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Sökning: WFRF:(Lekholm Ulf)

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1.
  • Albrektsson, Tomas, 1945, et al. (författare)
  • Histologic investigations on 33 retrieved Nobelpharma implants.
  • 1993
  • Ingår i: Clinical materials. - 0267-6605. ; 12:1, s. 1-9
  • 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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3.
  • Becker, W, et al. (författare)
  • Five-year evaluation of implants placed at extraction and with dehiscences and fenestration defects augmented with ePTFE membranes: results from a prospective multicenter study.
  • 1999
  • Ingår i: Clinical implant dentistry and related research. - 1523-0899. ; 1:1, s. 27-32
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Barrier membranes have been used to promote bone ingrowth on implants with dehiscences and fenestrations. Membranes also have been used to protect defects adjacent to implants placed at the time of extraction. The concept of guided bone regeneration relates to preferentially allowing cells from bone to migrate into various defects while excluding fibrous tissue and epithelium. The purpose of these procedures is to enhance bone-to-implant contact at the treated sites and to prevent mucosal complications. PURPOSE: The purpose of this article is to report clinical outcomes for implants placed at the time of extraction and augmented with expanded polytetrafluoroethylene (ePTFE) and followed for 5 years. The outcomes for implants with dehiscences and fenestrations augmented with ePTFE barriers and followed up to 5 years also are reported. METHODS AND MATERIALS: Four treatment centers participated in this study (Tucson, Gothenburg, Spokane, and Leuven). In the extraction group, teeth were removed for varying reasons, and Br?nemark implants were placed and stabilized within the host bone. Defects present at the coronal implant aspect were covered with ePTFE barrier membranes. Flaps were rotated to cover the membrane-treated sites. If exposure of the material occurred prior to second-stage surgery, the membranes were removed. Barriers remaining unexposed were removed at second-stage surgery. The implants were followed up to 5 years. In the fenestration and dehiscence group, implants with exposed threads were augmented with ePTFE barrier membranes. The barriers were removed at appropriate intervals, and the patients were followed up to 5 years. Radiographic measurements were made from nonstandardized periapical radiographs at abutment connection and 1, 3, and 5-year follow-up visits. RESULTS: Forty patients participated in the extraction group. They received a total of 49 implants. Three implants failed prior to loading. The 5-year cumulative survival rates for implants placed at the time of extraction were 93.9% and 93.8%, respectively, for maxillary and mandibular implants. The average maxillary mesial and distal marginal bone loss (1-5 yr) was 0.3 mm (standard deviation [SD] = 1.5) and 0.3 mm (SD = 1.0). In mandibles, the average mesial and distal bone loss (1-5 yr) was -0.2 mm (SD = 0.5) and -0.05 mm (SD = 0.6), respectively. The dehiscence and fenestration group included 44 patients. Twenty-six were followed for up to 5 years. Eight patients experienced total implant failure. For dehiscences and fenestrations, the cumulative survival rates were 76.8% and 83.8% for maxillary and mandibular implants, respectively. The average maxillary mesial and distal bone loss (1-5 yr) was 0.4 mm (SD = 0.8) and 0.2 mm (SD = 0.9), respectively. In mandibles, the average mesial and distal marginal bone loss was 0.3 mm (SD = 0.9) and 0.3 mm (SD = 0.8), respectively. CONCLUSIONS: Implants placed at the time of extraction and augmented with ePTFE barrier membranes have favorable long-term predictability. On the other hand, long-term evaluation of implant dehiscences and fenestrations augmented with barrier membranes indicates that they have less favorable 5-year survival rates. Membrane augmentation of these may be questioned.
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4.
  • Berglundh, Tord, 1954, et al. (författare)
  • Histopathological observations of human periimplantitis lesions.
  • 2004
  • Ingår i: Journal of clinical periodontology. - 0303-6979. ; 31:5, s. 341-7
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: The aim of the present study was to analyze some characteristics of advanced and progressive periimplantitis lesions in man. MATERIAL AND METHODS: Soft tissue biopsies were obtained from 12 implants in six patients. The implants had been in function between 4 and 21 years and were, with one exception, located in the maxilla. The radiographic examination performed prior to biopsy revealed that all sites exhibited advanced bone loss. Further, clinical signs of severe inflammation, such as suppuration, swelling and/or fistula formation were detected in the majority of sites and seven of the 12 implants were found to be mobile at biopsy. Each biopsy was following fixation embedded in epoxy resin and sections were prepared for histometric and morphometric analysis. RESULTS AND CONCLUSION: It was demonstrated (i). that all soft tissue units harbored large inflammatory cell infiltrates (ICT) that extended to a position apical of a pocket epithelium and (ii). that about 60% of the lesions were occupied by inflammatory cells, among which plasma cells dominated. Numerous amounts of PMN cells occurred not only in the pocket epithelium and adjacent connective tissue areas, but were also present in peri-vascular compartments in more central areas of the ICT.
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5.
  • Cardaropoli, Giuseppe, 1968, et al. (författare)
  • Peri-implant bone alterations in relation to inter-unit distances. A 3-year retrospective study.
  • 2003
  • Ingår i: Clinical oral implants research. - 0905-7161. ; 14:4, s. 430-6
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of the present retrospective study was to evaluate longitudinal alterations in radiographic bone topography at proximal sites of three-unit implant-supported fixed partial prostheses during the first 3 years after bridge installation, in relation to vertical and horizontal inter-unit distances. The subjects were partially dentate patients who had received implant-supported fixed partial prostheses during the year 1995 at the Brånemark Clinic, Göteborg, Sweden. For inclusion in the study, the patient had to have a three-unit bridge construction supported by three implants in the posterior area of the jaw. Twenty-eight patients having 35 screw-retained prostheses on Brånemark standard implants fulfilled the inclusion criteria. Radiographs obtained at bridge installation and at 1- and 3-year follow-ups were assessed for implant positions, contact point level, bone level at implants and adjacent tooth and mid-proximal bone crest level. The data were analysed with respect to two proximal units: tooth/implant units (n=35) and implant/implant units (n=70). Multiple regression analyses were used to evaluate the influence of various factors on the peri-implant and periodontal bone level changes during the 3 years of follow-up. At the tooth/implant units, the mean bone loss over the 3 years was 0.5 mm at the implant and 0.4 mm at the tooth. Multiple regression analysis failed to identify significant explanatory factors for the peri-implant/periodontal bone level changes at the tooth/implant units (R2=0.28). At the implant/implant units, the peri-implant bone loss was 0.6-0.7 mm and was significantly influenced by the vertical inter-implant distance (P<0.01), the difference in bone level at baseline between two neighbouring implants (P<0.001) and the bone level changes at the opposed implant surface (P<0.001) (R2=0.49). Furthermore, the magnitude of apical displacement of the inter-implant bone crest level during the 3 years of follow-up was negatively associated with the horizontal inter-implant distance (P<0.05). The results of the study demonstrated that both vertical and horizontal differences in implant positions might influence bone alterations in the inter-implant area during the first 3 years of loading, while the data failed to show corresponding relationships for the bone changes at the proximal area between the implant and the neighbouring tooth.
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6.
  • Cardaropoli, Giuseppe, 1968, et al. (författare)
  • Tissue alterations at implant-supported single-tooth replacements: a 1-year prospective clinical study.
