| 1. |
- Abrahamsson, Kajsa H., 1956, et al.
(författare)
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Altered expectations on dental implant therapy; views of patients referred for treatment of peri-implantitis
- 2017
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Ingår i: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 28:4, s. 437-442
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Tidskriftsartikel (refereegranskat)abstract
- © 2016 John Wiley & Sons A/S.Aim: The aim was to explore patients' reactions on being diagnosed with peri-implantitis, their opinions on dental implant therapy and expectations on treatment of the disease. Material and methods: The study subjects were patients referred to a specialist clinic for treatment of peri-implantitis. The method of grounded theory was used in collecting and analyzing data. Audiotaped, thematized open-ended interviews were conducted. The interviews were transcribed verbatim and consecutively analyzed in hierarchical coding processes that continued until saturation was met (n = 15). Results: In the analysis, a conceptual model was generated that illuminated a process among patients. From having very high initial expectations on dental implant therapy as a permanent solution of oral/dental problems, patients realized that dental implants, such as teeth, require continuous care and that there is no guarantee for that dental implants provides a treatment alternative free from future problems. The core concept of the model "altered expectations on dental implant therapy" was composed of three main categories: "initial expectations on dental implant therapy and living with dental implants", "being referred to periodontist and become diagnosed with peri-implantitis" and "investing again in an expensive therapy with no guarantee for the future". Conclusion: Patients may have unrealistically high expectations on dental implant therapy. The results illuminate the importance of patient-centered communication in dentistry and that treatment decisions should be based not only on professional expertise but also on expectations, abilities, wishes and life circumstances of the individual patient.
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| 2. |
- Dimenäs, Sandra L., 1989, et al.
(författare)
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A person-centred, theory-based, behavioural intervention programme for improved oral hygiene in adolescents: A randomized clinical field study
- 2022
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Ingår i: Journal of Clinical Periodontology. - : Wiley. - 0303-6979 .- 1600-051X. ; 49:4, s. 237-387
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To test the effectiveness of a person-centred and theory-based educational intervention to increase adolescents′ adherence to adequate oral hygiene behaviour, that is, self-performed periodontal infection control. Materials and Methods: Data were derived from a prospective, multi-centred, two-arm, quasi-randomized field study in which treatment was performed by dental hygienists (DHs) within the Public Dental Service, Västra Götaland, Sweden. Adolescents with poor oral hygiene conditions were invited to participate. The test intervention was based on cognitive behavioural theory and principles, and the DHs used a collaborative communicative approach, inspired by motivational interviewing. The control intervention consisted of conventional information/instruction. Clinical assessments and oral hygiene behaviours were evaluated at 6months. Results: Three-hundred and twelve adolescents were enrolled, of whom 274 followed the treatment to 6-month follow-up. There were significant improvements in gingival bleeding and plaque scores for both treatment groups at 6months, with significantly greater improvements in the test group. Adolescents in the test group brushed their teeth and used interdental cleaning aids more frequently compared to participants in the control group at 6months. Conclusion: A person-centred and theory-based oral health education programme ismore effective than conventional oral health education in improving adolescents' oral hygiene behaviour and periodontal infection control. ClinicalTrials.gov (NCT02906098). © 2022 The Authors. Journal of Clinical Periodontology published by John Wiley & Sons Ltd.
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| 3. |
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| 4. |
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| 5. |
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| 6. |
- Abrahamsson, Ingemar, 1953, et al.
(författare)
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Early bone formation adjacent to rough and turned endosseous implant surfaces. An experimental study in the dog
- 2004
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Ingår i: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 15:4, s. 381-92
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To validate a proposed model (Berglundh et al. 2003) and to evaluate the rate and degree of osseointegration at turned (T) and sand blasted and acid etched (SLA) implant surfaces during early phases of healing. MATERIAL AND METHODS: The devices used for the study of early healing had a geometry that corresponded to that of a solid screw implant with either a SLA or a T surface configuration. A circumferential trough had been prepared within the thread region (intra-osseous portion) that established a geometrically well-defined wound chamber. Twenty Labrador dogs received totally 160 experimental devices to allow the evaluation of healing between 2 h and 12 weeks. Both ground and decalcified sections were prepared from mesial/distal and buccal/lingual device sites. Histometric and morphometric analyses of the ground sections and morphometric analysis of the tissue components in decalcified sections were performed. RESULTS: The ground sections provided an overview of the various phases of tissue formation, while the decalcified, thin sections enabled a more detailed study of events involved in bone tissue modeling and remodeling for both SLA and T surfaces. The initially empty wound chamber became occupied with a coagulum and a granulation tissue that was replaced by a provisional matrix. The process of bone formation started already during the first week. The newly formed bone present at the lateral border of the cut bony bed appeared to be continuous with the parent bone, but on the SLA surface woven bone was also found at a distance from the parent bone. Parallel-fibered and/or lamellar bone as well as bone marrow replaced this primary bone after 4 weeks. In the SLA chambers, more bone-to-device contact, more initial woven bone and earlier lamellar bone formation was found than in the T chambers. CONCLUSION: Osseointegration represents a dynamic process both during its establishment and its maintenance. While healing showed similar characteristics with resorptive and appositional events for both SLA and T surfaces, the rate and degree of osseointegration were superior for the SLA compared with the T chambers.
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| 7. |
- Abrahamsson, Ingemar, 1953, et al.
(författare)
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Early bone healing to implants with different surface characteristics. A pre-clinical in vivo study
- 2023
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Ingår i: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 34:4, s. 312-9
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Tidskriftsartikel (refereegranskat)abstract
- AimTo examine early bone healing around implants with non-modified and modified surfaces. Material & MethodsFour implants with 4 different surface characteristics were installed in one side of the mandible following tooth extraction in 6 dogs. Implants in group A had a non-modified, turned surface, while implants in group B had a surface modification consisting of TiO-blasting and sequential acid-etching in oxalic and hydrofluoric acid. The surface modification of implants in group C was confined to sequential acid-etching in oxalic and hydrofluoric acid and Group D implants had a surface modification of TiO-blasting and acid-etching in hydrofluoric acid. The implant installation procedures were repeated in the opposite side of the mandible 4 weeks later. Biopsies were obtained and prepared for histological analysis 2 weeks later. ResultsB and C implants had a higher degree of bone-to-implant contact (BIC%) than A and D implants at 2 weeks of healing. At 6 weeks of healing, the BIC% was higher at B than at A, C and D implants, and higher at C implants than at A implants. The amount of newly formed bone in contact with the implant within the defect area at 2 weeks was higher at implants with modified surfaces (groups B, C and D) than at implants with a non-modified surface (group A). Corresponding results at 6 weeks were superior at B implants. ConclusionIt is suggested that an implant surface modification with acid-etching in oxalic and hydrofluoric acid promotes early formation of bone-to-implant contact.
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| 8. |
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| 9. |
- Abrahamsson, Ingemar, et al.
(författare)
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Försurningssituationen i rinnande vatten: Västra Götaland
- 2002
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Denna rapport behandlar försurningsläget i Västra Götalands rinnande vatten baserat på en vattenkemisk undersökning av 220 vattendrag hösten 2001. Syftet är att beskriva dagens situation och diskutera den närmaste framtiden i förhållande till det nationella miljömålet att högst 15% av sträckan rinnande vatten skall vara drabbad av antropogen (onaturlig) försurning år 2010. Rapporten skall dessutom utgöra ett underlag för regionala anpassningar och preciseringar av miljömålet samt ligga till grund för åtgärdsstrategiska överväganden.
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| 10. |
- Abrahamsson, Ingemar, 1953, et al.
(författare)
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Healing at fluoride-modified implants placed in wide marginal defects: an experimental study in dogs.
