| 1. |
- Christiaens, Veronique, et al.
(författare)
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Intraoral radiography lacks accuracy for the assessment of peri-implant bone level : a controlled clinical study
- 2017
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Ingår i: European Journal of Oral Implantology. - : Quintessence. - 1756-2406 .- 1756-2414. ; 10:4, s. 435-441
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to compare clinical and radiographic bone level assessments to intra-surgical bone level registration around implants with peri-implantitis and to identify the clinical variables rendering peri-implant bone level assessment accuracy. Materials and methods: The study sample included 50 implants with peri-implantitis in 23 patients. Registration methods included probing of the vertical distance between the implant/abutment interface and the bottom of the pocket (= VPD), intraoral radiography, bone sounding without flap elevation and intra-surgically assessed interproximal bone level. The latter was considered the true bone level (gold standard). Twenty clinicians evaluated all radiographs. Results: VPD and intraoral radiography resulted in a significant underestimation of the true bone level by 1.0 mm (95% CI: 0.495-1.585; P < 0.001) and 2.3 mm (95% CI: 1.650-2.980; P < 0.013) respectively. Bone sounding without flap elevation did not differ significantly from the true bone level (mean difference 0.2 mm; 95% CI: -0.775 - 0.335; P = 0.429). Duplicate magnification registration of 50 implants resulted in excellent intra- and inter-rater reliability (ICC intra <= 0.99; ICC inter = 0.964; P < 0.001). Radiographic underestimation was significantly affected by defect depth (P < 0.001). Variation among clinicians was substantial (mean underestimation range 1.1 mm to 3.8 mm); however, clinical experience had no impact on radiographic underestimation (P = 0.796). Conclusions: Bone sounding without flap elevation was the best predictor of peri-implant bone level, whereas intraoral radiography was the most inferior. Consequently, peri-implantitis may be under-diagnosed if examination is only based on radiographs.
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| 2. |
- Cosyn, Jan, et al.
(författare)
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A 5-year prospective study on single immediate implants in the aesthetic zone
- 2016
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Ingår i: Journal of Clinical Periodontology. - : Wiley-Blackwell. - 0303-6979 .- 1600-051X. ; 43:8, s. 702-709
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Tidskriftsartikel (refereegranskat)abstract
- Aim There is a paucity of long-term data on soft tissue aesthetics of single immediate implants. The objective of this study was to evaluate the 5-year clinical and aesthetic outcome of this treatment concept. Materials and methods Twenty-two periodontally healthy patients (12 men, 10 women; mean age 50) with low risk for aesthetic complications (thick gingival biotype, intact buccal bone wall, both neighbouring teeth present) were consecutively treated with a single immediate implant in the aesthetic zone (15-25). Flapless surgery was performed and the gap between the implant and buccal bone wall was systematically filled with bovine bone particles. Implants were immediately non-functionally loaded with a screw-retained provisional crown. Cases demonstrating major alveolar process changes and/or advanced mid-facial recession (>1mm) at 3months were additionally treated with a connective tissue graft (CTG). Permanent crowns were installed at 6months. The clinical and aesthetic results at 5years were compared to those obtained at 1 year Results Seventeen patients attended the 5-year re-assessment, of whom five had been treated with a CTG for early aesthetic complications. There was one early implant failure and one complication after 1 year (porcelain chipping). Mean marginal bone loss was 0.12mm at 1 year and 0.19mm at 5years (p=0.595) with the moment of implant installation as baseline. Papilla height increased between 1 and 5years (p0.007), whereas mid-facial contour (p=0.005) and alveolar process deficiency (p=0.008) deteriorated. Mean mid-facial recession was on average 0.28mm (SD 0.48) at 1 year and 0.53mm (SD 0.53) at 5years (p=0.072) with the preoperative status as baseline. Three implants demonstrated advanced mid-facial recession (>1mm) at 5years. All three were in a central incisor position and none had been treated with a CTG. Thus, 8/17 implants showed aesthetic complications (five early and three late aesthetic complications). Implants in a lateral incisor position showed stable soft tissue levels. The pink aesthetic score was on average 12.15 at 1 year and 11.18 at 5years (p=0.030 Conclusion Single immediate implants showed high implant survival and limited marginal bone loss in the long term. However, mid-facial recession, mid-facial contour and alveolar process deficiency deteriorated after 1year. With an aesthetic complication rate of 8/17 in well-selected patients who had been treated by experienced clinicians, type I placement may not be recommended for daily practice
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| 3. |
- De Bruyn, Hugo, et al.