  • 2006
  • Ingår i: Clinical oral implants research. - : Wiley. - 0905-7161 .- 1600-0501. ; 17:2, s. 165-71
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: The aim of this prospective study was to evaluate dimensional alterations of the peri-implant tissues at single-tooth restorations from the time of implant placement to 1-year post-loading. MATERIAL AND METHODS: Eleven patients, aged 18-36 years, subjected to single-tooth replacements with implant-supported restorations (Brånemark implant system) in the maxillary anterior region were included in the analysis. The implant installation was performed as a two-stage procedure with a 6-month healing interval. Bone dimensions were determined by direct assessments immediately following implant placement and at abutment connection. The prosthetic restoration was placed approximately 1 month after abutment surgery. Radiographic and clinical examinations were performed at crown placement and at 1-year post-loading. Assessments of the soft tissues at the implant site and at the neighboring teeth were performed before and during implant placement, before abutment connection, after crown placement and at the 1-year follow-up examination. Mean values and standard deviations were calculated for each variable and interval, with the subject as the statistical unit. RESULTS: At the time of abutment connection, a mean loss of bone height at the facial and lingual aspect of the implant amounting to 0.7-1.3 mm (P < 0.05) was recorded, whereas no significant change was noted at proximal sites. A mean reduction of 0.4 mm of the labial bone thickness was observed between implant placement and the second-stage surgery. The radiographic bone-to-implant level showed a mean loss of 0.9 mm between abutment connection and crown placement (P<0.05) and a further 0.7 mm loss at 1 year (P < 0.05). The thickness of the labial mucosa was increased at crown placement followed by a slight remission at 1 year. During the corresponding interval, a mean apical displacement of the labial soft tissue margin of 0.6 mm had taken place (P < 0.05). A papilla fill of > or = 50% was observed at a frequency of 32% at crown placement and 86% at 1 year. CONCLUSIONS: The results demonstrated that following implant surgery remodeling takes place, which is manifested in diminished bone dimensions, both horizontally and vertically, at the facial aspect of the implant. The observed soft tissue alterations after the crown placement may affect the esthetic appeal of the restorative therapy.
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7.
  • Dahlin, Christer, 1959, et al. (författare)
  • Generation of new bone around titanium implants using a membrane technique: an experimental study in rabbits.
  • 1989
  • Ingår i: The International journal of oral & maxillofacial implants. - 0882-2786. ; 4:1, s. 19-25
  • Tidskriftsartikel (refereegranskat)abstract
    • Insufficient bone volume may be a significant problem in connection with dental implants. In this study, a technique based on the principle of guided tissue regeneration was tested for its ability to generate bone tissue around titanium implants. Implants were inserted in tibiae of rabbits. To create a secluded space for osteogenesis and to prevent soft-tissue ingrowth, a porous Teflon membrane was placed around exposed parts of the implant. Where a membrane had been used, the threads of the implant were completely covered with significant amounts of new bone. This study indicates that the membrane technique is a reconstructive surgical method that may be applicable to create new bone around exposed parts of titanium implants in a clinical setting.
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8.
  • Esposito, Marco, 1965, et al. (författare)
  • Immunohistochemistry of soft tissues surrounding late failures of Brånemark implants.
  • 1997
  • Ingår i: Clinical oral implants research. - 0905-7161. ; 8:5, s. 352-66
  • Tidskriftsartikel (refereegranskat)abstract
    • The objective of the present investigation was to characterize the cellular composition of the soft tissues surrounding consecutively retrieved late failures of Brånemark implants. Criteria for implant failure were signs of loss of osseointegration (radiographic peri-fixtural radiolucency and mobility). The clinical history of the implants did not include adverse symptoms. At the time of retrieval, percussion-induced pain was experienced at 4/8 implants, but no macroscopical signs of inflammation or infection or infection was observed. Immunohistochemistry was applied on 6 marginal peri-implant specimens and on specimens of deeper tissues associated with the previously load-bearing implant surface from 8 failed implants, whereas 6 clinically healthy mucosal specimens and 4 hyperplastic biopsies from stable implants served as controls. The immunohistochemical evaluation showed that the soft tissues surrounding failed implants contained a large number of macrophages (CD68), HLA-DR positive cells, lymphocytes and plasma cells preferentially accumulated towards the removed implant surface. PMNs were a rare finding. Downgrowth of epithelium, in some cases encapsulating the whole fixture, was observed in sections where an intact implant/soft tissue interface was preserved. Healthy control mucosal specimens always contained labelled cells, albeit in a low amount, whereas hyperplastic control samples displayed an intense inflammatory and immunological response with numerous positive cells and PMNs scattered throughout the biopsy. In conclusion, failed implants were characterized by a chronic inflammatory response of the surrounding tissues with macrophages as the predominant labelled cell type, while hyperplastic tissues around stable implants were distinguished by an acute inflammatory process. These findings suggest that an on-going infection is unlikely to be the etiological factor for the late failures of dental implants examined in this study.
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9.
  • Fransson, Christer, 1956, et al. (författare)
  • Prevalence of subjects with progressive bone loss at implants.
  • 2005
  • Ingår i: Clinical oral implants research. - : Wiley. - 0905-7161. ; 16:4, s. 440-6
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: The aim of the present study was to assess the prevalence of subjects with progressive bone loss at implants with a function time of at least 5 years. MATERIAL AND METHODS: Radiographs of 1346 patients who had attended annual follow-up visits at the Brånemark Clinic, Public Dental Services, Gothenburg, Sweden were retrieved. Six hundred and sixty-two subjects fulfilled the inclusion criteria. Thus, they all had been provided with implant-supported (Brånemark System) Nobel BioCare, Gothenburg, Sweden) fixed partial or complete dentures or single-tooth replacements with a documented function time in radiographs of at least 5 years. Implants that demonstrated progressive bone loss to a level of > or =3 threads of an implant were detected. The number of subjects who exhibited one or more implants with progressive bone loss to the threshold level was recorded. RESULTS: Twenty-eight percent of 662 included subjects had one or more implants with progressive bone loss. A logistic regression analysis revealed that the individuals in this group carried a significantly larger number of implants than the subjects in whom no implants with progressive loss were detected (6 vs. 4.8). Furthermore, >30% of the subjects in the group with progressive bone loss had > or =3 identified implants and that about 33% of all such implants in this group exhibited extensive bone loss. Out of the total 3413 implants included in the study, 423 implants (12.4%) demonstrated progressive bone loss. CONCLUSION: It is suggested that the prevalence of progressive bone loss at implants assessed from subject-based data is higher than that evaluated from implant-based data.
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10.
  • Friberg, Bertil, 1950, et al. (författare)
  • A comparison between cutting torque and resonance frequency measurements of maxillary implants. A 20-month clinical study.
  • 1999
  • Ingår i: International journal of oral and maxillofacial surgery. - 0901-5027. ; 28:4, s. 297-303
  • Tidskriftsartikel (refereegranskat)abstract
    • Oral implant treatment ad modum Brånemark was undertaken in nine patients with edentulous maxillae. Cutting torque measurements and resonance frequency analyses (RFA) were conducted at implant placement and the corresponding values were subjected to correlation analyses. The implants were also evaluated with RFA at abutment connection and at one-year follow-up in order to identify possible changes in implant stability. A total of 61 implants were inserted, of which 49 were of the Mk II self-tapping type. Two implants were lost during the study period. The cumulative torque was presented as a mean value for the upper/crestal, the middle and the lower/apical third of the implant site respectively, as well as an overall value for the whole site. The highest correlation (r = 0.84, P<0.05) was found when comparing the mean torque values of the upper/crestal portion with the resonance frequency values at implant placement. The Mk II implant sites were divided into three groups based on the values of the cutting torque, i.e. soft (group 1), medium (group 2) and dense bone (group 3). The mean value of each group was plotted against the corresponding mean value of resonance frequency measured at implant insertion. Statistical analysis showed significant differences in resonance frequency at implant insertion between groups 1 and 2 (P = 0.047) and between groups 1 and 3 (P = 0.002). When repeating the resonance frequency analyses at second stage surgery and at one-year follow-up, no significant differences were detected between any of the groups. It was shown that the stability of implants placed in softer bone seemed to "catch up" over time with more dense bone sites.