- 2008
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Ingår i: Clinical oral implants research. - : Wiley. - 0905-7161 .- 1600-0501. ; 19:2, s. 153-9
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To study the healing at fluoride-modified implants placed in wide circumferential defects. Material and methods: Six mongrel dogs were used. The mandibular premolars and first molars were extracted. Three months later four implants were placed in one side of the mandible of each dog. The control implants (MicroThread(trade mark)) had a TiOblast surface, while the test implants (OsseoSpeed(trade mark)) had a fluoride-modified surface. Two implants of each type were placed. The marginal 50% of the prepared canal was widened using step drills. Following installation a 1 mm wide gap occurred between the implant surface and the bone wall in the defect. All implants were submerged. The installation procedure was repeated in the opposite side of the mandible 4 weeks after the first implant surgery. Two weeks later the animals were euthanized and block biopsies containing the implant and surrounding tissues were prepared for histological analysis. Results: The histological analysis revealed that a significantly larger area of osseointegration was established within the defect at fluoride-modified implants than at implants with a TiOblast surface after 6 weeks of healing. Further, the degree of bone-to-implant contact within the defect area was larger at fluoride-modified implants than at the TiOblast implants. Conclusion: It is suggested that the fluoride-modified implant surface promotes bone formation and osseointegration.
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| 11. |
- Abrahamsson, Ingemar, 1953, et al.
(författare)
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Healing at Implants Placed in an Alveolar Ridge with a Sloped Configuration: An Experimental Study in Dogs.
- 2014
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Ingår i: Clinical implant dentistry and related research. - : Wiley. - 1708-8208 .- 1523-0899. ; 16:1, s. 62-69
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To study healing around implants placed in an alveolar ridge with a sloped lingual-buccal configuration. Materials and Methods: Six Labrador dogs were used. Buccal bone defects were prepared in the mandible after extraction of premolars. Three months later, two test implants with a sloped marginal design and two control implants were placed in the chronic defect area with a sloped lingual-buccal configuration of each premolar region. The test implants were placed in such a way that the buccal margin of the implant coincided with the buccal bone crest. The lingual margin of the control implants was placed to a similar depth as the lingual margin of the test implants. Abutments were connected to the implants in the right mandibular premolar region and flaps were sutured around the neck of the abutments. In the left side of the mandible, cover screws were placed and the flaps were sutured to cover the implants. Biopsies were obtained 4 months later and prepared for histological examination. Results: It was demonstrated that healing around implants placed in an alveolar ridge with a sloped lingual-buccal configuration resulted in the preservation of a vertical discrepancy between the lingual and buccal marginal bone levels around implants with either a regular cylindrical outline or a modified marginal portion that matched the slope of the alveolar ridge. Conclusion: As the marginal buccal portion of the control implants with a regular design had no bone support, it is suggested that implants with a modified marginal portion may be considered in recipient sites with a sloped lingual-buccal configuration.
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| 12. |
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| 13. |
- Abrahamsson, Ingemar, 1953, et al.
(författare)
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Influence of implant geometry and osteotomy design on early bone healing: A pre-clinical in vivo study
- 2021
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Ingår i: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 32:10, s. 1190-1199
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To analyze the early stages of osseointegration around implants with different geometry following installation in sites using different osteotomy protocols. Materials and methods Two types of implants were installed using regular or modified (reduced diameter) osteotomy protocols in mandibular premolar/molar regions following tooth extraction in six dogs. Three implant site categories were created: Reference (A implant and regular osteotomy), Test-1 (B implant and regular osteotomy), and Test-2 (B implant and modified osteotomy). Implant installation procedures were repeated after 4 and 6 weeks. The insertion torque (ITQ) was measured during implant installation and resonance frequency analysis providing implant stability quotient (ISQ) values was performed following implant installation and once every week during the course of the study. Biopsies were obtained immediately after the 3rd installation procedure and prepared for histological analysis. Results The modified osteotomy protocol created a higher insertion torque (ITQ). The analysis also revealed a correlation between insertion torque at implant installation and radiographic bone loss after 6 weeks of healing. The decline in ISQ values during healing was more pronounced at Test-2 than other sites. While the degree of bone-to-implant contact (BIC%) in the marginal area was similar in test and reference sites at 6 weeks of healing, Test-2 implants presented with a significantly higher BIC% in the mid and apical areas than Test-1 implants. Conclusions It is suggested that placement of implants in undersized osteotomy sites will result in an increased remodeling of the cortical bone during the early healing process.
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| 14. |
- Abrahamsson, Ingemar, et al.
(författare)
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Kvalitet och kalkbehov inom kalkningsverksamheten : En granskning av de regionala åtgärdsplanerna
- 2013
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- År 2010 upprättade länsstyrelserna regionala åtgärdsplaner för kalkning av sjöar och vattendrag på uppdrag av Naturvårdsverket. Den 1 juli 2011 övertog Havs- och vattenmyndigheten det nationella ansvaret för kalkningsverksamheten och vintern 2012 påbörjade myndigheten en granskning av åtgärdsplanerna. Syftet var att utvärdera kvaliteten i kalkningsverksamheten och erhålla ett underlag vid fördelning av statsbidragsmedel. Denna rapport utgör en sammanställning av de resultat som framkom vid granskningen. Åtgärdsplanerna innehåller detaljerade redovisningar av den pågående verksamheten i form av försurningsstatus, motiv, mål, målområden, kalkningsinsatser, uppföljningsprogram och uppnådda resultat. Dessutom redovisas planerade förändringar och kalkmängder för åren 2011-2015. För varje åtgärdsområde bedömdes kvaliteten utifrån nio olika aspekter, bland annat angivna pH-mål, vattenkemisk effektuppföljning, vattenkemisk måluppfyllelse och kalkningsstrategi. Dessutom uppskattades kalkbehovet baserat på förutsättningen att de vattenkemiska målen ska kunna uppnås i samtliga målområden. Bedömningarna gjordes med utgångspunkt från de råd, riktlinjer och riktvärden som anges i Handboken för kalkning av sjöar och vattendrag. Granskningen visade att kvaliteten i den svenska kalkningsverksamheten har förbättrats avsevärt under den senaste tioårsperioden. Idag framstår verksamheten överlag som välmotiverad och effektiv. Samtidigt är de regionala skillnaderna omotiverat stora. I några län kvarstår ett betydande behov av ytterligare kvalitetsförbättringar. Försurningsbedömningar av kalkade vatten behöver förbättras. Den pågående målvattendragsundersökningen kommer att bidra med ett utökat underlagsmaterial. Samtidigt är det uppenbart att mycket arbete kvarstår. Bedömningsverktyget måste förenklas och utbildningsinsatserna behöver öka. De vattenkemiska målen behöver ses över så att tillämpningen blir likartad. I flera län förekommer ett överutnyttjande av pH-mål 6,0. I andra län används pH-mål 5,6 utan att risken för skadligt höga halter av oorganiskt aluminium har beaktats. Den vattenkemiska uppföljningen i vattendragen behöver förbättras. Detta gäller i olika grad för nästan alla län. En väl fungerande högflödesprovtagning är grundläggande för att bedöma måluppfyllelse och optimera kalkningsinsatsen. Den vattenkemiska måluppfyllelsen behöver förbättras i vattendragen. Förmågan att uppnå pH-målen varierar avsevärt från ett län till ett annat. För att öka måluppfyllelsen och höja effekten behöver kalkningsstrategierna optimeras i en fjärdedel av åtgärdsområdena. Kalkdoserarnas tekniska status behöver uppgraderas i några län och organisationen för tillsyn, larm och felavhjälpning behöver generellt stärkas. Omotiverad överdosering och kalkning av målområden som saknar kalkbehov bör, i olika omfattning, åtgärdas i samtliga län. Det totala årliga kalkbehovet beräknades till 105 000-121 000 ton inom befintliga åtgärdsområden, vilket kan jämföras med länsstyrelsernas planerade på 122 000 ton. Beräkningen visar att de vattenkemiska målen kan uppnås utan att det erfordrar en ökad kalkförbrukning i ett nationellt perspektiv. I vissa åtgärdsområden behövs utökad kalkning, men detta kompenseras av minskade behov i andra. Det finns en betydande besparingspotential i flera län. Endast i ett län behöver kalkanvändningen öka på länsnivå. Till följd av ökade omkostnader för kvalitetshöjande åtgärder och förväntade prishöjningar kommer behovet av statliga bidragsmedel sannolikt att öka. Besparingspotentialen liksom behovet av kvalitetshöjande insatser varierar mellan länen, vilket antyder att det också finns behov av en regional omfördelning. Länsstyrelser och huvudmän är ansvariga för att åtgärda brister i verksamheten. Förbättring av effektuppföljningen bör genomföras direkt. Försurningsbedömningar och pH-mål bör ses över i takt med att nya data inkommer. Justering av kalkdoser och avslutande av onödig kalkning bör ske inför nästkommande spridningstillfälle. Förändringar av kalkningsstrategin är i regel mera tidskrävande och bör prioriteras till åtgärdsområden där den kemiska målsättningen inte uppnås eller där kalkförbrukningen är omotiverat hög. Den regionala verksamheten behöver fortsatt stöd och styrning från Havs- och vattenmyndigheten. En betydande del av de förbättringar som uppnåtts under de senaste tio åren har åstadkommits via medelsfördelning och bidragsvillkor. Samtidigt finns det fortfarande uppenbara brister i verksamheten varför ytterligare och andra typer av styrmedel behövs. HaV behöver också bidra med utbildningsinsatser och rådgivning samt att bedömningsverktyg och vägledningar utvecklas i takt med att ny kunskap tillkommer.
