| 1. |
- Carlsson, Lars V, et al.
(författare)
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Stepwise introduction of a bone-conserving osseointegrated hip arthroplasty using RSA and a randomized study: I. Preliminary investigations--52 patients followed for 3 years.
- 2006
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Ingår i: Acta orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 77:4, s. 549-58
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: We developed a total hip system using osseointegration guidelines, a metaphyseal-loading proximal femoral replacement in the retained neck and a dual-geometry titanium shell in the acetabulum. PATIENTS AND METHODS: A randomized controlled clinical trial was undertaken in 52 patients (53 hips), using the cemented Spectron stem and cementless Harris-Galante II cup as control implants (24 patients in experimental group, 29 control patients). Clinical measures of Harris Hip Score (HHS), pain score and radiostereometric analysis (RSA) at regular intervals for up to three years were used to monitor progress. RESULTS: No statistically significant differences were found in HHS and pain score; the stability of the cementless experimental implant was also comparable to that of the cemented controls by RSA. 3 revisions were required for migration in the experimental group and 1 was required for component dislocation in the control group. INTERPRETATION: Our findings indicate the practicality of osseointegration of titanium implants, but suggest that current performance is inadequate for clinical introduction. However, the stable fixation achieved in the retained neck in the majority of patients is indicative of osseointegration. This finding will encourage technical and design improvements for enhancement of clinical osseointegration and should also encourage further study. Periprosthetic osteolysis might be avoided by the establishment and maintenance of direct implant-bone connection: "osseointegration".
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| 2. |
- Carlsson, Lars, 1952, et al.
(författare)
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Bone conserving hip replacement.
- 2004
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Ingår i: 3rd Annual SICOT/SIROT Conference 2004.
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Konferensbidrag (refereegranskat)
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| 3. |
- Carlsson, Lars, 1952, et al.
(författare)
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Stepwise introduction of a bone-conserving osseointegrated hip arthroplasty using RSA and a randomized study: II. Clinical proof of concept--40 patients followed for 2 years
- 2006
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 77:4, s. 559-566
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: We have developed a bone-conserving commercially pure titanium hip replacement system using osseointegration principles: a metaphyseal loading proximal femoral component affixing into the retained neck and metaphysis only, leaving the femoral canal untouched. The acetabular cup closely fits a dual-geometry cavity, avoiding stress protection at the dome. PATIENTS AND METHODS: After extensive laboratory and clinical pilot trial investigations, the surface-engineered implants were submitted to a prospective randomized controlled clinical trial involving 40 patients (40 hips), in which they were compared to the cemented Spectron femoral component and cementless Trilogy cup as control implant. The following clinical measures were used to monitor progress at regular intervals for the first 2 postoperative years: radiostereometric analysis (RSA), Harris Hip Score, pain score, WOMAC, and SF-36. RESULTS: After 2 years of follow-up, no statistically significant differences were seen between the groups concerning rotation or translation along the cardinal axes. The patients receiving the Gothenburg osseointegrated titanium (GOT) system had significantly higher Harris Hip Score at 6 months, suggesting more rapid recovery. WOMAC, SF-36 and pain analysis were similar for the first 2 postoperative years. INTERPRETATION: Our RSA data suggest that osseointegration was achieved for all patients receiving the GOT hip system. This bone-conserving prosthesis may provide a good alternative, especially for young and active patients.
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| 4. |
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| 5. |
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| 6. |
- Albrektsson, Tomas, 1945, et al.
