group had a higher prevalence of mechanical complications in comparison with the non‐bruxers group. Conclusions This study suggests that bruxism may significantly increase both the implant failure rate and the rate of mechanical and technical complications of implant‐supported restorations. Other risk factors may also have influenced the results.
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| 3. |
- Chrcanovic, Bruno, et al.
(författare)
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Factors influencing the fracture of dental implants
- 2018
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Ingår i: Clinical Implant Dentistry and Related Research. - : John Wiley & Sons. - 1523-0899 .- 1708-8208. ; 20:1, s. 58-67
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Tidskriftsartikel (refereegranskat)abstract
- Background: Implant fractures are rare but offer a challenging clinical situation. Purpose: To determine the prevalence of implant fracture and the possible risk factors predisposing an implant to a higher fracture risk. Materials and Methods: This retrospective study is based on 2670 patients consecutively treated with implant-supported prostheses. Anatomical-, patient-, and implant-related factors were collected. Descriptive statistics and survival analyses were performed. Generalized estimating equations (GEE) evaluated the effect of explanatory variables on implant fracture. Results: Forty-four implants (out of 10 099; 0.44%) fractured. The mean ± standard deviation time for fracture to occur was 95.1 ± 58.5 months (min-max, 3.8-294.7). Half of the occurrences of fracture happened between 2 and 8 years after implantation. Five factors had a statistically significant influence on the fracture of implants (increase/decrease in fracture probability): use of higher grades of titanium (decrease 72.9%), bruxism (increase 1819.5%), direct adjacency to cantilever (increase 247.6%), every 1 mm increase in implant length (increase 22.3%), every 1 mm increase in implant diameter (decrease 96.9%). Conclusions: It is suggested that 5 factors could influence the incidence of implant fractures: grade of titanium, implant diameter and length, cantilever, bruxism.
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| 4. |
- Chrcanovic, Bruno Ramos, et al.
(författare)
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Analysis of technical complications and risk factors for failure of combined tooth-implant-supported fixed dental prostheses
- 2020
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Ingår i: Clinical Implant Dentistry and Related Research. - : John Wiley & Sons. - 1523-0899 .- 1708-8208. ; 22:4, s. 523-532
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The oral rehabilitation with fixed restorations supported by the combination of teeth and dental implants has been advocated in some cases.PURPOSE: To assess the clinical outcomes of these prostheses. Fixed restorations supported by the combination of teeth and dental implants.MATERIALS AND METHODS: This retrospective study included all patients treated with combined tooth-implant-supported fixed dental prostheses (FDPs) at one specialist clinic. Abutment/prosthesis failure and technical complications were the outcomes analyzed.RESULTS: A total of 85 patients with 96 prostheses were included, with a mean follow-up of 10.5 years. Twenty prostheses failed. The estimated cumulative survival rate was 90.7%, 84.8%, 69.9%, and 66.2% at 5, 10, 15, and 20 years, respectively. The failure of tooth and/or implant abutments in key positions affected the survival of the prostheses. There were seven reasons for prostheses failure, with the loss of abutments exerting a significant influence. Bruxism was possibly associated with failures. Prostheses with cantilevers did not show a statistically significant higher failure rate. No group had a general higher prevalence of technical complications in comparison to the other groups.CONCLUSIONS: Although combined tooth-implant-supported FDPs are an alternative treatment option, this study has found that across 20 years of service nearly 35% the prostheses may fail.
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| 5. |
- Chrcanovic, Bruno Ramos, et al.