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| 15. |
- Abrahamsson, Ingemar, 1953, et al.
(författare)
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Peri-implant hard and soft tissue integration to dental implants made of titanium and gold.
- 2007
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Ingår i: Clinical oral implants research. - : Wiley. - 0905-7161 .- 1600-0501. ; 18:3, s. 269-74
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of the study is to compare the peri-implant hard and soft tissue integration around dental implants made of commercially pure (c.p.) titanium or a gold alloy but with the same shape and surface roughness. MATERIAL AND METHODS: In four beagle dogs, all mandibular premolars were extracted. Three months later, four experimental non-submerged implants were placed in each edentulous premolar region. Each implant comprised three different zones: zone A (coronal), zone B (central) and zone C (apical). Each zone was made of either c.p. titanium or a gold alloy. Four different combinations of metal and zone were used. A plaque control program was initiated and 6 months later, the animals were sacrificed and biopsies were obtained. The biopsies including the implant and the surrounding tissues were processed for ground sectioning. RESULTS: The height of the peri-implant mucosa and the length of the barrier epithelium were similar at the four experimental sites. The marginal bone level in the different metal combinations was located between 4.5 and 4.8 mm apical of the implant rim. The percent of mineralized bone that was in direct contact with the implant surface (BIC%) was consistently greater in the marginal than in the apical portion of the implants. The BIC% for the marginal and apical zone were consistently greater for implant portions made of titanium than for portions made of gold alloy (zone B: 42.7% vs. 36.5%, zone C: 33.2% vs. 19%). CONCLUSIONS: Osseointegration was achieved to surfaces made of both c.p. titanium and a gold alloy. BIC% was higher at titanium than at gold surfaces. Moreover, the peri-implant soft tissue dimensions were not influenced by the metal used in the 'marginal' zone of the implant.
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| 16. |
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| 17. |
- Abrahamsson, Ingemar, 1953, et al.
(författare)
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Probe penetration in periodontal and peri-implant tissues. An experimental study in the beagle dog.
- 2006
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Ingår i: Clinical oral implants research. - : Wiley. - 0905-7161 .- 1600-0501. ; 17:6, s. 601-5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Today, periodontal probing is the best diagnostic tool to assess the health status and attachment level of periodontal tissues. There are, however, doubts as to whether the same method could be used for implants. Experiments comparing peri-implant and periodontal probing provide conflicting results. The impact and interpretation of peri-implant probing are still not sufficiently known. PURPOSE: The purpose of the present study was to further analyze the histological level of probe penetration in healthy periodontal and peri-implant tissues. MATERIAL AND METHODS: In four beagle dogs, all mandibular premolars were extracted. Three months later, four experimental non-submerged implants were placed in each edentulous premolar region. Six months later, probing depth was determined at the buccal aspect at two of the implants and at the bilateral first mandibular molars. A pressure-controlled probe with a diameter of 0.4 mm and 0.2 N probing force was used. Following the probing depth assessment, a metal periodontal probe tip was inserted into the previously measured depth and attached to the implants and teeth using a composite material. Block biopsies were obtained and prepared for histometric examinations. RESULTS: The findings showed that probing resulted in similar probe extension at implants and teeth, that the probe extension corresponded to the extension of the barrier epithelium and that the distance between the probe tip and the bone was about 1 mm in both peri-implant and periodontal tissues. CONCLUSIONS: This experiment showed that under healthy conditions, the probe tip penetration in the soft tissues at teeth and implants is similar when a probing force of 0.2 N is used. Probing around implants using a moderate force is a valuable diagnostic tool in the maintenance of implant patients.
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| 18. |
- Abrahamsson, Ingemar
(författare)
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Referenssjöar i Västra Götalands län - beskrivning och trender
- 2005
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Denna rapport redovisar resultaten från den vattenkemiska övervakningen i 15 referenssjöar inom Västra Götalands län. Syftet med rapporten är att utvärdera tidsserierna och beskriva tillstånden för ett antal utvalda parametrar. Det huvudsakliga syftet med referenssjöarna är att följa vattenkemiska förändringar över tiden i ett urval av landets sjöar. Övervakningen påbörjades 1983 och bedrivs i Naturvårdsverkets regi. Det nationella programmet omfattar för närvarande ca 95 sjöar i landet. Dessutom sker övervakning i ett antal regionala referenssjöar som administreras av länsstyrelserna. Denna rapport behandlar de 15 referenssjöar som är belägna i Västra Götaland län.
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| 19. |
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| 21. |
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| 23. |
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| 24. |
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| 25. |
- Abrahamsson, Ingemar, 1953, et al.
(författare)
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Tissue characteristics at microthreaded implants: an experimental study in dogs.
- 2006
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Ingår i: Clinical implant dentistry and related research. - : Wiley. - 1523-0899 .- 1708-8208. ; 8:3, s. 107-13
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of the present study was to analyze bone tissue reactions at implants with and without a microthread configuration. MATERIALS AND METHODS: In six beagle dogs, one test and two control implants were installed in one side of the mandible. While both implant types had a similar dimension and surface roughness, the test implants were designed with a microthread configuration in the marginal portion. Abutment connection was performed after 3 months. Another 3 months later, fixed partial dentures (FPDs) were cemented to the maxillary canine and premolars and FPDs were connected to the implants in the mandible. Ten months later, the animals were sacrificed and biopsies from each implant region were processed for histological analysis. Radiographs were obtained at implant placement after FPD connection and at the termination of the experiment. RESULTS: The radiographic examination revealed that the marginal bone level was well preserved at both test and control implants during the entire 16-month period. The degree of bone-implant contact within the marginal portion of the implants was significantly higher at the test (microthread) implants (81.8%) than at the control implants (72.8%). CONCLUSIONS: It was suggested that the microthread configuration offered improved conditions for osseointegration.
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| 26. |
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| 27. |
- Abrahamsson, Ingemar
(författare)
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Vattenkemiska tillstånd och trender i vattendrag på Gotland
- 2010
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Rapporten behandlar resultaten från de fysikalisk-kemiska provtagningar som har utförts vid 27 vattendragslokaler sedan 1988 inom den samordnade recipientkontrollen på Gotland. Dessutom redovisas resultat från två nationella trendstationer där provtagning och analys har utförts i regi av SLU. Utvärderingen omfattar främst en beskrivning av tillstånd och trender för parametrarna totalfosfor, totalkväve, alkalinitet, organiskt material, vattenfärg och grumlighet. De provtagna vattendragen var under åren 2007-2009 genomgående mycket näringsrika. Med avseende på fosforhalter uppvisade 24 av de 29 provpunkterna en måttlig, otillfredsställande eller dålig status. Vad gäller kväve registrerades mycket höga till extremt höga halter i 26 av de 29 provpunkterna. Vattenfärgen och grumligheten var måttlig till betydande och halterna av organiskt material var generellt måttligt hög till hög. De provtagna vattendragen hade samtliga mycket god buffertförmåga.