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11.
  • Friberg, Bertil, 1950, et al. (författare)
  • A new self-tapping Brånemark implant: clinical and radiographic evaluation.
  • 1992
  • Ingår i: The International journal of oral & maxillofacial implants. - 0882-2786. ; 7:1, s. 80-5
  • Tidskriftsartikel (refereegranskat)abstract
    • A new self-tapping Brånemark implant designed for denser bone qualities was evaluated with regard to insertion technique, complications, marginal bone remodeling, and survival rate. Thirty patients, representing 21 mandibles and 9 maxillae, participated in the study. In each patient both standard and self-tapping implants were placed, and a total of 179 implants, 88 self-tapping and 91 standard, were inserted. Thirteen of 62 mandibular self-tapping implants reached their correct positions only after using the screw tap or the cylinder wrench for manual insertion. No such problems were noted when using standard fixtures after bone pre-tapping. In the maxillae, neither of the two implant designs presented any problems. One standard and one self-tapping fixture failed to osseointegrate. Radiolucencies were seen in the bone around the apical portion of two fixtures, one of each design. The mean marginal bone resorption after 1 year of follow-up was 0.5 to 0.6 mm for the two fixture types.
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12.
  • Friberg, Bertil, 1950, et al. (författare)
  • Early failures in 4,641 consecutively placed Brånemark dental implants: a study from stage 1 surgery to the connection of completed prostheses.
  • 1991
  • Ingår i: The International journal of oral & maxillofacial implants. - 0882-2786. ; 6:2, s. 142-6
  • Tidskriftsartikel (refereegranskat)abstract
    • This study comprised 4,641 Brånemark dental implants, which were retrospectively followed from stage 1 surgery to completion of the prosthetic restorations. The implants were placed during a 3-year period (1986 to 1988) in 943 jaws, representing 889 patients with complete and partial edentulism. The jaw and sex distribution revealed a predominance of mandibles (564/943) and females (534/943). The mean age of the patients was 57.5 years (range 13 to 88 years) at implant placement. Only 69 (1.5%) fixtures failed to integrate, and most losses were seen in completely edentulous maxillae (46/69), in which the jaw bone exhibited soft quality and severe resorption. A preponderance of failures could also be seen among the shortest fixtures (7 mm). A majority of the mobile implants were recorded at the abutment connection (stage 2) operation (48/69).
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13.
  • Friberg, Bertil, 1950, et al. (författare)
  • Evaluation of bone density using cutting resistance measurements and microradiography: an in vitro study in pig ribs.
  • 1995
  • Ingår i: Clinical oral implants research. - 0905-7161. ; 6:3, s. 164-71
  • Tidskriftsartikel (refereegranskat)abstract
    • A method using cutting resistance measurements during low-speed threading for identification of various bone densities has been evaluated with regard to its precision and potential. Pig ribs were used as test samples. Differing hand pressure, minor deviation (5 degrees) from a vertical tapping direction and individual threading did not reveal any significant differences in cutting resistance values. After implants were inserted into the threaded canals, the total bone as well as trabecular and compact bone areas surrounding the implants were calculated via a computer program and using microradiographs of the bone test samples. The outcome of the cutting resistance measurements was compared with that of the microradiographic technique, and good agreement was observed between the two procedures in the ability to identify bone density. Therefore, cutting resistance measurements may in the future also be used to clinically identify bone qualities in jaws.
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14.
  • Friberg, Bertil, 1950, et al. (författare)
  • Identification of bone quality in conjunction with insertion of titanium implants. A pilot study in jaw autopsy specimens.
  • 1995
  • Ingår i: Clinical oral implants research. - 0905-7161. ; 6:4, s. 213-9
  • Tidskriftsartikel (refereegranskat)abstract
    • Ten autopsy jaw specimens (6 mandibles, 4 maxillae) were used for cutting resistance measurements during low-speed threading. Overall, 31 sites were analyzed where implants were inserted into threaded canals. Bone area measurements were performed around the implants as described previously. The cutting resistance values together with the total bone area values were found to be higher in mandibles than in maxillae, and a tendency towards higher values was seen in incisor regions compared with premolar regions. Furthermore, an intraindividual comparison between the true cutting resistance and the bone density values of prepared sites showed a statistically significant correlation. The method with cutting resistance measurements for evaluation of bone quality seems therefore to be reliable, at least when used in human autopsy jaw bone specimens.
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15.
  • Friberg, Bertil, 1950, et al. (författare)
  • Inferior alveolar nerve transposition in combination with Brånemark implant treatment.
  • 1992
  • Ingår i: The International journal of periodontics & restorative dentistry. - 0198-7569. ; 12:6, s. 440-9
  • Tidskriftsartikel (refereegranskat)abstract
    • The surgical protocol for inferior alveolar nerve transposition together with the Brånemark implant treatment is described. The short-term follow-up results of the first ten procedures are presented and show an initial 2- to 3-week duration of anesthesia. In all regions treated, signs of paresthesia/hypoesthesia have been registered for 1 to 7 months. After 6 months, seven of the regions recovered completely with regard to nerve sensation.
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16.
  • Friberg, Bertil, 1950, et al. (författare)
  • Long-term follow-up of severely atrophic edentulous mandibles reconstructed with short Brånemark implants.
  • 2000
  • Ingår i: Clinical implant dentistry and related research. - 1523-0899. ; 2:4, s. 184-9
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Oral implant treatment (Brånemark System) of edentulous mandibles has been presented in numerous studies. However, with regard to the severely atrophic lower jaw, no long-term follow-up studies with solely short implants are available. PURPOSE: The purpose of the present investigation was to retrospectively follow the long-term treatment outcome of patients with severely resorbed edentulous mandibles being subjected to oral implant placement with short (6-7 mm) Brånemark implants. MATERIALS AND METHODS: A total of 247 standard (7 mm long, Ø 3.75 mm) and 13 wide (6 mm long, Ø 5 mm) implants were inserted in 49 patients, all of whom exhibited severe resorption of edentate mandibles. Fixed implant-supported prostheses were manufactured for 45 patients, whereas 4 patients received overdentures. The patients were followed for a mean period of 8 years (range, 1-14 yr). RESULTS: Seventeen implants failed during the study period (cumulative implant survival rate 95.5% at 5-yr and 92.3% at 10-yr follow-up). Implant-supported constructions were worn continuously throughout the investigation by all study subjects. Marginal bone loss, measured after 1, 5, and 10 years of function, concurred with studies of Brånemark implants placed in more voluminous mandibles. No major clinical or construction complications occurred in the followed patients. CONCLUSIONS: The outcome of the present study showed that placement of short Brånemark implants without the use of bone grafting procedures for reconstruction of severely atrophic edentulous mandibles is a highly predictable treatment procedure.
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17.
  • Friberg, Bertil, 1950, et al. (författare)
  • On cutting torque measurements during implant placement: a 3-year clinical prospective study.