(författare)
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Dental implants in patients with Sjögren's syndrome: a case series and a systematic review
- 2019
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Ingår i: International Journal of Oral and Maxillofacial Surgery. - : Elsevier BV. - 0901-5027 .- 1399-0020. ; 48:9, s. 1250-1259
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Forskningsöversikt (refereegranskat)abstract
- The purpose of this study was to assess the clinical outcomes of dental implants in patients with Sjögren's syndrome (SS). The study consisted of two parts: report of a case series and a systematic review of the literature. The results of the clinical series revealed that 19 patients received 107 implants and were followed for a mean of 125 months. Two patients lost three implants (failure rate 2.8%, 3/107). At the last follow-up, there was a mean marginal bone loss (MBL) of −2.190 ± 1.384 mm; estimated MBL after 30 years was 4.39 mm. The review identified 18 studies, resulting in 19 studies for analysis including the present clinical series. A total of 712 implants were placed in 186 patients; 705 implants were followed up for a mean of 72.5 months (failure rate 4.1%, 29/705; failed at a mean time of 12.9 ± 31.7 months). The probability of failure was 2.8% (95% confidence interval 1.6–4.1%). Primary SS patients had a lower implant failure rate (2.5%, 3/118) than secondary SS patients (6.5%, 12/184). In conclusion, dental implants should be considered by dentists as a viable treatment option for patients with SS, as the failure rate is fairly low. SS patients may, however, present a higher MBL around implants than patients from the general population. © 2019 International Association of Oral and Maxillofacial Surgeons
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| 6. |
- Chrcanovic, Bruno Ramos, et al.
(författare)
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Retrospective clinical evaluation of 2- to 6-unit implant-supported fixed partial dentures : Mean follow-up of 9 years.
- 2020
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Ingår i: Clinical Implant Dentistry and Related Research. - : John Wiley & Sons. - 1523-0899 .- 1708-8208. ; 22:2, s. 201-212
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Implant-supported fixed partial dentures (ISFPDs) are one of the most common options to rehabilitate partially edentulous patients.PURPOSE: To assess the clinical outcomes of ISFPDs.METHODS: This retrospective study included all patients treated with ISFPDs with 2 to 6 prosthetic units at one specialist clinic. Implant/prosthesis failure and technical complications were the outcomes analyzed.RESULTS: Six hundred and forty-two patients with 876 ISFPDs (2241 implants) were included, followed up for 108.0 ± 76.2 months. Eighty-eight prostheses and 112 implants (26 before, 86 after prosthesis installation) failed. The estimated CSR of ISFPDs at 30 years was 72.7%. Smokers presented lower implant survival than nonsmokers. Two hundred and ninety-nine ISFPDs (33.2%) presented technical complications. Bruxism was a factor to exert a higher risk of screw and implant fracture, and ceramic chipping. ISFPDs with cantilever presented higher risk of failure, and screw loosening/fracture. Prostheses supported by implants with internal abutment connection or with two pontics had higher risk of presenting ceramic chipping. Extension of the prosthesis did not seem to exert influence on prosthesis failure/complications.CONCLUSIONS: ISFPDs presented good long-term prognosis. Implant failure was the main reason for ISFPD failure. The results suggest that bruxism and the presence of cantilever may contribute to the increased rate of mechanical complications and prosthesis failure.
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| 7. |
- Chrcanovic, Bruno Ramos, et al.
(författare)
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Retrospective clinical evaluation of implant‐supported single crowns : mean follow‐up of 15 years
- 2019
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Ingår i: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 30:7
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To retrospectively assess the clinical outcomes of implant‐supported single crowns and the supporting implants. Material and Methods: This retrospective study included all patients treated with implant‐supported single crowns at one specialist clinic. Implant and prosthesis failure, and mechanical/technical complications (ceramic fracture/chipping; crown loss of retention/mobility; crown failure/fracture; loosening/loss/fracture of prosthetic screw; implant failure/fracture) were the outcomes analyzed. Any condition/situation that led to the removal/replacement of crowns was considered prosthesis failure. Results: 438 patients with 567 crowns were included. Mean±SD follow‐up of 183.4±69.3 months. 37 implants (6.5%) and 54 crowns (9.5%) failed. If only technical problems were considered, the crown failure rate decreased to 4.1% (23/567). Most common reasons for crown failure: esthetic issue (n=12), crown constantly mobile (n=9), change to another type of prosthesis together with other implants (n=8), crown fracture (n=7), crown in infraposition in comparison to adjacent teeth (n=7). The odds of crown failure were shown to be statistically significantly higher for the following factors: younger patients, maxillary crowns, and screw‐retained crowns. Loose prosthetic screw was much more prevalent in screw‐retained than in cemented crowns. Ceramic fracture/chipping was more prevalent in screw‐retained crowns, maxillae, females. Crown fracture was more prevalent in ceramic crowns, screw‐retained crowns, maxillae, posterior region, females. However, these differences were statistically significant only for crown fractures in females. Conclusions: The odds of crown failure were significant for some factors, but one must keep in mind that non‐technical complications are as common as technical ones as reasons for the replacement of implant‐supported single crowns.