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| 28. |
- Abrahamsson, Ingemar
(författare)
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Vattenkemiska tillstånd och trender ivattendrag på Gotland : En utvärdering av resultat från den samordnade recipientkontrollen
- 2009
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- SammanfattningFöreliggande rapport har tillkommit på uppdrag av Länsstyrelsen i Gotlands län. Syftetmed uppdraget var att utvärdera de vattenkemiska tillstånden och trenderna i gotländskavattendrag samt belysa några specifika frågeställningar med avseende på belastning avnäringsämnen.Rapporten behandlar resultaten från de fysikalisk-kemiska provtagningar som har utförtsvid 27 vattendragslokaler sedan 1988 inom den samordnade recipientkontrollen påGotland. Dessutom redovisas resultat från två nationella trendstationer där provtagningoch analys har utförts i regi av SLU. Utvärderingen omfattar främst en beskrivning avtillstånd och trender för parametrarna totalfosfor, totalkväve, alkalinitet, organiskt material,vattenfärg och grumlighet.De provtagna vattendragen var under åren 2007-2009 genomgående mycket näringsrika.Med avseende på fosforhalter uppvisade 24 av de 29 provpunkterna en måttlig, otillfredsställandeeller dålig status. Vad gäller kväve registrerades mycket höga till extremthöga halter i 26 av de 29 provpunkterna. Vattenfärgen och grumligheten var måttlig tillbetydande och halterna av organiskt material var generellt måttligt hög till hög. Deprovtagna vattendragen hade samtliga mycket god buffertförmåga.I hälften av provpunkterna uppvisar fosforhalterna en tydligt sjunkande trend sedanmätningarna påbörjades i slutet av 1980-talet. För kvävehalterna finns inga tydliga trenderi merparten av vattendragen. Färgtalen, grumligheten, alkaliniteten och halterna avorganiskt material har inte förändrats nämnvärt under de senaste 20 åren.I den nedre delen av Halorån minskade halterna av fosfor med 40 % från åren 1988-94till tidsperioden 2004-2009. Sannolikt har de förbättringar av enskilda avlopp som inleddes2003 i Haloråns avrinningsområde varit en starkt bidragande orsak till dennaförändring.Vid Roma och Stånga finns bevattningsdammar med renat avloppsvatten. Resultatenfrån recipientkontrollen tyder på att avloppsdammarna vid Roma endast obetydligt hartillfört näringsämnen till den närliggande Gothemsån i samband med de provtagningarsom utfördes under åren 2000-2009. Vad gäller avloppsdammarna vid Stånga ger resultatenfrån provtagningarna inte något bra underlag för en bedömning av eventuell tillförselav näringsämnen till den närliggande Närkån.De gotländska miljömålen med avseende på övergödning anger att utsläppen av fosforskall minska från 1995 till 2010 medan utsläppen av kväve skall minska med 30 % undersamma tidsperiod. En sammanvägd beräkning av de flödesvägda halterna av fosforoch kväve under åren 1994-2009 vid åtta åmynningar ger ett underlag för att bedömaom dessa miljömål kommer att uppfyllas. Åmynningarna representerar utvecklingen iett sammanlagt avrinningsområde som utgör 40 % av Gotlands yta. Baserat på haltförändringarnafrån 1994 till 2009 beräknas belastningen av fosfor ha minskat med knappt30 % i de åtta provpunkterna sedan mitten av 1990-talet. Belastningen av kväve hardäremot varit oförändrad. Resultaten visar att miljömålet för fosfor, men inte för kväve,kommer att uppnås till 2010.
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| 29. |
- Aghazadeh, Ahmad
(författare)
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Peri-implantitis : risk factors and outcome of reconstructive therapy
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis is focused on (I) the outcome of reconstructive treatment of peri-implant defects and (II) risk factors for the development of peri-implantitis.BackgroundAn increasing number of individuals have dental implant-supported reconstructions. The long-time survival rate of dental implants is good, but complications do occur. Accumulation of bacteria on oral implants and the development of a pathogenic biofilm at the mucosal margin will result in inflammatory responses diagnosed as peri-implant mucositis(PiM). Furthermore, PiM may progress to peri-implantitis (Pi) involving the implant-supporting bone and potentially result in a severe inflammatory process resulting in alveolar bone destruction and consequently implantloss. Currently, Pi is a common clinical complication following implant therapy.The prevalence of peri-implantitis has been reported to be around 20 %. Susceptibility to infections and a history of periodontitis are considered as important risk indicators for peri-implantitis. It seems logical that a past history of periodontitis is linked to an increased risk of peri-implantitis. It is possible that other patient-associated factors such as a smoking habit, and presence of general diseases may also be linked to a higher risk for developing peri-implantitis.Treatment of peri-implantitis is difficult. Non-surgical treatment modalities may not be sufficient to resolve the inflammatory process to obtain healthy conditions.Surgical treatment of peri-implantitis has commonly been employed in clinical practice to obtain access to the implant surface thereby increasing the possibility to effectively decontaminate the implant surfaces.The effectiveness and long-term outcomes of reconstructive surgical treatments of peri-implantitis has been debated. The scientific evidence suggests that regular supportive care is an essential component in order to maintain and secure long-term results following treatment of peri-implantitis.Aims1. To assess the short-term efficacy of reconstructive surgical treatmentof peri-implantitis (Study I).2. To analyse risk factors related to the occurrence of peri-implantitis(Study II).3. To assess the importance of defect configuration on the healing response after reconstructive surgical therapy of peri-implantitis (Study III).4. To assess the long-term efficacy of reconstructive surgical treatmentof peri-implantitis (Study IV).MethodsFour studies were designed to fulfil the aims:- A single-blinded prospective randomised controlled longitudinal human clinical trial evaluating the clinical and radiographic results of reconstructive surgical treatment of peri-implantitis defects usingeither AB or BDX.- A retrospective analysis of individuals with either peri-implantitis, or presenting with either peri-implant health, or peri-implant mucositis assessing the likelihood that peri-implantitis was associated with a history of systemic disease, a history of periodontitis, and smoking.- A prospective study evaluating if the alveolar bone defect configuration at dental implants diagnosed with peri-implantitisis related to clinical parameters at the time of surgical intervention and if the short- and long-term outcome of surgical intervention of peri-implantitis is dependent on defect configuration at the time of treatment.- A prospective 5-year follow-up of patients treated either with AB or BDX.Results- The success for both surgical reconstructive procedures was limited. Nevertheless, bovine xenograft provided evidence of more radiographic bone fill than AB. Improvements in PD, BOP, and SUP were observed for both treatment modalities-In relation to a diagnosis of peri-implantitis, a high likelihood of comorbidity was expressed in the presence of a history of periodontitis and a medical history of cardiovascular disease- The buccal-lingual width of the alveolar bone crest was explanatory to defect configuration- 4-wall defects and deeper defects demonstrated more radiographic evidence of defect fill- Reconstructive surgical treatment of peri-implant defects may result in successful clinical outcomes, that can be maintained over at least five years- The use of BDX is more predictable than use of harvested bone from the patient (AB)ConclusionsThe study results suggest that a bovine xenograft provides better radiographic evidence of defect fill than the use of autogenous bone harvested from cortical autologous bone grafts.Treatment with bone grafts to obtain radiographic evidence of defect fill is more predictable at 3- and 4-wall defects than at peri-implantitis bone defects with fewer bone walls.In relation to a diagnosis of peri-implantitis, a high likelihood of comorbidity was found for a history of periodontitis and a history of cardiovascular disease.
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| 30. |
- Ahlström, Johan, et al.