  • 1999
  • Ingår i: Clinical implant dentistry and related research. - 1523-0899. ; 1:2, s. 75-83
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Evaluation of jaw bone quality at implant placement is mainly based on preoperative radiographic assessments and subjective hand registrations during implant site preparation. An objective technique with cutting torque measurements has been introduced, presenting an objective bone quality or bone hardness value of individual implant sites. PURPOSE: The purpose of this study was to evaluate cutting torque measurements during implant placement and to compare these values in different regions in mandibles and maxillae. The objective was to identify implants at risk for failing at implant placement. MATERIAL AND METHODS: Cutting torque measurements were performed during placement of Mk II self-tapping implants (Brånemark System) in 105 patients, comprising 72 edentulous (40 maxillae) and 34 partially edentulous (22 maxillae) jaws. A total of 523 implants were inserted, of which 420 were of the Mk II design and of which 412 were subjected to cutting torque measurements. Statistical analyses were performed by comparing cutting torque values of maxillae and mandibles and of different jaw regions. Cutting torque values were also correlated with radiographically and clinically assessed bone quality scores. Patients were followed clinically for a minimum of 3 years. RESULTS: A statistically significant difference in cutting torque values of maxillae and mandibles was seen, although not when comparing anterior and posterior regions within the same jaws or of different jaws. Significant correlations were found between values of cutting torque and bone quality. The majority of failures were seen in bone of medium to high density, whereas implants inserted in bone of poor density presented a better outcome, perhaps due to an adapted surgical protocol and an extended healing period. The overall implant survival rate at 3 years was 95%, and when analyzing different jaw categories, survival rates of 92.0% and 99.4% were seen for edentulous maxillae and mandibles, respectively. The corresponding figures for partially edentulous jaws were 95.4% and 97.6%. CONCLUSION: It was not possible to identify sites at risk for future implant losses or to determine a lower limit value of cutting torque in order to achieve successful implant integration.
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18.
  • Friberg, Bertil, 1950, et al. (författare)
  • Stability measurements of one-stage Brånemark implants during healing in mandibles. A clinical resonance frequency analysis study.
  • 1999
  • Ingår i: International journal of oral and maxillofacial surgery. - 0901-5027. ; 28:4, s. 266-72
  • Tidskriftsartikel (refereegranskat)abstract
    • Using a one-stage surgical protocol, 75 implants ad modum Brånemark of three different designs were inserted in 15 edentulous mandibles of high bone density. All implants were followed with repeated stability measurements by means of resonance frequency analysis (RFA) from implant placement to connection of the fixed prostheses (3-4 months), in order to evaluate possible stability changes during healing. It was shown that the resonance frequency (RF) values slightly decreased for the majority of the implants during the study period independent of design. Consequently, the results of the present study indicated that the implants were as stable at time of placement as when measured at 3-4 months post-surgery, i.e. when the prostheses were attached. The available data support the concept of direct loading of implants when inserted between the mental interforaminal regions. One implant failed during healing and the corresponding RF measurement disclosed, at six weeks post-surgery, a value being far below the one registered at implant placement. The lowered RF value indicated the failure several weeks before the mobility was clinically diagnosed. The presence or absence of a fixture/abutment junction did not exert any influence on the marginal bone level, as determined radiographically at the end of the short investigation period.
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19.
  • Gualini, Federico, et al. (författare)
  • Outcome of Brånemark Novum(R) Implant Treatment in Edentulous Mandibles: A Retrospective 5-Year Follow-Up Study.
  • 2009
  • Ingår i: Clinical implant dentistry and related research. - : Wiley. - 1708-8208 .- 1523-0899. ; 11:4, s. 330-337
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: A gradual progression from a two-stage surgical technique to a one-stage and even immediate surgical protocol has occurred during the last decade with most oral implant systems. However, every new approach must obviously be reported individually, with long-term results, in order to assess whether the changes have any real patient value. Purpose: The aim of the present report was to retrospectively review the 5-year outcome of patients treated with the Br?nemark Novum(R) (Nobel Biocare AB, G?teborg, Sweden) protocol. Methods: The first 15 patients treated according to the Novum procedure in a private specialist clinic in Lovere, Italy, were followed-up with clinical, radiographic, and resonance frequency analyses. All the patients' fixed constructions had been in function for an average of 5 years. Parameters recorded were implant survival, prosthesis success, oral hygiene and mucosal health, marginal bone remodeling, type and frequency of complications, and patient's opinion of the treatment outcome. Results: After 5 years, the cumulative survival rate for implants was 91%, and for inserted bridge constructions it was 87%. Very small changes in implant stability occurred during implant loading from 1 to 5 years. Oral health conditions were good; 87% of mucosal quadrants around the implants were free from signs of inflammation. Very small marginal bone height changes were observed at the implants during the examination period, and except for four implant losses reported, severe complications were few. All patients were satisfied with the functional outcome of their constructions, but two patients were not completely happy with the aesthetics of their bridgework as supplied. Conclusion: This report shows 5-year evidence of acceptably good results with the Br?nemark Novum implant technique in edentulous mandibles, when using only three implants to support the fixed bridge construction, and as long as inserted implants become and remain osseointegrated.
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20.
  • Herrmann, Irene, 1950, et al. (författare)
  • A study on variances in multivariate analyses of oral implant outcome.
  • 2007
  • Ingår i: Clinical implant dentistry and related research. - : Wiley. - 1523-0899 .- 1708-8208. ; 9:1, s. 6-14
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Elaborate studies have shown that interdependency exists between implants being placed in the same patient/jaw. Therefore, interdependency ought to be an important aspect to address, whenever performing statistical analyses of oral implant outcomes. A Jackknife method could be an option when conducting statistical evaluations of oral implant failure prognoses. PURPOSE: The aim of this study was to evaluate whether a statistical difference can be detected by using the Jackknife method in conjunction with life table analyses and/or a log rank test of four different combinations of jaw density and quantity. MATERIALS AND METHODS: Four multicenter studies were pooled and adjusted in order to create a research database consisting of 486 patients and 1,737 implants in preparation for the Jackknife resampling method. Combinations of jaw shapes and bone qualities were constructed to select at-risk patients. STATISTICAL METHODS: Life tables with confidence intervals were calculated and a log rank test was used to determine whether a statistical difference between the combinations could be established. RESULTS: Both statistical analyses, after the Jackknife resampling method, showed that patients with poor bone quality and resorbed jaws (combination IV) had a statistically higher risk of implant failure. CONCLUSION: By rearranging data using the Jackknife method, standardized statistical tests seem to work well even when the study population tested was affected by interdependency.
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21.
  • Herrmann, Irene, 1950, et al. (författare)
  • Evaluation of patient and implant characteristics as potential prognostic factors for oral implant failures.
  • 2005
  • Ingår i: The International journal of oral & maxillofacial implants. - 0882-2786. ; 20:2, s. 220-30
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: The purpose of this study was to evaluate patient, implant, and treatment characteristics to identify possible prognostic factors for implant failure. MATERIALS AND METHODS: Out of a database with different dental implant treatment protocols, a research database of 1 randomly selected implant per patient was created. The database consisted of 487 implants. Of these, 80 were withdrawn, 36 failed, and 371 remained successful during a 5-year follow-up period. Potential risk factors were evaluated by chi-square tests and post hoc analyses. RESULTS: Significant or strongly significant differences were found regarding implant failures as a result of jawbone quality, jaw shape, implant length, treatment protocol, and combinations of jawbone-related characteristics. Responsible clinics and number of implants supporting the restoration were factors that could not be associated with implant failure. DISCUSSION: Implant failures in this study were more often seen when negative patient-related factors were present. Approximately 65% of the patients with a combination of the 2 most negative bone-related factors (jawbone quality 4 and jaw shape D or E) experienced implant failure. However, only 3% of the patients had this combination. Implant length, the only implant-related factor evaluated, was also significantly correlated with the success rate, but implant length could also be regarded as a result of the jawbone volume available. Another negative patient-related factor was the treatment protocol; however, in most cases this was also indirectly or partly related to the status of the jawbone available for implant placement. CONCLUSION: Patient selection appears to be of importance for increasing implant success rates.