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| 8. |
- Chrcanovic, Bruno R., et al.
(författare)
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Retrospective evaluation of implant-supported full-arch fixed dental prostheses after a mean follow-up of 10 years.
- 2020
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Ingår i: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 31:7, s. 634-645
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess the outcomes of implant-supported full-arch fixed dental prostheses (ISFAFDPs) and the supporting implants.MATERIAL AND METHODS: This retrospective study included patients treated with ISFAFDPs at one specialist clinic. Implant/prosthesis failure and complications were the outcomes analyzed. Survival analysis methods were used.RESULTS: A total of 709 patients with 869 ISFAFDPs (4,797 implants) were included, with a mean ± SD follow-up of 10.7 ± 7.2 years. A total of 353 implants and 62 prostheses failed. Estimated cumulative survival rates were as follows: 93.3% (95% CI 91.3, 95.3) after 10 years and 87.1% (95% CI 83.4, 90.8) after 20 years. Implants installed in bruxers, smokers, and maxilla had a lower survival than implants installed in non-bruxers, non-smokers, and mandible, respectively. A total of 415 ISFAFDPs (47.8%) presented technical complications, of which 67 (7.7%) presented only occurrences of loss/fracture of implant access hole sealing. Bruxism was a factor to exert a higher risk of screw loosening (HR 3.302; also in younger patients), screw fracture (HR 4.956), ceramic chipping/fracture (HR 5.685), and loss/fracture of acrylic teeth (HR 2.125; this last complication with higher risk also in men, in maxillae, and when the opposing jaw presented natural dentition or fixed prostheses). Patients with bruxism had a statistically significant higher risk of prosthesis failure than non-bruxers (HR 3.276).CONCLUSIONS: ISFAFDPs presented good long-term prognosis. Failure of several supporting implants was the main reason for failure. The results of the present study strongly suggest that bruxism is an important contributor to implant and prosthesis failure, as well as to an increased prevalence of technical complications in ISFAFDPs.
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| 9. |
- Chrcanovic, Bruno Ramos, DDS, MSc, PhD, et al.
(författare)
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Retrospective study comparing the clinical outcomes of bar-clip and ball attachment implant-supported overdentures
- 2020
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Ingår i: Journal of Oral Science. - : Tokyo Nihon University School of Dentistry. - 1343-4934 .- 1880-4926. ; 62:4, s. 397-401
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to compare the clinical outcomes of implant-supported overdentures (ODs) with either bar-clip or ball attachments. The implant, prosthesis failure, and technical complications were the outcomes analyzed in this retrospective clinical study conducted in a specialty clinic. Seventy-five patients with 242 implants supported by 76 ODs (36 maxillary, 40 mandibular) were included in the study and followed up for 88.8 ± 82.9 months (mean ± standard deviation). Bar-clip and ball attachments were used in 78.9% and 21.1% of the cases, respectively. Forty-three implant failures (17.8%) in 17 prostheses (17/76; 22.4%) were observed in this study. The average period of implant failure was 43.3 ± 41.0 months, and most of them were maxillary turned implants. The bar-clip system demonstrated more complications in the attachment parts compared to the ball attachment system. Poor retention of the prosthesis was similar between the two systems. Loss of implants resulted in the failure of 10 ODs in this study. ODs opposed by natural dentition or fixed prostheses presented with more complications. The Cox proportional hazards model did not show a significant effect on prosthesis failure for any of the factors. These findings indicated that patients with ODs need constant maintenance follow-ups to address the technical complications and perform prosthodontic maintenance regardless of the attachment system used.
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