(författare)
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An Imbalance of the Immune System Instead of a Disease Behind Marginal Bone Loss Around Oral Implants: Position Paper
- 2020
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Ingår i: The International journal of oral & maxillofacial implants. - : Quintessence Publishing. - 1942-4434 .- 0882-2786. ; 35:3, s. 495-502
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of this paper is to present evidence that supports the notion that the primary reason behind marginal bone loss and implant failure is immune-based and that bacterial actions in the great majority of problematic cases are of a secondary nature. MATERIALS AND METHODS: The paper is written as a narrative review. RESULTS: Evidence is presented that commercially pure titanium is not biologically inert, but instead activates the innate immune system of the body. For its function, the clinical implant is dependent on an immune/inflammatory defense against bacteria. Biologic models such as ligature studies have incorrectly assumed that the primary response causing marginal bone loss is due to bacterial action. In reality, bacterial actions are secondary to an imbalance of the innate immune system caused by the combination of titanium implants and ligatures, ie, nonself. This immunologic imbalance may lead to marginal bone resorption even in the absence of bacteria. CONCLUSION: Marginal bone loss and imminent oral implant failure cannot be properly analyzed without a clear understanding of immunologically caused tissue responses.
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| 7. |
- Albrektsson, Tomas, 1945
(författare)
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Are Oral Implants the Same As Teeth?
- 2019
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Ingår i: Journal of clinical medicine. - : MDPI AG. - 2077-0383. ; 8:9
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Tidskriftsartikel (refereegranskat)abstract
- Osseointegration of oral implants was initially discovered by Brånemark [...].
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| 8. |
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| 9. |
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| 10. |
- Albrektsson, Tomas, 1945, et al.
(författare)
-
Bone loss around oral and orthopedic implants: An immunologically based condition
- 2019
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Ingår i: Clinical Implant Dentistry and Related Research. - : Wiley. - 1523-0899 .- 1708-8208. ; 21:4, s. 786-795
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Tidskriftsartikel (refereegranskat)abstract
- Background Marginal bone resorption has by some been identified as a "disease" whereas in reality it generally represents a condition. Purpose The present article is a comparison between oral and orthopedic implants, as previously preferred comparisons between oral implants and teeth seem meaningless. Materials and Methods The article is a narrative review on reasons for marginal bone loss. Results and Conclusions The pathology of an oral implant is as little related to a tooth as is pathology of a hip arthroplasty to a normally functioning, pristine hip joint. Oral as well as orthopedic implants are recognized as foreign bodies by the immune system and bone is formed, either in contact or distance osteogenesis, to shield off the foreign materials from remaining tissues. A mild immune reaction coupled to a chronic state of inflammation around the implant serve to protect implants from bacterial attacks. Having said this, an overreaction of the immune system may lead to clinical problems. Marginal bone loss around oral and orthopedic implants is generally not dependent on disease, but represents an immunologically driven rejection mechanism that, if continuous, will threaten implant survival. The immune system may be activated by various combined patient and clinical factors or, if rarely, by microbes. However, the great majority of cases with marginal bone loss represents a temporary immune overreaction only and will not lead to implant failure due to various defense mechanisms.
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| 11. |
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| 12. |
- Albrektsson, Tomas, 1945, et al.
(författare)
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Crestal Bone Loss and Oral Implants
- 2012
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Ingår i: Clinical Implant Dentistry and Related Research. - : Wiley. - 1523-0899 .- 1708-8208. ; 14:6, s. 783-791
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Tidskriftsartikel (refereegranskat)abstract
- Background: A consensus meeting was arranged to critically analyze whether the high figures of peri-implantitis at machined implants that recently have been reported in the literature are valid also for modern implants. Purpose: The aims of this paper were to present the outcomes from the consensus meeting and to evaluate recent long-term clinical studies on modern implants with regard to frequency of peri-implant infection. Materials and Methods: Ten different studies of three modern implant brands of moderately rough surfaces with 10-year or longer follow-up times were found through a PubMed and manual search. Results: It was concluded that bleeding on probing or probing depths are weak indicators of crestal bone loss (CBL); that CBL occurs for many other reasons than infection; that implant-, clinician-, and patient-related factors contribute to CBL; and that modern oral implants outperform older devices. Based on a literature search, the frequency of implants with reported peri-implant infection and significant bone loss leading to implant removal or other surgical intervention was on average 2.7% during 7 to 16 years of function. Conclusion: The summed frequency of peri-implantitis and implant failure is commonly less than 5% over 10 years of follow-up for modern implants when using established protocols.
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| 13. |
- Albrektsson, Tomas, 1945, et al.