  •  
22.
  • Hultin, M., et al. (författare)
  • Oral Rehabilitation of Tooth Loss: A Systematic Review of Quantitative Studies of OHRQoL
  • 2012
  • Ingår i: International Journal of Prosthodontics. - : Quintessence. - 0893-2174 .- 1139-9791. ; 25:6, s. 543-552
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: This study aimed to review published quantitative studies for evidence regarding the influence of oral rehabilitation following total or partial tooth loss on self-perceived oral health-related quality of life (OHRQoL). Materials and Methods: Three databases were searched using specified indexing terms. The reference lists of relevant publications were also searched manually. Quality of evidence was classified according to GRADE guidelines as high, moderate, low, or very low. Results: The search yielded 2,138 titles and abstracts, 2,102 of which were of a quantitative study design. Based on pre-established criteria, the full-text versions of 322 articles were obtained. After data extraction and interpretation, 5 publications of high or moderate study quality remained. The results of these 5 studies showed positive effects of oral rehabilitation on OHRQoL. Two studies showed substantial improvements. Conclusions: This is a relatively new field of research; there are very few quantitative studies of how patients perceive OHRQoL following tooth loss and subsequent rehabilitation. While this review indicates that treatment has positive effects on quality of life, the scientific basis is insufficient to support general conclusions about the influence of various interventions on the OHRQoL of patients who have experienced total or partial tooth loss. To achieve a more comprehensive analysis, it is recommended that future studies be based on a combination of quantitative and qualitative methods, ie, questionnaires and semi-structured interviews. The follow-up period must also be appropriate for the specific intervention studied.
  •  
23.
  • Ivanoff, Carl-Johan, et al. (författare)
  • Influence of implant diameters on the integration of screw implants. An experimental study in rabbits.
  • 1997
  • Ingår i: International journal of oral and maxillofacial surgery. - : Elsevier BV. - 0901-5027. ; 26:2, s. 141-8
  • Tidskriftsartikel (refereegranskat)abstract
    • The influence of diameter on the integration of titanium screw-shaped implants was studied in the rabbit tibia by means of removal torque measurements and histomorphometry. Implants 3.0, 3.75, 5.0, and 6.0 mm in diameter and 6.0 mm long were inserted through one cortical layer in the tibial metaphyses of nine rabbits and allowed to heal for 12 weeks. The implants were then unscrewed with a torque gauge, and the peak torque required to shear off the implants was recorded. The histologic analysis in undemineralized ground sections comprised (1) a gross description of the implant sites and assessments of (2) the total implant length in bone and (3) in the cortical passage, as well as (4) the thickness of the cortical bone adjacent to the implants. From the removal torque values obtained and morphometric measurements, a mean shear stress value was calculated for each implant type. The biomechanical tests showed a statistically significant increase of removal torque with increasing implant diameter. The resistance to shear seemed to be determined by the implant surface in supportive cortical bone, whereas the newly formed bone at the periosteal and endosteal surfaces did not seem to have any supportive properties after 12 weeks. It is suggested that wide diameter implants may be used clinically to increase implant stability.
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24.
  • Ivanoff, Carl-Johan, et al. (författare)
  • Influence of initial implant mobility on the integration of titanium implants. An experimental study in rabbits.
  • 1996
  • Ingår i: Clinical oral implants research. - 0905-7161. ; 7:2, s. 120-7
  • Tidskriftsartikel (refereegranskat)abstract
    • In the present study, the influence of initial instability on the healing of titanium implants was studied in 9 lop-eared rabbits. Titanium implants (Brånemark System) were inserted in the tibiae, a location with cortical bone only, in such a way that they were either stable (control), rotation-mobile, or totally mobile. Implants were also inserted in the distal femoral condyles, representing an implantation bed with mainly cancellous bone, so they either showed no initial mobility (control) or were rotation-mobile. After 12 weeks of healing, the implants were retrieved, together with surrounding bone, fixed, dehydrated, and embedded in plastic resin. About 10 micron thick ground sections were prepared for light microscopic morphometry. The mineralized bone to titanium contact, and the amount of bone occupying the threads, were calculated, whereafter the outcome of the different locations were compared. All retrieved implants were clinically stable at the of the experiment. For the tibia sites, a statistically significant less bone to titanium contact, and a less amount of bone in the threads, were found for the totally mobile implants, as compared to the corresponding initially stable controls. Moreover, a statistically significant higher amount of bone was found in the threads of the rotation-mobile implants inserted in the femoral condyle as compared to their initially stable controls. The study indicated that initial rotation-mobility, independent if it occurs in cortical or trabecular bone, does not necessarily lead to an inferior integration of unloaded implants. However, initial total implant mobility within the cortical layer results in a statistically significant less amount of bone around the implants, as compared to stable controls.
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25.
  • Ivanoff, Carl-Johan, et al. (författare)
  • Influence of mono- and bicortical anchorage on the integration of titanium implants. A study in the rabbit tibia.
  • 1996
  • Ingår i: International journal of oral and maxillofacial surgery. - : Elsevier BV. - 0901-5027. ; 25:3, s. 229-35
  • Tidskriftsartikel (refereegranskat)abstract
    • The study aimed to evaluate the removal torque and bone tissue response to titanium implants supported by one or two cortical layers. A total of 72 screw titanium implants, either 10 or 16 mm in length and 3.75 mm in diameter, were inserted in right and left tibiae of 18 adult New Zealand rabbits. The implants engaged either one or two cortical layers, and the animals were allowed a healing period of 6 or 12 weeks. The degree of integration was assessed by measuring the removal torque with a torque gauge manometer. Histomorphometric calculations were also performed in 10-microns-thick ground sections. All implants were clinically stable at the end of the experiment. The removal torque was two times higher for the bicortical implants after 6 weeks, and three times higher after 12 weeks, than for the monocortical ones. The 16-mm implants also showed a statistically higher amount of bone contact and bone area after 6 and 12 weeks, respectively, than the short ones. The results support bicortical anchorage of implants also in the clinical situation.
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26.
  • Ivanoff, Carl-Johan, et al. (författare)
  • Influence of soft tissue contamination on the integration of titanium implants. An experimental study in rabbits.
  • 1996
  • Ingår i: Clinical oral implants research. - 0905-7161. ; 7:2, s. 128-32
  • Tidskriftsartikel (refereegranskat)abstract
    • In the present study, the influence of peroperative soft tissue contamination on the healing of titanium implants was studied in 9 lop-eared rabbits. Titanium implants (Brånemark System) were inserted in the tibiae, a location with cortical bone only, in such a way that one group was inserted the standard way (control), and another group was contaminated for 30 s in the adjacent soft tissues, prior to insertion. The implants were allowed to heal for 12 weeks and were then retrieved together with surrounding bone, fixed, dehydrated and embedded in plastic resin. About 10 micron thick ground sections were prepared for light microscopic morphometry. The mineralized bone-to-titanium contact, and the amount of bone occupying the threads, were calculated for each implant, and the results of the two groups were compared. All retrieved implants were clinically stable at the end of the experiment. Regarding bone-to-titanium contact and bone area within the threads, a statistically nonsignificant difference was observed between the 2 groups. This study indicated that peroperative soft tissue contamination of c.p. titanium implants does not prevent osseointegration from occurring, when studied in the rabbit tibia.