(författare)
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Implant surface roughness and patient factors on long-term peri-implant bone loss
- 2017
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Ingår i: Periodontology 2000. - : John Wiley & Sons. - 0906-6713 .- 1600-0757. ; 73:1, s. 218-227
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Forskningsöversikt (refereegranskat)abstract
- Dental implant placement is a common treatment procedure in current dental practice. High implant survival rates as well as limited peri-implant bone loss has been achieved over the past decades due to continuous modifications of implant design and surface topography. Since the turn of the millennium, implant surface modifications have focused on stronger and faster bone healing. This has not only yielded higher implant survival rates but also allowed modifications in surgical as well as prosthetic treatment protocols such as immediate implant placement and immediate loading. Stable crestal bone levels have been considered a key factor in implant success because it is paramount for long-term survival, aesthetics as well as peri-implant health. Especially during the past decade, clinicians and researchers have paid much attention to peri-implant health and more specifically to the incidence of bone loss. This could furthermore increase the risk for peri-implantitis, the latter often diagnosed as ongoing bone loss and pocket formation beyond the normal biological range in the presence of purulence or bleeding on probing. Information on the effect of surface topography on bone loss or peri-implantitis, a disease process that is to be evaluated in the long-term, is also scarce. Therefore, the current narrative review discusses whether long-term peri-implant bone loss beyond physiological bone adaptation is affected by the surface roughness of dental implants. Based on comparative studies, evaluating implants with comparable design but different surface roughness, it can be concluded that average peri-implant bone loss around the moderately rough and minimally rough surfaces is less than around rough surfaces. However, due to the multifactorial cause for bone loss the clinical impact of surface roughness alone on bone loss and peri-implantitis risk seems rather limited and of minimal clinical importance. Furthermore, there is growing evidence that certain patient factors, such as a history of periodontal disease and smoking, lead to more peri-implant bone loss.
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| 4. |
- Doornewaard, Ron, et al.
(författare)
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Long-Term Effect of Surface Roughness and Patients' Factors on Crestal Bone Loss at Dental Implants : A Systematic Review and Meta-Analysis
- 2017
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Ingår i: Clinical Implant Dentistry and Related Research. - : John Wiley & Sons. - 1523-0899 .- 1708-8208. ; 19:2, s. 372-399
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Forskningsöversikt (refereegranskat)abstract
- Publications from 2011 to 2015 were selected to evaluate effect of implant surface roughness on long-term bone loss as surrogate for peri-implantitis risk. 87 out of 2,566 papers reported the mean bone loss after at least 5 years of function. Estimation of the proportion of implants with bone loss above 1, 2, and 3 mm as well as analysis the effect of implant surface roughness, smoking, and history of periodontitis was performed. By means of the provided statistical information of bone loss (mean and standard deviation) the prevalence of implants with bone loss ranging from 1 to 3 mm was estimated. The bone loss was used as a surrogate parameter for peri-implantitis given the fact that peri-implantitis prevalence was not reported in most studies or when reported, the diagnostic criteria were unclear or of dubious quality. The outcome of this review suggests that peri-implant bone loss around minimally rough implant systems was statistically significant less in comparison to the moderately rough and rough implant systems. No statistically significant difference was observed between moderately rough and rough implant systems. The studies that compared implants with comparable design and different surface roughness, showed less average peri-implant bone loss around the less rough surfaces in the meta-analysis. However, due to the heterogeneity of the papers and the multifactorial cause for bone loss, the impact of surface roughness alone seems rather limited and of minimal clinical importance. Irrespective of surface topography or implant brand, the average weighted implant survival rate was 97.3% after 5 years or more of loading. If considering 3 mm bone loss after at least 5 years to represent the presence of peri-implantitis, less than 5% of the implants were affected. The meta-analysis indicated that periodontal history and smoking habits yielded more bone loss.