(författare)
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Direct bone anchorage of oral implants: clinical and experimental considerations of the concept of osseointegration.
- 1990
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Ingår i: The International journal of prosthodontics. - 0893-2174. ; 3:1, s. 30-41
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Forskningsöversikt (refereegranskat)abstract
- The term osseointegration is analyzed in relation to its theoretical and clinical definitions, and comparisons are made to other implant modalities. The term osseointegration has a clear clinical meaning, but there is doubt about its precise usage in an experimental setting. Clinically, an implant can be described as osseointegrated if there is no discernable movement when force is applied to the fixture. This is in contrast to implants surrounded by fibrous connective tissue, which move within soft tissue. Newly developed laboratory techniques may be used in the future to precisely characterize osseointegration in the laboratory.
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| 14. |
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| 15. |
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| 16. |
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| 17. |
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| 18. |
- Albrektsson, Tomas, 1945
(författare)
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From the Desk of the Editor
- 2006
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Ingår i: Appl. Osseointegration Research 2006. ; 5
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Tidskriftsartikel (refereegranskat)
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| 19. |
- Albrektsson, Tomas, 1945
(författare)
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Hard tissue implant interface
- 2008
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Ingår i: Australian Dental Journal. ; 53:suppl 1
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Tidskriftsartikel (refereegranskat)
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| 20. |
- Albrektsson, Tomas, 1945
(författare)
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Hard tissue response
- 2016
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Ingår i: Murphy W., Black J., Hastings G. (eds) Handbook of Biomaterial Properties.. - New York, NY : Springer New York. - 9781493933037 ; , s. 581-592
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Bokkapitel (refereegranskat)abstract
- The initial tissue response when a biomaterial is implanted in the body is dependent on release of specific growth factors. It has been indicated by Frost [1] that the inevitable bone injury resulting from surgery and the presence of an implant will release various types of growth factors that will sensitize cells and promote cellular mitosis. This is a general healing response that will result in growth of all sorts of local connective tissues, bone as well as various types of soft tissue. © Springer Science+Business Media New York 2016.
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| 21. |
- Albrektsson, Tomas, 1945, et al.
(författare)
-
healing response
- 2008
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Ingår i: osseointegration. - : Quintessence Publishing Co, Inc. - 9780867154795 ; , s. 47-50, s. 51-57
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 22. |
- Albrektsson, Tomas, 1945, et al.
(författare)
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Histologic investigations on 33 retrieved Nobelpharma implants.
- 1993
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Ingår i: Clinical materials. - 0267-6605. ; 12:1, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Thirty Nobelpharma implants were retrieved from 17 patients despite a remaining clinical stability, after between 1 and 16 years of clinical function. The reasons for implant removal were bone resorption in combination with soft tissue disorders, psychological causes, implant fracture and post mortem cases. When measured at the cortical passage, there was an average of 84.9% direct bone-to-implant contact and 81.8% average surface bone area in individual threads as evaluated in a computerized morphometric system at the light microscopic level.
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| 23. |
- Albrektsson, Tomas, 1945, et al.
(författare)
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Implant survival and complications. The Third EAO consensus conference 2012.
- 2012
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Ingår i: Clinical oral implants research. - : Wiley. - 1600-0501 .- 0905-7161. ; 23 Suppl 6, s. 63-5
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Tidskriftsartikel (refereegranskat)abstract
- The task of this working group was to analyze biological, technical and aesthetic complications of single crowns on implants and fixed dental prostheses with or without cantilevers on implants over 5 years or more. In addition, the group analyzed economic aspects on such implant treatment.
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| 24. |
- Albrektsson, Tomas, 1945
(författare)
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Implantathistorik
- 2009
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Ingår i: Runord. ; 120:1, s. 10-15
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Tidskriftsartikel (refereegranskat)
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| 25. |
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| 26. |
- Albrektsson, Tomas, 1945, et al.