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27.
  • Ivanoff, Carl-Johan, et al. (författare)
  • Influence of variations in implant diameters: a 3- to 5-year retrospective clinical report.
  • 1999
  • Ingår i: The International journal of oral & maxillofacial implants. - 0882-2786. ; 14:2, s. 173-80
  • Tidskriftsartikel (refereegranskat)abstract
    • Sixty-seven patients ranging in age from 16 to 86 years were included in this 3- to 5-year retrospective report focusing on implant survival and marginal bone remodeling in relation to implant diameter. A total of 299 Brånemark implants (3.75-mm diameter: 141; 4.0-mm diameter: 61; 5.0-mm diameter: 97) were placed in 16 completely and 51 partially edentulous arches. Seven of the 141 implants in the 3.75-mm-diameter group failed (5%). The corresponding value for the 4.0-mm-wide implants was 2 of 61 (3%). The highest failure rate, 18% (17/97), was seen for the 5.0-mm-diameter implants. The least favorable cumulative survival rates were seen in mandibles after 5 years and involving 4.0-mm- and 5.0-mm-diameter implants (84.8% and 73.0%, respectively). The marginal bone loss was generally low over the 5-year period. When the data were evaluated by the Cox regression analysis, a relationship was found between implant failure and implant diameter (P < .05), with a higher failure rate for the 5.0-mm-diameter implant. However, no relationship could be seen between implant failure and jaw type, or bone quality and quantity (P > .05). Neither was any relationship seen between marginal bone loss and bone quality and quantity, implant diameter, or jaw type when tested by multiple linear regression analysis (P > .05). A learning curve, poor bone quality, and changed implant design were suggested as possible reasons for the less positive outcome seen for the 5.0-mm-diameter implant. The fact that this implant was often used as a rescue implant when the standard ones were not considered suitable or did not reach initial stability was another plausible explanation.
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28.
  • Ivanoff, Carl-Johan, et al. (författare)
  • Reintegration of mobilized titanium implants. An experimental study in rabbit tibia.
  • 1997
  • Ingår i: International journal of oral and maxillofacial surgery. - : Elsevier BV. - 0901-5027. ; 26:4, s. 310-5
  • Tidskriftsartikel (refereegranskat)abstract
    • The possibility of re-establishing a rigid bone-implant fixation, i.e. osseointegration, after mechanical loosening of titanium implants, was evaluated in the rabbit tibia. Implants were inserted to engage either one (10 mm long, n = 24) or two (16 mm long, n = 24) cortical layers and were allowed to heal for six weeks. A re-entry was then made and 12 test implants in each group subjected to a reverse torque procedure until the integration failed. The remaining nonrotated 24 implants were left as controls. Thereafter all implants were allowed to heal for an additional period of six weeks. At the end of the 12 weeks, the degree of integration was assessed by measuring the removal torque for six test and six control implants in each group of implant lengths. Histomorphometric measurements were also performed on ground sections of the remaining test and control implants. A statistically significant higher removal torque was observed for the monocortical test implants than for the corresponding control implants. No differences were seen for the bicortical implants of either kind, however, no morphological differences could be revealed either, when comparing monocortical and bicortical test and control implants. These results indicate that osseointegrated implants that have been mobilized due to a traumatic disruption of the bone-implant interface, may reintegrate if allowed to heal for an additional period of time.
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29.
  • Jemt, Torsten, 1950, et al. (författare)
  • Bone response to implant-supported frameworks with differing degrees of misfit preload: in vivo study in rabbits.
  • 2000
  • Ingår i: Clinical implant dentistry and related research. - 1523-0899. ; 2:3, s. 129-37
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: To study the bone response around implants placed in tibia of rabbits that supported misfitting superstructures secured with different degrees of preload. MATERIALS AND METHODS: Twelve rabbits were provided with two terminal 10-mm and one intermediate 7-mm-long implant in each tibia. After an integration time of about 9 weeks, nine of the animals received one control framework each (n = 9), designed with good fit to all three implants. In the other tibia of these animals, and in both tibias in the remaining three rabbits, test frameworks (n = 15) were connected with a vertical misfit of about 1 mm to the intermediate implant. The intermediate set screws were tightened with a torque ranging from 15 Ncm to 26 Ncm in the different test frameworks. The fascia and skin was then sutured back over the implants. After a loading period of 2 to 3 weeks, the animals were sacrificed, and histomorphometric measurements were made and correlated to the different levels of preload of the central implant. RESULTS: The mean bone-to-metal contact for the three best consecutive threads of the central implant was 40% for both test and control sites (p > .05). Compared to the other regions of the implant thread, less bone-to-metal contact was found at the tip of the test implant threads in the low preload group (p < .05). However, the same relation was not observed in the high preload group. A significant correlation was observed between increasing degree of preload in the central screw joint and increasing bone-to-metal contact, most obviously noticed at the tip of the implant thread (p < .01). CONCLUSIONS: Misfit stress levels of clinical magnitudes do not seem to jeopardize osseointegration per se. On the contrary, clinical levels of preload stress seem to significantly promote bone remodeling at the tip of the implant thread.
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30.
  • Jemt, Torsten, 1950, et al. (författare)
  • Failures and complications in 127 consecutively placed fixed partial prostheses supported by Brånemark implants: from prosthetic treatment to first annual checkup.
  • 1992
  • Ingår i: The International journal of oral & maxillofacial implants. - 0882-2786. ; 7:1, s. 40-4
  • Tidskriftsartikel (refereegranskat)abstract
    • Ninety-six partially edentulous maxillae and mandibles were consecutively treated with 127 freestanding fixed prostheses supported by 354 implants. The patients were followed for 1 year and the overall success rate was 98.6% for the examined implants. None of the inserted prostheses was lost during the observation period. The most commonly reported problems during the first year of function were related to loose gold screws and esthetic complaints, complications that were easily resolved. Furthermore, the total number of complications was low and was less than has been reported for routine full-arch fixed prostheses.
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31.
  • Jemt, Torsten, 1950, et al. (författare)
  • Implant treatment in edentulous maxillae: a 5-year follow-up report on patients with different degrees of jaw resorption.
  • 1995
  • Ingår i: The International journal of oral & maxillofacial implants. - 0882-2786. ; 10:3, s. 303-11
  • Tidskriftsartikel (refereegranskat)abstract
    • In a retrospective study, 150 patients with edentulous maxillae were selected for treatment with Brånemark implants. The patients were arranged into four different groups, based on jaw shape prior to implant placement. After second-stage surgery, they were provided with either fixed prostheses, removable overdentures followed by fixed prostheses after at least 1 year, or overdentures for the whole period. Patients were followed up for 5 years, with implant and prosthesis survival, annual visits, marginal bone loss, and complications recorded. Results of the study indicated that treatment outcome in edentulous maxillae might be predicted by careful presurgical evaluation of jaw shape. Five-year cumulative implant failure rates varied from 7.9% for patients considered to have enough bone to be provided with fixed prostheses immediately after second-stage surgery to 28.8% for those with severely resorbed jaws receiving an overdenture. The corresponding cumulative prosthesis failure rates were 3.0% and 18.9%, respectively. Patients provided with autogenous bone grafts compared favorably to the group presenting severely resorbed jaws and provided with overdentures, but showed a compromised result compared to the group with the least resorption. Failure of implant treatment correlated significantly with bone quality and ratio of 7-mm implants. All groups, except those treated with bone grafts, showed an average marginal bone level of 1.2 mm after 5 years, irrespective of type of prosthesis. The bone-grafted group showed a corresponding mean level of 2.3 mm after 5 years of function. Regarding clinical complications, a different pattern, mainly related to the type of prosthetic construction used, was observed between the groups. The number of visits clearly indicated that severely resorbed jaws provided with overdentures were the most demanding.