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| 5. |
- Glibert, Maarten, et al.
(författare)
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Clinical and Radiographic Comparison between Platform-Shifted and Nonplatform-Shifted Implant : A One-Year Prospective Study
- 2016
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Ingår i: Clinical Implant Dentistry and Related Research. - : John Wiley & Sons. - 1523-0899 .- 1708-8208. ; 18:1, s. 129-137
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Tidskriftsartikel (refereegranskat)abstract
- Background Developments in implant hardware and biologic understanding improved treatment predictability in terms of implant survival. Current research focuses on accelerated loading protocols and crestal bone preservation. Purpose This prospective, monocenter study analyzed the clinical and radiographic outcome of a novel parallel-walled implant, with and without platform shift Materials and Methods Forty-eight consecutively treated patients (30 women, 18 men) with crowns/bridges supported by 115 implants were included. Eighty-three percent of implants were nonocclusal, immediately loaded, and 17% were subjected to one-stage surgery and delayed loading after 10 weeks; 39.1% were of diameter 5.0mm, enabling platform shifting with a 4.0mm-wide prosthetic component; 60.9% were of diameter 4.0mm with a 4.0mm component. Radiographic crestal bone levels were assessed at baseline and 1 year. A multivariate statistical analysis was performed to determine factors affecting crestal bone loss after 1 year Results All implants survived and mean marginal bone loss was 0.73mm (SD: 0.13; range: -0.60 to 5.0mm). There was a statistically significant difference between platform-shifted (0.63mm; SD: 0.18) and nonplatform-shifted (1.02mm; SD: 0.14) implants. Implants in abundant bone volume lost significant less crestal bone (0.45mm; SD: 0.14) compared with implants in small volume (1.20mm; SD: 0.21). Implant diameter, loading time, anatomical position, smoking, and bone quality did not affect crestal bone loss Conclusion After 1 year of loading, both implant-prosthetic features yield a high survival and limited crestal bone loss. Crestal bone loss is minimized using platform-shifted implants placed in sufficiently voluminous bone. To limit the crestal bone loss, an adopted implant diameter with platform shifting should be considered.
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| 6. |
- Koole, Sebastiaan, et al.
(författare)
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Exploring the relation between online case-based discussions and learning outcomes in dental education
- 2014
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Ingår i: Journal of Dental Education. - : John Wiley & Sons. - 0022-0337 .- 1930-7837. ; 78:11, s. 1552-7
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Tidskriftsartikel (refereegranskat)abstract
- Online case-based discussions, parallel to theoretical dental education, have been highly valued by students and supervisors. This study investigated the relation between variables of online group discussions and learning outcomes. At Ghent University in Belgium, undergraduate dental students (years two and three) are required to participate in online case-based discussion groups (five students/group) in conjunction with two theoretical courses on basic periodontics and related therapy. Each week, a patient case is discussed under supervision of a periodontist, who authored the case and performed the treatment. Each case includes treatment history and demand, intra- and extraoral images, and full diagnostic information with periodontal and radiographic status. For this retrospective study, data were obtained for all 252 students in forty-three discussion groups between 2009 and 2012. Spearman's rank correlations were calculated to investigate the relation among group dynamics (number of group posts and views), individual student contributions (number of individual posts, newly introduced elements, questions, and reactions to other posts), supervisors' interventions (number of posts and posed questions), and learning outcomes (examination result). The results showed that learning outcomes were significantly related to the number of student posts (Spearman's rho (ρ)=0.19), newly introduced elements (ρ=0.21), reactions to other posts (ρ=0.14), number of supervisors' interventions (ρ=0.12), and supervisors' questions (ρ=0.20). These results suggest that individual student contributions during online case-based discussions and the provided supervision were related to learning outcomes.