(författare)
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Implications of considering peri-implant bone loss a disease, a narrative review
- 2022
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Ingår i: Clinical Implant Dentistry and Related Research. - : Wiley. - 1523-0899 .- 1708-8208. ; 24:4, s. 532-543
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Tidskriftsartikel (refereegranskat)abstract
- Background Peri-implantitis has been suggested to cause significant increasing proportions of implant failure with increasing time. Purpose To assess whether implant failure rates in long term studies are matching the supposed high prevalence of peri-implantitis. Material and Methods This paper is written as a narrative review of the long-term clinical investigations available in the literature. Results Some implant systems have seen unacceptable marginal bone loss figures with time coupled to increased implant failure rates, resulting in the withdrawal of these systems. The reasons for such mishap are generally unknown, with the exception of one system failure that was found to be due to improper clinical handling. Modern, moderately rough implant systems have functioned excellently over 10-15 years of follow up with minor problems with marginal bone loss and implant failure rates within a few per cent. Machined implants have functioned adequately over 20-30 years of follow up. Implant failures occur predominantly during the first few years after implant placement. No significant increase of implant failures has been observed thereafter over 20-30 years of follow up. Over the years of our new millennium, scientific and technical advances have allowed the discovery of numerous molecular pathways and cellular interactions between the skeletal and immune system promoting the development of the interdisciplinary field called osteoimmunology. Nowadays, this knowledge has not only allowed the emergence of new etiologic paradigms for bone disease but also a new dynamic approach on the concept of osseointegration and MBL around oral implants, re-evaluating our older disease oriented outlook. This facilitates at the same time the emergence of translational applications with immunological perspectives, scientific approaches based on omics sciences, and the beginning of an era of personalized dental implant therapy to improve the prognosis of oral implant treatment. Conclusions Oral implant systems have been found to function with very good clinical outcome over follow-up times of 20-30 years. Registered implant failures have occurred predominantly during the first few years after implantation, and there has been no significant increase in late failures due to peri-implantitis.
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| 27. |
- Albrektsson, Tomas, 1945, et al.
(författare)
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Initial and long-term crestal bone responses to modern dental implants
- 2017
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Ingår i: Periodontology 2000. - : Wiley. - 0906-6713 .- 1600-0757. ; 73:1, s. 41-50
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Forskningsöversikt (refereegranskat)abstract
- Successful osseointegration is the result of a controlled foreign body reaction to dental implants. Osseointegrated implants have demonstrated excellent long-term survivability, although they may be subject to limited marginal bone loss. Marginal bone loss during the first few years after implant placement seldom represents disease, but is instead the result of an adaptive bone response to surgical trauma and implant loading. It is not uncommon for implants with early marginal bone loss to enter a long-lasting state of bone stability. Extensive bone resorption after the first year is generally due to an exacerbation of adverse body reactions caused by non-optimal implant components, adverse surgery or prosthodontics and/or compromised patient factors. Disease in the form of peri-implantitis is a late complication that affects some implants with suppuration and rapid loss of crestal bone, and is probably caused by bacterial pathogens and immunological reactions. Unfortunately, the literature is not consistent with respect to the type or magnitude of clinical implant problems, including how they are defined and diagnosed. If the peri-implantitis diagnosis is confined to cases with infection, suppuration and significant bone loss, the frequency of the disease is relatively low, which is in sharp contrast to the frequencies reported with unrealistic definitions of peri-implantitis. We suggest that when modern implants are placed by properly trained individuals, only 1–2% of implants show true peri-implantitis during follow-up periods of 10 years or more. Peri-implantitis must be separated from the initial and self-limiting marginal bone loss.
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| 28. |
- Albrektsson, Tomas, 1945, et al.
(författare)
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Les implants oxidés perspectives d’avenir?
- 2003
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Ingår i: Réalités Cliniques. - 0999-5021. ; 13:4, s. 329-337
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Tidskriftsartikel (refereegranskat)abstract
- Tous les implants en titane présentent une fine couche adhérente d’oxydes de titane d’environ 5nm. Les techniques d’anodisation
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| 29. |
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| 30. |
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| 31. |
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| 32. |
- Albrektsson, Tomas, 1945, et al.
(författare)
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On crestal/marginal bone loss around dental implants.