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32.
  • Jemt, Torsten, 1950, et al. (författare)
  • Measurements of bone and frame-work deformations induced by misfit of implant superstructures. A pilot study in rabbits.
  • 1998
  • Ingår i: Clinical oral implants research. - : Wiley. - 0905-7161. ; 9:4, s. 272-80
  • Tidskriftsartikel (refereegranskat)abstract
    • This in vivo study used a 3-D photogrammetric technique to measure distortion of 3 unit implant frame-works and bone surrounding osseointegrated implants after securing misfitting superstructures to the implants. Four adult loop-eared rabbits were provided with 3 implants each in the proximal part of 1 tibia each. After a healing period of 8 weeks, a titanium frame-work was connected with a misfit to the central implant. Three-dimensional photographs were taken before and after securing the central screw, which induced a calculated mean preload of 246 N. Measurements and comparisons of the topography of the frame-works and surrounding bone before and after tightening the central screw indicated a complex and inconsistent deformation pattern. Generally, it could be observed that the top edge of the central cylinder showed vertical movement towards the bone of about 150 microns, always in combination with a rotation of the entire super-structure. The head of the central implant seemed to show a corresponding displacement towards the frame-work of about 50 to 200 microns. Bone deformation was found to be basically localized between the implants, where compressions of about half a millimetre were observed. This concentration of bone deformation as a result of misfit may be one contributing factor to initial marginal bone loss, occasionally observed after insertion of implant supported prostheses.
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33.
  • Jemt, Torsten, 1950, et al. (författare)
  • Measurements of buccal tissue volumes at single-implant restorations after local bone grafting in maxillas: a 3-year clinical prospective study case series.
  • 2003
  • Ingår i: Clinical implant dentistry and related research. - 1523-0899. ; 5:2, s. 63-70
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: The purpose of this study was to measure changes in buccal and proximal tissue volumes after local bone grafting and single-implant treatment. MATERIALS AND METHODS: Ten patients were provided with buccal bone grafts 6 months prior to implant treatment in central upper incisor regions. Following a healing time of 6 months, abutments and single-implant crowns were installed and followed up for 2 years. Clinical photographs and impressions were taken prior to the surgical intervention as well as after crown placement and at first and second annual checkups. The photographs and study models were analyzed with regard to papilla regeneration and changes in buccal crest volume during the study period by means of a clinical papilla index and optical scanning of study models. RESULTS: All bone grafts healed without problems. A significant reduction of the buccal crest volume (-50%, p <.01) was observed in the grafted area before abutment connection. However, a significant increase of tissue volume (+100%, p <.05) was noticed at the subsequent crown placement, followed by a second but slow reduction of the volume during the following 2 years of function. The interdental papillae increased significantly (p <.05) in volume during the first year, almost completely filling up the embrasure areas after 2 years. CONCLUSIONS: It may be concluded that local bone grafting seems to be a valuable protocol to create sufficient bone volume for implant placement. However, significant resorption of the graft may be present, which reduces the impact of grafting on the esthetic outcome. Instead, placement of the abutment cylinder and the crown seems to play a more important role for reestablishing the tissue volume at the implant-supported single crowns.
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34.
  • Jemt, Torsten, 1950, et al. (författare)
  • Oral implant treatment in posterior partially edentulous jaws: a 5-year follow-up report.
  • 1993
  • Ingår i: The International journal of oral & maxillofacial implants. - 0882-2786. ; 8:6, s. 635-40
  • Tidskriftsartikel (refereegranskat)abstract
    • Sixty-seven partially edentulous patients with Applegate-Kennedy Class I or II situations were consecutively treated with freestanding implant-supported prostheses and followed up for 5 years. A total of 70 jaws were provided with 94 prostheses supported by 259 implants. During the report period, seven patients were lost to follow-up. Seven implants were found to be loose and were subsequently removed, which did not influence prosthesis stability. Thus, the overall cumulative survival rate was 97.2% and 100% for implants and prostheses, respectively. On average, 0.8 mm of marginal bone was lost around implants in maxillae, as compared to 0.6 mm in mandibles. The major clinical problem was related to fatigue fractures of the resin veneer material. Loose gold alloy screws were also observed.
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35.
  • Jemt, Torsten, 1950, et al. (författare)
  • Single implants and buccal bone grafts in the anterior maxilla: measurements of buccal crestal contours in a 6-year prospective clinical study.
  • 2005
  • Ingår i: Clinical implant dentistry and related research. - 1523-0899. ; 7:3, s. 127-135
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Patients provided with buccal bone grafts seem to lose a substantial part of the graft in the short term. PURPOSE: To measure long-term changes in buccal and proximal tissue volumes after local bone grafting and single implant treatment. MATERIALS AND METHODS: Eight of 10 originally treated male patients were followed up for 6 years after treatment with buccal bone grafts in the central incisor region. After a healing time of 6 months, a two-stage implant surgery procedure was performed followed by single crown placement. Clinical photographs and impressions were taken prior to the surgical interventions and after crown placement and at first and fifth annual checkups. The photographs were analyzed with regard to papilla regeneration by means of a clinical papilla index. The models were used to measure the clinical length of teeth and tooth movements adjacent to the implants. Changes in buccal crest volume during the study period were measured by means of optical scanning of obtained study models. RESULTS: Papillae volume increased significantly (p<.05) during the first year, thereafter showing a slow further increase during the 4 following years. Three of the patients (38%) presented small movements of their adjacent central incisor in a vertical or palatal direction of less than 1 mm during the follow-up period. All patients showed resorption during the first year after grafting (p<.01), in which three patients (38%) had lost basically all of increased volume at second surgery. After abutment or crown placement, all patients showed an increased volume (p<.01), followed by an average reduction during the first year, reaching a significant level in the apical part of the crest (p<.05). Thereafter, a relatively stable average situation was observed during the following 4 years, with individual variations, however. CONCLUSION: Local bone grafting seems to create sufficient bone volume for implant placement after 6 months, but individual variations in resorption pattern make the grafting procedure unpredictable for long-term prognosis. Instead, the abutment and the crown seem to play a more important role for building up and maintaining the buccal contour in the coronal part of the crest long term.
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36.
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37.