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| 7. |
- Matthys, Carine, et al.
(författare)
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Impact of crestal bone resorption on quality of life and professional maintenance with conventional dentures or locator-retained mandibular implant overdentures
- 2018
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Ingår i: The Journal of prosthetic dentistry (Print). - : Elsevier. - 0022-3913 .- 1097-6841. ; 120:6, s. 886-894
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Tidskriftsartikel (refereegranskat)abstract
- STATEMENT OF PROBLEM: The influence of the mandibular resorption profile on clinical outcome after converting a conventional complete denture into a Locator-retained implant overdenture is unknown. PURPOSE: The purpose of this prospective study was to assess the oral health-related quality of life (OHRQoL) and prosthetic maintenance of mandibular overdentures on 2 Locator abutments in relation to the resorption degree of the edentulous mandible. MATERIAL AND METHODS: Twenty-five participants were treated and classified according to the Cawood and Howell (CAW-H) resorption classification for the resorption profile of the mandible, CAW-H group III-IV (n=14) and CAW-H group V (n=11). Participants received conventional complete dentures (CDs) before implant placement and immediate nonfunctional loading on locators with a resilient liner. After 3 months, the attachments were functionally activated. Assessments were made using the Oral Health Impact Profile 14 (OHIP-14) questionnaires with existing CDs and new CDs at 1, 3, and 15 months after loading. Prosthetic maintenance (repairs, rebasings, replacement of retention parts) and biological prosthetic aftercare were assessed. For comparison between groups, the Kruskal-Wallis and Mann-Whitney U tests were applied for continuous and ordinal variables and the chi-square test for cross-tabulations. To analyze repeated OHIP-14 scores, the Friedman test was used for ordered alternatives to test whether the measurements differed (overall significance level alpha=.05). Then the Wilcoxon signed rank test was conducted to detect specific differences (alpha=.05). RESULTS: OHIP-14 scores decreased significantly after implant placement and functional connection for the whole population (P<.001) and for both sub groups, the CAW-H group III-IV (P<.001) and the CAW-H group V (P=.013). CAW-H group V participants needed more retention inserts than CAW-H group III-IV participants (26 versus 3, respectively; P=.006). The incidence of repair and rebasing was limited for both groups, and biological aftercare and pain relief were comparable. CONCLUSIONS: Changing a CD to an overdenture significantly improved ORLQoL regardless of the resorption degree, but heavily resorbed mandibles require more replacements of retention inserts.
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| 8. |
- Raes, Stefanie, et al.
(författare)
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Oral health-related quality of life changes after placement of immediately loaded single implants in healed alveolar ridges or extraction sockets : a 5-year prospective follow-up study
- 2016
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Ingår i: Clinical Oral Implants Research. - : Blackwell Munksgaard. - 0905-7161 .- 1600-0501. ; 28:6, s. 662-667
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The impact of single implants on oral health-related quality of life (OHRQoL) is scarcely investigated, especially when combined with immediate placement and loading in extraction sockets. The aim was to describe prospectively the changes of OHRQoL with single implants placed in the esthetic zone in healed ridges or in extraction sockets after 5 years. MATERIAL AND METHODS: Ninety-six patients, enrolled at three clinical centers, received 102 single implants placed in a healed ridge (n = 54 implants/50 patients) or in extraction sockets (n = 48 implants/46 patients). Implants were immediately provisionalized, and permanent crowns were cemented after 12 weeks. Oral health impact profile questionnaires (OHIP-14) were completed before surgery, after 1 (provisional crown), 6 (permanent crown), 12 and 60 months, respectively. The overall OHIP-14 score pertains to seven domains with two items each and was assessed on a Likert scale of 0-4 (0 = never and 4 = very often). The evolution of the total OHIP-14 score and changes within all OHIP domains over time and between groups were assessed with a linear mixed-effect model analysis. RESULTS: After 5 years, overall implant survival was 98%. The total OHIP-14 score for both groups combined decreased from 0.50 at baseline to 0.17 at 6 months (P < 0.001), indicative of improvement. For both groups, this remained stable up to 5 years (P = 0.41). However, after 5 years, the total OHIP-14 score revealed a statistically significantly higher improvement in the healed group compared with the extraction group (P = 0.027). CONCLUSION: Missing a single tooth in the maxillary esthetic zone leads to limited OHRQoL problems as reflected by a low overall OHIP score. However, OHRQoL improves less in the extraction group, reflecting that replacing a missing tooth is perceived as more beneficial than replacing a present tooth.