- 2012
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Ingår i: The International journal of prosthodontics. - : Quintessence Publishing co inc. - 0893-2174 .- 1139-9791. ; 27:4, s. 736-738
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 33. |
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| 34. |
- Albrektsson, Tomas, 1945, et al.
(författare)
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On inflammation-immunological balance theory—A critical apprehension of disease concepts around implants: Mucositis and marginal bone loss may represent normal conditions and not necessarily a state of disease
- 2019
-
Ingår i: Clinical Implant Dentistry and Related Research. - : Wiley. - 1523-0899 .- 1708-8208. ; 21:1, s. 183-189
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Tidskriftsartikel (refereegranskat)abstract
- Background: Oral implants have displayed clinical survival results at the 95%-99% level for over 10 years of follow up. Nevertheless, some clinical researchers see implant disease as a most common phenomenon. Oral implants are regarded to display disease in the form of mucositis or peri-implantitis. One purpose of the present article is to investigate whether a state of disease is necessarily occurring when implants display soft tissue inflammation or partially lose their bony attachment. Another purpose of this article is to analyze the mode of defense for implants that are placed in a bacteria rich environment and to analyze when an obtained steady state between tissue and the foreign materials is disturbed. Materials and Methods: The present article is authored as a narrative review contribution. Results: Evidence is presented that further documents the fact that implants are but foreign bodies that elicit a foreign body response when placed in bone tissue. The foreign body response is characterized by a bony demarcation of implants in combination with a chronic inflammation in soft tissues. Oral implants survive in the bacteria-rich environments where they are placed due to a dual defense system in form of chronic inflammation coupled to immunological cellular actions. Clear evidence is presented that questions the automatic diagnostics of an oral implant disease based on the finding of so called mucositis that in many instances represents but a normal tissue response to foreign body implants instead of disease. Furthermore, neither is marginal bone loss around implants necessarily indicative of a disease; the challenge to the implant represented by bone resorption may be successfully counteracted by local defense mechanisms and a new tissue-implant steady state may evolve. Similar reactions including chronic inflammation occur in the interface of orthopedic implants that display similarly good long-term results as do oral implants, if mainly evaluated based on revision surgery in orthopedic cases. The most common mode of failure of orthopedic implants is aseptic loosening which has been found coupled to a reactivation of the inflammatory- immune system. Conclusions: Implants survive in the body due to balanced defense reactions in form of chronic inflammation and activation of the innate immune system. Ten year results of oral and hip /knee implants are hence in the 90+ percentage region. Clinical problems may occur with bone resorption that in most cases is successfully counterbalanced by the defense/healing systems. However, in certain instances implant failure will ensue characterized by bacterial attacks and/or by reactivation of the immune system that now will act to remove the foreign bodies from the tissues.
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| 35. |
- Albrektsson, Tomas, 1945, et al.
(författare)
-
On osseointegration in relation to implant surfaces
- 2019
-
Ingår i: Clinical Implant Dentistry and Related Research. - : Wiley. - 1523-0899 .- 1708-8208. ; 21, s. 4-7
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Tidskriftsartikel (refereegranskat)abstract
- Background The understanding of mechanisms of osseointegration as well as applied knowledge about oral implant surfaces are of paramount importance for successful clinical results. Purpose The aim of the present article is to present an overview of osseointegration mechanisms and an introduction to surface innovations with relevance for osseointegration that will be published in the same supplement of Clinical Implant Dentistry and Related Research. Materials and Methods The present article is a narrative review of some osseointegration and implant surface-related details. Results and Conclusions Osseointegration has a changed definition since it is realized today that oral implants are but foreign bodies and that this fact explains osseointegration as a protection mechanism of the tissues. Given adequate stability, bone tissue is formed around titanium implants to shield them from the tissues. Oral implant surfaces may be characterized by microroughness and nanoroughness, by surface chemical composition and by physical and mechanical parameters. An isotropic, moderately rough implant surface such as seen on the TiUnite device has displayed improved clinical results compared to previously used minimally rough or rough surfaces. However, there is a lack of clinical evidence supporting any particular type of nanoroughness pattern that, at best, is documented with results from animal studies. It is possible, but as yet unproven, that clinical results may be supported by a certain chemical composition of the implant surface. The same can be said with respect to hydrophilicity of implant surfaces; positive animal data may suggest some promise, but there is a lack of clinical evidence that hydrophilic implants result in improved clinical outcome of more hydrophobic surfaces. With respect to mechanical properties, it seems obvious that those must be encompassing the loading of oral implants, but we need more research on the mechanically ideal implant surface from a clinical aspect.