(författare)
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Arbetsfördelning och resursanvändning inom kalkningsverksamheten
- 2015
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Under det första decenniet av 2000-talet genomförde Naturvårdsverket en rad åtgärder med syfte att skapa gemensamma strukturer och förbättra kvaliteten i den svenska kalkningsverksamheten. Efter att ha granskat länsstyrelsernas regionala åtgärdsplaner för 2010-2015 konstaterade Havs- och vattenmyndigheten att kvaliteten förbättrats avsevärt, men att de regionala skillnaderna fortfarande var omotiverat stora. I syfte att kartlägga den regionala arbetsfördelningen och resursanvändningen samt behovet av fortbildning och stödsystem inhämtade Havs- och vattenmyndigheten under 2014 information från kalkningens regionala och lokala aktörer. Uppgifterna insamlades via enkäter till länsstyrelser och huvudmän samt genom inhämtande av underlag i form av tidsredovisning och nyckeltal från länsstyrelserna. I föreliggande rapport presenteras resultaten av kartläggningen samt förslag på förändringar som kan leda till att resurser frigörs för kvalitetshöjande åtgärder. Kalkningsverksamheten finansieras huvudsakligen med statsbidrag som fördelas till huvudmän via länsstyrelsen. I nuläget finns drygt 150 huvudmän som huvudsakligen utgörs av kommuner. I enkätsvaren uppgav drygt 80 procent av huvudmännen att systemet med statsbidrag är bra. Utifrån denna synvinkel finns således ingen anledning att förändra nuvarande system. Till stor del finansieras kalkningsverksamheten via anslaget 1:12 ”åtgärder för havs- och vattenmiljö”. Inför 2013 genomfördes en förändring som innebar att länsstyrelsernas anslag till kalkning inte specificerades i förhållande till övriga verksamheter inom 1:12. Det nya förfaringssättet tycks inte generellt ha påverkat kalkningsverksamhetens finansiella utrymme under 2013. Det finns emellertid indikationer på att den biologiska uppföljningen minskade i några län. Länsstyrelsernas prioritering av verksamheten via ramanslagen varierade avsevärt. I förhållande till den förstärkning som länsstyrelserna erhöll på ramanslaget 2002 redovisade några län betydligt lägre lönekostnader 2013. Det förekom också att anslaget 1:12 belastats med lönekostnader som inte omfattas av villkoren i bidragsbeslutet och därmed borde belasta ramanslaget. Enkätsvaren samt länsstyrelsernas tidsredovisning visade att det föreligger stora skillnader mellan länen avseende såväl arbetsfördelning som tidsåtgång för de olika arbetsmomenten. Detta gäller även till vad och i vilken omfattning som konsulter anlitas. Skillnaderna mellan länen är delvis beroende på verksamhetens omfattning och karaktär. Till stor del framstår emellertid skillnaderna som en konsekvens av att länsverksamheten med tiden kommit att utformas på olika sätt. Tidsåtgången för länsstyrelsernas bidragsadministration kunde bara i liten utsträckning förklaras med verksamhetens omfattning och antalet huvudmän. På flera län finns utrymme för effektivisering av rutiner och arbetsmoment. I Havs- och vattenmyndighetens rapport 2015:3 10 förhållande till den enkla redovisning som länsstyrelserna efterfrågar framstår många huvudmäns tidsåtgång för bidragsadministration inte heller som rimlig. Länsstyrelserna behöver kommunicera med huvudmännen i syfte att tydliggöra behovet av underlag och därmed reducera tidsåtgången. Upphandling av kalk och kalkspridning bör i större utsträckning samordnas mellan flera huvudmän och även mellan flera län. Små uppdrag innebär höga kostnader för kalk och kalkspridning. Genom att samordna upphandlingar och välja fleråriga avtal när detta är relevant och möjligt kan arbetstiden sannolikt mer än halveras. Försurningsbedömningen av kalkade vatten upplevs både som krånglig och osäker. Oklarheter kring beräkningsverktyg och bedömningsgrunder behöver redas ut. Dessutom behöver länsstyrelser och huvudmän ytterligare utbildning och vägledning. Översyn och justering av kalkdoseringen bör ske årligen. För all kalkning i landet kan detta teoretiskt genomföras på ungefär 50 arbetsdagar. Enligt enkätsvaren arbetade länsstyrelser och huvudmän närmare 800 arbetsdagar med spridningsplanering under 2013. Endera är uppgifterna i enkätsvaren rejält överskattade eller så präglas arbetet av stor ineffektivitet. I princip behövs en lika omfattande organisation för att sköta en kalkdoserare som 20 eller 30. Detta talar för att doserardriften bör samordnas för att uppnå stordriftsvinster. Endera mellan flera huvudmän eller med liknande kommunala verksamheter. Ansvaret för att sköta kalkdoserarna åligger huvudmannen. Länsstyrelsen ska se till att driftorganisationen uppfyller nödvändiga krav och behöver därför vara insatt i teknik och skötselbehov. Mot denna bakgrund är det oroväckande att huvudmännen i flera län bedömer länsstyrelsens kompetens som mindre bra avseende doserare. Kalkningens effektuppföljning omsätter årligen närmare 25 miljoner kronor. Uppföljningens kvalitet och omfattning uppvisade omotiverat stora skillnader mellan länen. Det behövs system som säkerställer att vattenprover tas när kalkeffekten kan befaras vara otillräcklig, vilket i praktiken innebär vid höga flöden. För den biologiska uppföljningen behövs system som reglerar verksamhetens omfattning i förhållande till erhållna medel. Spridningskontrollens kostnader varierade avsevärt mellan länen. Till viss del torde detta vara en följd av olika ambitionsnivå. Till stor del beror emellertid skillnaderna på att olika schabloner tillämpas för att beräkna huvudmannens kostnader samt ett varierande nyttjande av konsulter. Detta talar för att det finns utrymme att minska kostnaderna för spridningskontrollen inom ett antal län. Baserat på det underlag som legat till grund för denna resurskartläggning bedöms den samlade arbetstid som länsstyrelser och huvudmän lägger på kalkningsverksamheten vara tillräckligt omfattande för att säkerställa en bra kvalitet. De brister i kvalitet som framkommit vid tidigare granskningar antyder därför att verksamheten inte på ett effektivt sätt förmår att omsätta tillgängliga resurser till effektiv arbetstid. En viktig orsak torde vara splittringen på många aktörer där flera huvudmän och ett antal länsstyrelser hanterar mycket små kalkmängder. Ineffektiva rutiner för hantering av exempelvis kalkdata, kemidata och bidragsutbetalningar utgör också ett problem. Likaså dubbelarbete och arbete som utförs av personal med otillräcklig erfarenhet och kompetens. Fördelningen av ekonomiska resurser mellan länen för bland annat administration, upphandling, spridningsplanering, spridningskontroll, försurningsbedömning och effektuppföljning har sedan 1990-talet skett via schabloner. Syftet med att använda schabloner är främst att skapa rättvisa förutsättningar mellan länen. Ursprungligen baserades schablonerna enbart på totalmängden spridd kalk. Varefter nya underlag funnits tillgängliga har justering gjorts för såväl spridningsmetoder som målområden. Det finns inget som pekar på att schablonerna i nämnvärd omfattning skapat orättvisa förutsättningar mellan länen.
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| 31. |
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| 32. |
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| 33. |
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| 34. |
- Albouy, Jean-Pierre, 1969, et al.
(författare)
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Spontaneous progression of peri-implantitis at different types of implants. An experimental study in dogs. I: clinical and radiographic observations.