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| 9. |
- Vervaeke, Stijn, et al.
(författare)
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A 9-Year Prospective Case Series Using Multivariate Analyses to Identify Predictors of Early and Late Peri-Implant Bone Loss
- 2016
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Ingår i: Clinical Implant Dentistry and Related Research. - : John Wiley & Sons. - 1523-0899 .- 1708-8208. ; 18:1, s. 30-39
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The study aims to identify predictors of early and late peri-implant bone loss following complete implant-supported rehabilitation using multivariate analyses. Materials and Methods Fifty patients (28 women, 22 men; mean age 58, range 35-76) in need of a complete implant-supported rehabilitation on five to eight implants were consecutively treated. Patients were reinvited for a clinical and radiographic examination after an average 9 years of function. Implant survival and peri-implant bone loss were considered the dependent variables. Multivariate analyses were adopted to identify predictors of early and late peri-implant bone loss Results In total, 39 patients were examinated. Two implants failed after 4 years of function, resulting in an overall survival rate of 99.2%. After a mean follow-up of 9 years, mean bone loss of 1.68mm (SD 2.08, range -1.05 to 10.95) was found. The abutment height was a significant predictor of early peri-implant bone loss (1 year) (p=.024), whereas smoking (p=.046) and history of periodontitis (p=.046) affected late peri-implant bone loss Conclusion Within the limits of this study, it can be concluded that initial bone remodeling was affected by soft tissue thickness as reflected by the height of the abutment, whereas smoking and history of periodontitis affected long-term peri-implant bone stability
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| 10. |
- Vervaeke, Stijn, et al.
(författare)
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A Multifactorial Analysis to Identify Predictors of Implant Failure and Peri-Implant Bone Loss
- 2013
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Ingår i: Clinical Implant Dentistry and Related Research. - : John Wiley & Sons. - 1523-0899 .- 1708-8208. ; 17:S1, s. e298-e307
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To identify risk factors for failure and bone loss of implants in a large study sample on the basis of multivariate analyses. MATERIALS AND METHODS: Patient files of all patients referred for implant treatment from November 2004 to December 2007 were scrutinized, and information on implant- and patient-related factors was collected. The study sample in this retrospective cohort study consisted of both partially dentate and fully edentulous patients referred for various indications. The only inclusion criterion was a follow-up of at least 2 years. Implant survival and bone loss were assessed by an external investigator (SV) comparing digital periapical radiographs taken during recall visits with the postoperative ones. Univariate and multivariate tests were adopted to identify possible risk indicators for implant failure and peri-implant bone loss. RESULTS: Twenty-one of 1,320 (1.6%) implants were lost in 19 of 376 (5.1%) patients (210 female, 166 male; mean age 56, range 17-82) after a mean follow-up of 32 months (range 24-62). Based on multivariate analysis, only smoking (p = .001) and recall compliance (p = .010) had a significant influence on implant failure, with smokers more prone to failure. The overall mean bone loss was 0.36 mm (SD 0.68, range 0.00-7.10). Smoking (p = .001) and jaw of treatment (p = .001) affected peri-implant bone loss. More peri-implant bone loss was observed in smokers and in the maxilla. A clear discrepancy was found between univariate and multivariate analysis with regard to identification of risk factors. CONCLUSION: Multivariate analysis demonstrated that implant-related factors did not affect the clinical outcome, but smoking was identified as a predictor for implant failure. Predictors for peri-implant bone loss were smoking and jaw of treatment.
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