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| 36. |
- Albrektsson, Tomas, 1945
(författare)
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Oral implant Surfaces
- 2007
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Ingår i: Academy of osseointegration Annual meeting 2007.
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Konferensbidrag (refereegranskat)
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| 37. |
- Albrektsson, Tomas, 1945, et al.
(författare)
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Oral Implant Surfaces 1
- 2005
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Ingår i: Perio & Implant Quarterly 2005. ; 1, s. 33-43
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Tidskriftsartikel (refereegranskat)
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| 38. |
- Albrektsson, Tomas, 1945, et al.
(författare)
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Oral Implant Surfaces 11
- 2005
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Ingår i: Perio & Implant Quarterly 2005. ; 2, s. 22-49
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Tidskriftsartikel (refereegranskat)
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| 39. |
- Albrektsson, Tomas, 1945, et al.
(författare)
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Oral implant surfaces: Part 1--review focusing on topographic and chemical properties of different surfaces and in vivo responses to them
- 2004
-
Ingår i: Int J Prosthodont. ; 17:5, s. 536-43
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: This article reviews the topographic and chemical properties of different oral implant surfaces and in vivo responses to them. MATERIALS AND METHODS: The article considers detailed mechanical, topographic, and physical characteristics of implant surfaces. Anchorage mechanisms such as biomechanical and biochemical bonding are examined. Osteoattraction and doped surfaces are discussed. RESULTS: Surface quality of an oral implant may be subdivided into mechanical, topographic, and physicochemical properties. Topographic properties are evaluated at the micrometer level of resolution. Moderately rough surfaces (Sa between 1.0 and 2.0 microm) show stronger bone responses than smoother or rougher surfaces. The majority of currently marketed implants are moderately rough. Oral implants permit bone ingrowth into minor surface irregularities-biomechanical bonding or osseointegration. Additional biochemical bonding seems possible with certain surfaces. Osteoattraction is a commercial term without precise biologic correspondence. Surfaces doped with biochemical agents such as bone growth factors have been developed. CONCLUSION: Moderately roughened surfaces seem to have some clinical advantages over smoother or rougher surfaces, but the differences are small and often not statistically significant. Bioactive implants may offer some promise.
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| 40. |
- Albrektsson, Tomas, 1945, et al.
(författare)
-
Oral implant surfaces: Part 2--review focusing on clinical knowledge of different surfaces
- 2004
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Ingår i: Int J Prosthodont. ; 17:5, s. 544-64
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: This article reviews clinical knowledge of selected oral implant surfaces. MATERIALS AND METHODS: The surfaces most commonly used in clinical practice, marketed by the five largest oral implant companies, are identified; their clinical documentation was scrutinized following a strict protocol. Experimental knowledge of the surfaces is briefly summarized. Retrospective, prospective, and comparative clinical studies were analyzed separately, as were studies of implants in conjunction with bone grafts. RESULTS: TiUnite anodized surfaces are clinically documented in 1- to 2-year follow-up studies at best, with failures at about 3%. Sandblasted and acid-etched SLA surfaces are documented with good clinical results for up to 3 years. Osseotite dual acid-etched implants are documented with good clinical results for up to 5 years. Frialit-2 sandblasted and etched implants are positively documented for about 3 years in one study only. The Tioblast implant is the only design documented for survival over 10 years of follow-up and success over 7 years of follow-up. CONCLUSION: Generally, oral implants are introduced clinically without adequate clinical documentation. Implant companies initiate clinical documentation after product launch. The standards of clinical reporting have improved over the years. Proper long-term reports have been published for only one surface, Tioblast.