- 2008
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Ingår i: Clinical oral implants research. - : Wiley. - 1600-0501 .- 0905-7161. ; 19:10, s. 997-1002
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of the present study was to analyze tissue reactions to plaque formation following ligature removal at commercially available implants exposed to experimental peri-implantitis. Material and methods: Six Labrador dogs about 1 year old were used. All mandibular premolars and the three anterior premolars in both sides of the maxilla were extracted. After 3 months four implants representing four different implant systems with different surface characteristics--implant group A (turned), B (TiOblast), C (sandblasted acid-etched; SLA) and D (TiUnite)--were placed in a randomized order in the right side of the mandible. Three months after implant installation experimental peri-implantitis was initiated by placement of ligatures in a submarginal position and plaque accumulation. At week 12, when about 40-50% of the supporting bone was lost, the ligatures were removed. During the subsequent 24-week period plaque accumulation continued. Radiographic and clinical examinations were performed during the 'active breakdown' period (plaque accumulation and ligatures) and the plaque accumulation period after ligature removal. The experiment was terminated at week 36. Results: The bone loss that took place during the 'active breakdown' period varied between 3.5 and 4.6 mm. The additional bone loss that occurred during the plaque accumulation period after ligature removal was 1.84 (A), 1.72 (B), 1.55 (C) and 2.78 mm (D). Conclusion: Spontaneous progression of experimentally induced peri-implantitis occurred at implants with different geometry and surface characteristics. Progression was most pronounced at implants of type D (TiUnite surface).
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| 35. |
- Almohandes, Ahmed, et al.
(författare)
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Accuracy of bone-level assessments following reconstructive surgical treatment of experimental peri-implantitis
- 2022
-
Ingår i: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 33:4, s. 433-440
-
Tidskriftsartikel (refereegranskat)abstract
- Aims The purpose of this study was to evaluate the accuracy of bone-level assessments using either cone-beam computed tomography (CBCT), intra-oral peri-apical (PA) radiographs or histology following reconstructive treatment of experimental peri-implantitis. Materials and Methods Six Labrador dogs were used. Experimental peri-implantitis was induced 3 months after implant placement. Surgical treatment of peri-implantitis was performed and peri-implant defects were allocated to one of four treatment categories; no augmentation, bone graft materials with or without a barrier membrane. Six months later, intra-oral PA radiographs and block biopsies from all implants sites were obtained. Marginal bone levels (MBLs) were measured using PA radiographs, CBCT and histology. Results Significant correlations of MBL assessments were observed between the three methods. The measurements in PA radiographs consistently resulted in an overestimation of the bone level of about 0.3-0.4 mm. The agreement between the methods was not influenced by the use of bone substitute materials in the management of the osseous defects. Conclusions Although MBL assessments obtained from PA radiographs showed an overestimation compared to MBL assessments on corresponding CBCT images and histological sections, PA radiographs can be considered a reliable technique for peri-implant bone-level evaluations following reconstructive surgical therapy of experimental peri-implantitis.
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| 36. |
- Almohandes, Ahmed, et al.
(författare)
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Effect of biofilm formation on implant abutments with an anti-bacterial coating: A pre-clinical in vivo study
- 2021
-
Ingår i: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 32:6, s. 756-766
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives To analyse the long-term effect of plaque formation on implant abutments with an antibacterial coating and the ensuing host response in peri-implant tissues. Materials and methods Four implants were installed in each mandibular premolar region following tooth extraction in six dogs. Three months later, two test abutments with a titanium-bismuth-gallium (Ti-Bi-Ga) coating and two control titanium abutments were connected to the implants on each side of the mandible. After 2 months, ligatures were placed around the implants in one side of the mandible and plaque formation was allowed until the end of the experiment. The ligatures were removed after 4 weeks. Radiographs and microbiological samples were obtained from each implant site during the plaque formation period. Biopsies were obtained 8 months after abutment connection and prepared for histological analysis. Results The analysis did not reveal any statistically significant differences in bone loss, bacterial growth and size of inflammatory lesions between implant units with and without the Ti-Bi-Ga coating. Implant sites exposed to the short period of ligature-induced breakdown demonstrated more pronounced bone loss and bacterial growth than non-ligature sites. Conclusions It is suggested that a Ti-Bi-Ga coating does not prevent biofilm formation on the implant device and does not influence the ensuing host response in the adjacent peri-implant mucosa.
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| 37. |
- Almohandes, Ahmed, et al.
(författare)
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Re-osseointegration following reconstructive surgical therapy of experimental peri-implantitis. A pre-clinical in vivo study
- 2019
-
Ingår i: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 30:5, s. 447-456
-
Tidskriftsartikel (refereegranskat)abstract
- Objective To evaluate the effect of bone substitute materials on hard and soft tissue healing in reconstructive surgical therapy of experimental peri-implantitis at implants with different surface characteristics. Material and methods Six female, Labrador dogs were used. 3 months after tooth extraction, four implants with two different surface characteristics (A and B) were installed on each side of the mandible. Experimental peri-implantitis was induced 3 months later. During surgical treatment of peri-implantitis, the implants were cleaned with curettes and cotton pellets soaked in saline. The implant sites were allocated to one of four treatment categories; (a) Group C; no augmentation, (b) Group T1; bone defect filled with deproteinized bovine bone mineral (c) Group T2; bone defect filled with a biphasic bone graft material, (d) Group T3; bone defect filled as T1 and covered with a collagen membrane. Clinical and radiological examinations were performed, and biopsies were obtained and prepared for histological analysis 6 months after peri-implantitis surgery. Results Implant B (smooth surface) sites showed significantly (a) larger radiographic bone level gain, (b) enhanced resolution of peri-implantitis lesions, and (c) larger frequency of re-osseointegration than implant A (moderately rough surface) sites. Implant B sites also showed superior preservation of the mucosal margin. Differences between bone substitute materials and control procedures were overall small with limited advantages for T1 and T2 sites. Conclusion Healing following reconstructive surgical treatment of experimental peri-implantitis was superior around implants with a smooth surface than implants with a moderately rough surface. Benefits of using bone substitute materials during surgical therapy were overall small.
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| 38. |
- Almohandes, Ahmed, et al.
(författare)
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Surgical treatment of experimental peri-implantitis using mechanical and chemical decontamination procedures: A pre-clinical in vivo study
- 2022
-
Ingår i: Journal of Clinical Periodontology. - : Wiley. - 0303-6979 .- 1600-051X. ; 49:5, s. 518-525
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: To evaluate the effect of surgical treatment of experimental peri-implantitis at implants with different surface characteristics using mechanical and chemical decontamination methods. Materials and Methods: Following extraction of mandibular premolars, four implants with two different surface characteristics (A, moderately rough and B, smooth) were placed in each side of the mandible of six dogs. Experimental peri-implantitis was induced. Surgical treatment of the peri-implantitis sites was carried out using four implant surface decontamination protocols: (i) deposition of a citric acid gel, (ii) mechanical cleaning using a rotating titanium brush, (iii) a combination of the mechanical and chemical procedures, and (iv) saline (control). Clinical and radiographic examinations were performed. Block biopsies were obtained 6months after therapy and prepared for histological analysis. Results: Irrespective of the treatment group, treatment resulted in 0.63 ± 0.92 and 0.65 ± 0.67 mm radiographic bone gain around implants A and B, respectively. Histological analyses revealed that persisting soft tissue inflammation as assessed using an infiltrated connective tissue (ICT) score was significantly lower at implant type B than at implant type A for all treatment groups. The test decontamination procedures did not demonstrate better results regarding resolution of peri-implantitis lesions, as indicated by the ICT scores, than the control procedure. The control treatment resulted in significantly superior outcomes of resolution of peri-implantitis lesions than the citric acid regimen. Conclusions: It is concluded that decontamination procedures including citric acid gel or rotating titanium brush did not improve outcomes following surgical treatment of experimental peri-implantitis. Results were, however, influenced by the implant surface characteristics. © 2022 John Wiley & Sons A/S.
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| 39. |
- Berglundh, Tord, 1954, et al.
(författare)
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Bone healing at implants with a fluoride-modified surface: an experimental study in dogs.
- 2007
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Ingår i: Clinical oral implants research. - : Wiley. - 0905-7161 .- 1600-0501. ; 18:2, s. 147-52
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of the present experiment was to study early stages of osseointegration to implants with a fluoride-modified surface. MATERIAL AND METHODS: Six mongrel dogs, about 1-year old, were used. All mandibular premolars and the first mandibular molars were extracted. Three months later, mucoperiosteal flaps were elevated in one side of the mandible and six sites were identified for implant placement. The control implants (MicroThread) had a TiOblast surface, while the test implants (OsseoSpeed) had a fluoride-modified TiOblast surface. Both types of implants had a similar geometry, a diameter of 3.5 mm and were 8 mm long. Following installation, cover screws were placed and the flaps were adjusted and sutured to cover all implants. Four weeks after the first implant surgery, the installation procedure was repeated in the opposite side of the mandible. Two weeks later, biopsies were obtained and prepared for histological analysis. The void that occurred between the cut bone wall of the recipient site and the macro-threads of the implant immediately following implant installation was used to study early bone formation. RESULTS: It was demonstrated that the amount of new bone that formed in the voids within the first 2 weeks of healing was larger at fluoride-modified implants (test) than at TiOblast (control) implants. It was further observed that the amount of bone-to-implant contact that had been established after 2 weeks in the macro-threaded portion of the implant was significantly larger at the test implants than at the controls. CONCLUSION: It is suggested that the fluoride-modified implant surface promotes osseointegration in the early phase of healing following implant installation.
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| 40. |
- Berglundh, Tord, 1954, et al.
(författare)
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Bone reactions to longstanding functional load at implants: an experimental study in dogs.
- 2005
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Ingår i: Journal of clinical periodontology. - 0303-6979. ; 32:9, s. 925-32
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aims of the present investigation were (i) to study marginal bone level alterations following implant installation, abutment connection and functional loading and (ii) to analyse bone tissue reactions to functional load. MATERIAL AND METHODS: Six beagle dogs, about 1-year old, were used. All mandibular pre-molars were extracted. Three months later four implants of the Astra Tech Implants Dental System were installed in one side of the mandible and four standard fixtures of the Brånemark System were placed in the contralateral side of the mandible. Abutment connection was performed 3 months later and a plaque control programme was initiated. Three months after abutment connection fixed partial dentures (FPDs) made in gold were cemented to the maxillary canines and pre-molars. FPDs were also connected to the three posterior implants in each side of the mandible, while the mesial implant in each side was used as an unloaded control. Radiographs were obtained from all implant sites following implant installation, abutment connection and FPD placement. Ten months after the FPD placement the radiographic examination was repeated. The animals were sacrificed and biopsies from all implant sites were obtained and prepared for histological analysis. RESULTS: The radiographic analysis revealed that largest amount of bone loss occurred following implant installation and abutment connection and that this loss was more pronounced at Brånemark than at Astra implants. The bone level alterations that were observed at implants exposed to 10 months of functional load in both implant systems were small and did not differ from control sites. The histological analysis revealed that implants exposed to functional load exhibited a higher degree of bone-to-implant contact than control implants in both implant systems. CONCLUSION: It is suggested that functional load at implants may enhance osseointegration and does not result in marginal bone loss.
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| 41. |
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| 42. |
- Berglundh, Tord, 1954, et al.
(författare)
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Morphogenesis of the peri-implant mucosa: an experimental study in dogs.
- 2007
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Ingår i: Clinical oral implants research. - : Wiley. - 0905-7161 .- 1600-0501. ; 18:1, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The objective of the present experiment was to study the morphogenesis of the mucosal attachment to implants made of c.p. titanium. MATERIAL AND METHODS: All mandibular premolars were extracted in 20 Labrador dogs. After a healing period of 3 months, four implants (ITI Dental Implant System) were placed in the right and left sides of the mandible. A non-submerged implant installation technique was used and the mucosal tissues were secured to the conical marginal portion of the implants with interrupted sutures. The sutures were removed after 2 weeks and a plaque control program including daily cleaning of the remaining teeth and the implants was initiated. The animals were sacrificed and biopsies were obtained at various intervals to provide healing periods extending from Day 0 (2 h) to 12 weeks. The mandibles were removed and placed in the fixative. The implant sites were dissected using a diamond saw and processed for histological analysis. RESULTS: Large numbers of neutrophils infiltrated and degraded the coagulum that occupied the compartment between the mucosa and the implant during the initial phase of healing. At 2 weeks after surgery, fibroblasts were the dominating cell population in the connective tissue interface but at 4 weeks the density of fibroblasts had decreased. Furthermore, the first signs of epithelial proliferation were observed in specimens representing 1-2 weeks of healing and a mature barrier epithelium occurred after 6-8 weeks of healing. The collagen fibers of the mucosa were organized after 4-6 weeks of healing. CONCLUSION: It is suggested that the soft-tissue attachment to implants placed using a non-submerged installation procedure is properly established after several weeks following surgery.
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| 43. |
- Carcuac, Olivier, 1974, et al.
(författare)
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Adjunctive Systemic and Local Antimicrobial Therapy in the Surgical Treatment of Peri-implantitis: A Randomized Controlled Clinical Trial
- 2016
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Ingår i: Journal of Dental Research. - : SAGE Publications. - 0022-0345 .- 1544-0591. ; 95:1, s. 50-57
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present randomized controlled clinical trial was to investigate the adjunctive effect of systemic antibiotics and the local use of chlorhexidine for implant surface decontamination in the surgical treatment of peri-implantitis. One hundred patients with severe peri-implantitis were recruited. Surgical therapy was performed with or without adjunctive systemic antibiotics or the local use of chlorhexidine for implant surface decontamination. Treatment outcomes were evaluated at 1 y. A binary logistic regression analysis was used to identify factors influencing the probability of treatment success, that is, probing pocket depth <= 5 mm, absence of bleeding/suppuration on probing, and no additional bone loss. Treatment success was obtained in 45% of all implants but was higher in implants with a nonmodified surface (79%) than those with a modified surface (34%). The local use of chlorhexidine had no overall effect on treatment outcomes. While adjunctive systemic antibiotics had no impact on treatment success at implants with a nonmodified surface, a positive effect on treatment success was observed at implants with a modified surface. The likelihood for treatment success using adjunctive systemic antibiotics in patients with implants with a modified surface, however, was low. As the effect of adjunctive systemic antibiotics depended on implant surface characteristics, recommendations for their use in the surgical treatment of peri-implantitis should be based on careful assessments of the targeted implant (ClinicalTrials.gov NCT01857804).
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| 44. |
- Carcuac, Olivier, 1974, et al.
(författare)
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Experimental periodontitis and peri-implantitis in dogs
- 2013
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Ingår i: Clinical Oral Implants Research. - : Wiley. - 0905-7161. ; 24:4, s. 363-371
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Aim: To analyze the tissue reactions following ligature removal in experimental periodontitis and peri-implantitis in dogs. Material and methods: Four implants with similar geometry and with two different surface characteristics (turned/TiUnite Nobel BioCare AB, Go ̈ teborg) were placed pair-wise in a randomized order in the right side of the mandible 3 months after tooth extraction in 5 dogs. Experimental peri-implantitis and periodontitis were initiated 3 months later by ligature placement around implants and mandibular premolars and plaque formation. The ligatures were removed after 10 weeks, and block biopsies were obtained and prepared for histological analysis 6 months later. Results: It was demonstrated that the amount of bone loss that occurred during the period following ligature removal was significantly larger at implants with a modified surface than at implants with a turned surface and at teeth. The histological analysis revealed that peri-implantitis sites exhibited inflammatory cell infiltrates that were larger, extended closer to the bone crest and contained larger proportions of neutrophil granulocytes and osteoclasts than in periodontitis. Conclusion: It is suggested that lesions produced in experimental periodontitis, and peri- implantitis are different and that implant surface characteristics influence the inflammatory process in experimental peri-implantitis and the magnitude of the resulting tissue destruction.
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| 45. |
- Carcuac, Olivier, 1974, et al.