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| 41. |
- Albrektsson, Tomas, 1945
(författare)
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Orala implantat - från djurexperiment till klinisk rutinmetod
- 2010
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Ingår i: Tandläkartidningen. - 0039-6982. ; 102:1, s. 56-62
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Tidskriftsartikel (refereegranskat)abstract
- I dag är implantatbehandling en klinisk rutinmetod. Men vägen hit har varit lång. När Per Ingvar Brånemark upptäckte osseointegrationen på 1960-talet ansågs orala implantat ha mycket låg lyckandefrekvens. Metoden stod länge i centrum för kraftfulla akademiska bataljer.
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| 42. |
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| 43. |
- Albrektsson, Tomas, 1945, et al.
(författare)
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Osteoimmune regulation underlies oral implant osseointegration and its perturbation
- 2023
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Ingår i: Frontiers in Immunology. - : Frontiers Media SA. - 1664-3224. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- In the field of biomaterials, an endosseous implant is now recognized as an osteoimmunomodulatory but not bioinert biomaterial. Scientific advances in bone cell biology and in immunology have revealed a close relationship between the bone and immune systems resulting in a field of science called osteoimmunology. These discoveries have allowed for a novel interpretation of osseointegration as representing an osteoimmune reaction rather than a classic bone healing response, in which the activation state of macrophages ((M1-M2 polarization) appears to play a critical role. Through this viewpoint, the immune system is responsible for isolating the implant biomaterial foreign body by forming bone around the oral implant effectively shielding off the implant from the host bone system, i.e. osseointegration becomes a continuous and dynamic host defense reaction. At the same time, this has led to the proposal of a new model of osseointegration, the foreign body equilibrium (FBE). In addition, as an oral wound, the soft tissues are involved with all their innate immune characteristics. When implant integration is viewed as an osteoimmune reaction, this has implications for how marginal bone is regulated. For example, while bacteria are constitutive components of the soft tissue sulcus, if the inflammatory front and immune reaction is at some distance from the marginal bone, an equilibrium is established. If however, this inflammation approaches the marginal bone, an immune osteoclastic reaction occurs and marginal bone is removed. A number of clinical scenarios can be envisioned whereby the osteoimmune equilibrium is disturbed and marginal bone loss occurs, such as complications of aseptic nature and the synergistic activation of pro-inflammatory pathways (implant/wear debris, DAMPs, and PAMPs). Understanding that an implant is a foreign body and that the host reacts osteoimmunologically to shield off the implant allows for a distinction to be drawn between osteoimmunological conditions and peri-implant bone loss. This review will examine dental implant placement as an osteoimmune reaction and its implications for marginal bone loss.
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| 44. |
- Albrektsson, Tomas, 1945, et al.
(författare)
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Osteoinduction, osteoconduction and osseointegration
- 2001
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Ingår i: European Spine Journal. - : Springer Science and Business Media LLC. - 0940-6719 .- 1432-0932. ; 10:SUPPL. 2
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Tidskriftsartikel (refereegranskat)abstract
- Osteoinduction is the process by which osteogenesis is induced. It is a phenomenon regularly seen in any type of bone healing process. Osteoinduction implies the recruitment of immature cells and the stimulation of these cells to develop into preosteoblasts. In a bone healing situation such as a fracture, the majority of bone healing is dependent on osteoinduction. Osteoconduction means that bone grows on a surface. This phenomenon is regularly seen in the case of bone implants. Implant materials of low biocompatibility such as copper, silver and bone cement shows little or no osteoconduction. Osseointegration is the stable anchorage of an implant achieved by direct bone-to-implant contact. In craniofacial implantology, this mode of anchorage is the only one for which high success rates have been reported. Osseointegration is possible in other parts of the body, but its importance for the anchorage of major arthroplasties is under debate. Ingrowth of bone in a porouscoated prosthesis may or may not represent osseointegration.
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| 45. |
- Albrektsson, Tomas, 1945, et al.