(författare)
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Risk for recurrence of disease following surgical therapy of peri-implantitis-A prospective longitudinal study
- 2020
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Ingår i: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 31:11, s. 1072-1077
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim of the present prospective study was to assess the risk for disease recurrence following surgical therapy of peri-implantitis. Material & Methods 73 patients (130 implants) treated surgically for peri-implantitis were examined at 1 and 5 years after therapy. The primary outcome was recurrence/progression of disease defined as any of the following events: (a) bone loss >1.0 mm, (b) surgical retreatment, (c) implant removal/loss after year 1. Patient- and implant-related parameters as well as 1-year outcomes were evaluated as potential predictors through multiple logistic regression analysis. Results 57 implants (44%) displayed recurrence/progression of peri-implantitis during follow-up. Among these, 27 implants were removed. Residual deep probing pocket depth (>= 6 mm; odds ratio 7.4; 95% confidence interval 2.8-19.3) and reduced marginal bone level (OR 1.4; 95%CI 1.1-1.7) at 1 year after surgery constituted risk factors for recurrence/progression of disease. Furthermore, implants with modified surfaces were at higher risk than implants with non-modified surfaces (OR 5.1; 95%CI 1.6-16.5). Conclusion Implants with (a) residual deep probing pocket depth, (b) reduced marginal bone level, or (c) modified surfaces following surgical therapy of peri-implantitis present with increased risk for recurrence/progression.
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| 46. |
- Carcuac, Olivier, 1974, et al.
(författare)
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Spontaneous progression of experimental peri-implantitis in augmented and pristine bone. A pre-clinical in vivo study.
- 2020
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Ingår i: Clinical oral implants research. - : Wiley. - 1600-0501 .- 0905-7161. ; 31:2, s. 192-200
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Tidskriftsartikel (refereegranskat)abstract
- To examine progression of experimental peri-implantitis around different implants placed in augmented and pristine sites. M&M: 6 Labrador dogs were used. 3months after tooth extraction, 4 implants with different surface modifications were installed on each side of the mandible. A standard osteotomy was applied on one side, while on the contralateral side the osteotomy was modified, resulting in a gap between the implant and the bone wall. The gap was filled with a bone substitute and covered by a resorbable membrane. 3months after implant installation, implants were exposed and healing abutments were connected. 2months later, oral hygiene procedures were abandoned and a cotton ligature was placed in a submarginal position around the neck of all implants and kept in place for 4weeks. Following ligature removal, plaque formation continued for 6months (spontaneous progression period). Radiographs were obtained throughout the experiment and biopsies were collected and prepared for histological evaluation at the end of the spontaneous progression period.Differences in bone loss during the spontaneous progression period between pristine and augmented sites were small. The size and vertical dimension of the peri-implantitis lesion were larger at augmented than at pristine sites. Implants with non-modified surfaces exhibited smaller amounts of bone loss and smaller dimensions of peri-implantitis lesions than implants with modified surfaces.Small differences in spontaneous progression of peri-implantitis were detected between pristine and augmented sites. Implants with modified surfaces exhibited more bone loss and larger lesions than implants with non-modified surfaces, irrespective of the type of surrounding bone.
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| 47. |
- Carcuac, Olivier, 1974, et al.
(författare)
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Surgical treatment of peri-implantitis: 3-year results from a randomized controlled clinical trial.
- 2017
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Ingår i: Journal of clinical periodontology. - : Wiley. - 1600-051X .- 0303-6979. ; 44:12, s. 1294-1303
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Tidskriftsartikel (refereegranskat)abstract
- This study reports on the 3-year follow-up of patients enrolled in a randomized controlled clinical trial on surgical treatment of advanced peri-implantitis.A total of 100 patients with advanced peri-implantitis were randomly assigned to one of four treatment groups. Surgical therapy aiming at pocket elimination was performed and, in three test groups, supplemented by either systemic antibiotics, use of an antiseptic agent for implant surface decontamination or both. Outcomes were evaluated after 1 and 3years by means of clinical and radiological examinations. Differences between groups were explored by regression analysis.Clinical examinations at 3years after treatment revealed (i) improved peri-implant soft tissue health with a mean reduction in probing depth of 2.7mm and a reduction in bleeding/suppuration on probing of 40% and (ii) stable peri-implant marginal bone levels (mean bone loss during follow-up: 0.04mm). Implant surface characteristics had a significant impact on 3-year outcomes, in favour of implants with non-modified surfaces. Benefits of systemic antibiotics were limited to implants with modified surfaces and to the first year of follow-up.It is suggested that surgical treatment of peri-implantitis is effective and that outcomes of therapy are affected by implant surface characteristics. Potential benefits of systemic antibiotics are not sustained over 3years.
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| 48. |
- Carcuac, Olivier, 1974, et al.
(författare)
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The effect of the local use of chlorhexidine in surgical treatment of experimental peri-implantitis in dogs
- 2015
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Ingår i: Journal of Clinical Periodontology. - : Wiley. - 0303-6979. ; 42:2, s. 196-203
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To evaluate the effect of surgical treatment of experimental peri-implantitis at implants with different surface characteristics using different anti-infective procedures. Material and methods: Four implants with different surface characteristics (A: TiOblast, B: OsseoSpeed, C: AT-I, D: TiUnite) were installed in a random- ized order in each side of the mandible in 6 labrador dogs 3 months after tooth extraction. Experimental peri-implantitis was induced 3 months later. Surgical treatment of peri-implantitis was performed. The implants were cleaned with gauze soaked in either saline (control) or chlorhexidine (test). Clinical and radio- graphical examinations were performed and microbiological samples were taken during a 6-month period after surgery. Biopsies were obtained and prepared for histological analysis. Results: Clinical signs of soft tissue inflammation were reduced after surgical therapy in most test and control sites. While the analysis of bone level alterations in radiographs together with histological and microbiological assessments of reso- lution of peri-implantitis lesions failed to demonstrate statistically significant dif- ferences between test and control procedures, the evaluations disclosed significant differences between implant D and implants A, B and C on treatment outcome. Conclusion: It is suggested that (i) the local use of chlorhexidine has minor influ- ence on treatment outcome, (ii) resolution of peri-implantitis following surgical treatment without the adjunctive use of local and systemic antimicrobial agents is possible and (iii) the results are influenced by implant surface characteristics.
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| 49. |
- Charalampakis, Georgios, et al.
(författare)
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Effect of cleansing of biofilm formed on titanium discs.
- 2015
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Ingår i: Clinical oral implants research. - : Wiley. - 1600-0501 .- 0905-7161. ; 26:8, s. 931-936
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Tidskriftsartikel (refereegranskat)abstract
- To study the combined effect of mechanical and chemical cleansing on a 4-day biofilm grown intra-orally on titanium discs with different surface characteristics.
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| 50. |
- Charalampakis, Georgios, et al.
(författare)
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Microbiota in experimental periodontitis and peri-implantitis in dogs
- 2014
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Ingår i: Clinical Oral Implants Research. - : Wiley. - 0905-7161. ; 25:9, s. 1094-1098
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Tidskriftsartikel (refereegranskat)abstract
- Aim To analyze the microbial profile around teeth and implants following ligature removal in experimental periodontitis and peri-implantitis in dogs. Material and methods Four implants with similar geometry and with two different surface characteristics (implant A: turned/implant B: TiUnite; NobelBiocare AB) were placed pairwise in the right side of the mandible 3 months after tooth extraction in five dogs. Experimental periodontitis and peri-implantitis were initiated 3 months later by ligature placement around implants and mandibular premolars and plaque formation. The ligatures were removed after 10 weeks. Microbial samples were obtained using paper points immediately after ligature removal, at 10 and 25 weeks after ligature removal. The microbiological analysis was performed by “checkerboard” DNA-DNA hybridization, including a panel of 16 bacterial species. Results The amount of bone loss that occurred during the period following ligature removal was significantly larger at implants with a modified surface than at implants with a turned surface and at teeth. The microbiological analysis revealed that the total bacterial load increased during the period following ligature removal and established an anaerobic Gram-negative microflora. Conclusion It is suggested that the large variation in regard to the microbial profiles makes interpretation of a correlation between disease progression and microbial profiles difficult.
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