(författare)
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Overview of surface Microtopography/Chemistry/Physics/Nano-roughness
- 2015
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Ingår i: Implant Surfaces and their Biological and Clinical Impact. - Berlin, Heidelberg : Springer. - 9783662453797 ; , s. 7-12
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Bokkapitel (refereegranskat)abstract
- The implant surface has since long been recognised as important for the host response to oral implants. When the implant is inserted in the body, blood will immediately cover the implant surface. Different surface properties may trigger proteins and signalling system to enhance and speed up the healing process. The implant surface can be altered with respect to topography, chemistry, physics and mechanical properties. In particular, so far the surface topography and chemistry have gained the greatest interest from researchers and manufacturers of oral implants. © Springer-Verlag Berlin Heidelberg 2015.
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| 46. |
- Albrektsson, Tomas, 1945, et al.
(författare)
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"Peri-Implantitis": A Complication of a Foreign Body or a Man-Made "Disease". Facts and Fiction
- 2016
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Ingår i: Clinical Implant Dentistry and Related Research. - : Wiley. - 1523-0899 .- 1708-8208. ; 18:4, s. 840-849
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Tidskriftsartikel (refereegranskat)abstract
- Background: The discrepancy between some scientific views and the daily clinical experience with dental implants has made the topic of "periimplantitis" highly controversial, especially the discussion whether "periimplantitis" should even be considered a "disease" or whether marginal bone loss instead would represent a complication of having a foreign body placed in the oral cavity. Purpose: The aim of the present paper was to present the outcomes from a consensus meeting on "peri-implantitis" in Rome, Italy (January 8-10, 2016). Materials and Methods: Seventeen clinical scientists were invited to, based on prepared reviews of the literature, discuss topics related to "periimplantitis." Results and conclusions: Oral implants may lose bone or even display clinical failure. However, progressive bone loss threatening implant survival is rare and limited to a percent or two of all implants followed up over 10 years or more, provided that controlled implant systems are being used by properly trained clinicians. There is very little evidence pointing to implants suffering from a defined disease entity entitled "peri-implantitis." Marginal bone loss around implants is in the great majority of cases associated with immune-osteolytic reactions. Complicating factors include patient genetic disorders, patient smoking, cement or impression material remnants in the peri-implant sulcus, bacterial contamination of the implant components and technical issues such as loose screws, mobile components or fractured materials. These reactions combine to result in cellular responses with the end result being a shift in the delicate balance between the osteoblast and the osteoclast resulting in bone resorption. However, the great majority of controlled implants display a foreign body equilibrium resulting in very high survival rates of the implants over long term of follow-up.
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| 47. |
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| 48. |
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| 49. |
- Albrektsson, Tomas, 1945, et al.
(författare)
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State of the art in oral implants.
- 1991
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Ingår i: Journal of clinical periodontology. - : Wiley. - 0303-6979 .- 1600-051X. ; 18:6, s. 474-81
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Forskningsöversikt (refereegranskat)abstract
- Uncontrolled oral implant devices are still being widely used. The documentation of most oral implant systems is poorly backed up or not followed up for an adequate time period. Success rates are being quoted without reference to any defined success criteria. Frequently used oral implant designs such as the Core-Vent, IMZ and Calcitek hydroxyapatite coated implants are in neither case supported by any adequate clinical reports from minimally 5-years of follow-up. Other implant systems such as the ITI, some subperiosteal designs and the Tübingen implant demonstrate well-controlled and acceptable 5-year data but are not followed up in a sufficient number or have demonstrated less good results in the 10-year evaluation. The Small transosteal staple has been adequately reported for more than 10 years of follow-up, whereas the Brånemark implant is the only endosseous design that has demonstrated acceptable 15-year success rates.
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| 50. |
- Albrektsson, Tomas, 1945, et al.
(författare)
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State of the art of oral implants
- 2008
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Ingår i: Peridontology 2000. - : Wiley. - 1600-0757 .- 0906-6713. ; 47:1, s. 15-26
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Tidskriftsartikel (refereegranskat)
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