  • Lekholm, Ulf, 1944, et al. (författare)
  • Outcome of oral implant treatment in partially edentulous jaws followed 20 years in clinical function
  • 2006
  • Ingår i: Clin Implant Dent Relat Res. - : Wiley. - 1523-0899. ; 8:4, s. 178-186
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Most long-term follow-up studies of implants in partially edentulous jaws present their outcomes as mean values of implant survival and follow-up time, and few address the fate of the remaining teeth. PURPOSE: The aim of this study was to investigate the results of oral implant treatment in partially edentulous jaws after 20 years, and simultaneously to assess what happens to teeth present at the time of implant placement. MATERIALS AND METHODS: Seventeen partially edentulous patients, of 27 originally treated individuals, were retrospectively reviewed after receiving implants from 1983 to 1985. The parameters studied were implant survival, prosthesis stability, marginal bone loss at teeth and implants, treatment complications, need for dental treatment, and patient's satisfaction with the outcome. RESULTS: The cumulative survival rate was 91%, when all 27 patients were assessed, that is, including the 10 dropouts. Of the 69 inserted and followed implants (Brånemark system; Nobel Biocare AB, Göteborg, Sweden), six failed (8.7%) during the 20-year period, four during the first decade, and the remaining two during the second. A majority (n=4) of the losses were due to implant fractures, two after 8 years, and two after 17 years. In all, 10 of the original fixed bridges being followed (n=24) remained in function during the entire investigation period, whereas 12 were exchanged for new constructions after an average of 7 years. The mean marginal bone loss at teeth was 0.7 mm, and at implants it was 1.0 mm. The major complication observed during the second decade was veneer material fractures, which occurred 14 times in six patients. Component loosening and abutment- and bridge-locking screw fractures were the second most common problems seen, indicating material/component fatigue. Most patients were satisfied with their treatment and many mentioned that they did not think of the constructions as anything but a part of their own body. CONCLUSION: Over the decades, treatment of partially edentulous jaws with turned titanium implants seems to function well and to provide patients with good support for fixed short-span bridge constructions.
  •  
38.
  • Lekholm, Ulf, 1944, et al. (författare)
  • Soft tissue and marginal bone conditions at osseointegrated implants that have exposed threads: a 5-year retrospective study.
  • 1996
  • Ingår i: The International journal of oral & maxillofacial implants. - 0882-2786. ; 11:5, s. 599-604
  • Tidskriftsartikel (refereegranskat)abstract
    • The purpose of this retrospective clinical investigation was to study possible soft tissue complications and marginal bone resorption related to exposed threads of osseointegrated Brånemark oral implants during a 5-year period. Group 1 comprised 27 patients with 38 test implants that had not become completely covered with bone at implant placement. Thirty control implants in 25 of the patients were each next to a test implant and had no exposed threads initially. Group 2 comprised 51 patients with 107 test implants that had developed marginal bone loss beyond the second thread, as judged radiographically at the first annual checkup. Forty-eight control implants showed no or minor marginal bone resorption up to the first thread. Initial marginal defects and fenestrations at Brånemark implants (group 1) did not lead to mucosal problems or progressive marginal bone resorption during the first 5 years of function. Moreover, bone resorption, seen after the first year of loading at initially completely bone-covered implants, did not lead to any specific soft tissue problems, nor did it result in any further progressive bone resorption during a subsequent 4-year period. Based on the observed low incidence of soft tissue pathology at implants with exposed threads, it is suggested that bone augmentation techniques in the situations studied be used with restriction.
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39.
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40.
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41.
  •  
42.
  • Nordenram, G., et al. (författare)
  • Qualitative studies of patients' perceptions of loss of teeth, the edentulous state and prosthetic rehabilitation: A systematic review with meta-synthesis
  • 2013
  • Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 71:3-4, s. 937-951
  • Forskningsöversikt (refereegranskat)abstract
    • Objective. To conduct a systematic review and meta-synthesis of qualitative studies addressing patients' perceptions of loss of teeth, edentulism and oral rehabilitation. Background. Qualitative studies can complement quantitative studies by achieving deep understanding of patients' subjective experiences of losing teeth and coping with edentulism. They can also explore the perception that the benefits of prosthetic rehabilitation extend far beyond primary clinical treatment goals of restoration of oral function. Materials and methods. The major data bases were searched extensively for relevant qualitative and quantitative studies, followed by manual searching of the reference lists of included publications. Two authors independently read all abstracts. Relevant papers were retrieved in full-text and included or excluded according to a specially designed protocol. The included articles were then appraised and rated for quality: high, moderate or low. Articles of low quality were excluded. Results. The database search yielded 36 abstracts of qualitative studies; manual search disclosed one further article. All were read in full-text by two independent authors: 28 were excluded. Of the remaining nine, two (assessed as of low quality) were excluded for further analysis. Meta-synthesis, based on seven studies, disclosed two major themes: loss of quality-of-life associated with losing teeth and restored quality-of-life after oral rehabilitation. Conclusions. In this relatively new field of research, there are few published papers. Nevertheless, the studies to date show that loss of teeth is associated not only with compromised oral function, but also loss of social status and diminished self-esteem. Oral rehabilitation has broad positive implications, restoring quality of life and self-worth.
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43.
  • Odman, J, et al. (författare)
  • Osseointegrated implants as orthodontic anchorage in the treatment of partially edentulous adult patients.
  • 1994
  • Ingår i: European journal of orthodontics. - 0141-5387. ; 16:3, s. 187-201
  • Tidskriftsartikel (refereegranskat)abstract
    • In nine partially edentulous adult patients, mean age 47 years (range 17-64 years) 23 osseointegrated implants were used as orthodontic anchorage to perform the following types of orthodontic tooth movements: tipping, torquing, rotation, intrusion, extrusion, and those associated with bodily movements. The total orthodontic treatment period varied between 4 and 33 months (x = 17 months). Pre-operatively, at the start and end of orthodontic treatment, and at the annual controls, clinical as well as biometric and radiographic (panoramic, lateral cephalograms and periapical radiographs) recordings were performed. The osseointegrated anchorage units were used as reference points for measurements of two- and three-dimensional tooth movements with a co-ordinate machine. The 2-D tooth movements varied between 0.2 and 6.2 mm, whereas movements in the third dimension, extrusion and intrusion, ranged from 0.0 to 13.5 mm. The movement in space for the individual tooth was observed to be, as a mean, 3.9 mm (range 0.6-18.7 mm). However, the osseointegrated titanium implants (fixtures) used as orthodontic anchorage remained in position when orthodontically loaded for the various tooth movements. After completion of the orthodontic treatment the fixtures served as abutments for permanent prosthetic constructions.
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44.
  •  
45.
  • Rohlin, Madeleine, et al. (författare)
  • Treatment of Adult Patients with Edentulous Arches: A Systematic Review
  • 2012
  • Ingår i: International Journal of Prosthodontics. - : Quintessence. - 0893-2174 .- 1139-9791. ; 25:6, s. 553-567
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: This study aimed to evaluate the outcomes of treatment methods used to rehabilitate adult patients with maxillary and/or mandibular edentulism after at least 5 years of follow-up. The risks, adverse effects, and cost effectiveness of these methods were also evaluated. Materials and Methods: Three databases as well as the reference lists of included publications were searched using specified indexing terms. Publications that met the inclusion criteria were read and interpreted using pre-established protocols. Quality of evidence was classified according to the GRADE system (high, moderate, low, or very low). Results: The search yielded 2,130 titles and abstracts. Of these, the full-text versions of 488 publications were obtained. After data extraction and interpretation, 10 studies with moderate study quality of evidence and 1 study with low quality of evidence regarding outcomes, risks, and adverse effects remained. Three studies on the economic aspects of treatment were also included (1 with moderate quality and 2 with low quality). Low-quality evidence showed that the survival rate of implant-supported fixed prostheses is 95% after 5 years in patients with maxillary edentulism and 97% after 10 years in patients with mandibular edentulism. The survival rate of implant-supported overdentures is 93% after 5 years (low-quality evidence). In implant-supported fixed prostheses, 70 of every 1,000 implants are at risk of failing in the maxilla after 5 years and 17 of every 1,000 implants in the mandible are at risk after 10 years. Regarding economic aspects, the evidence was insufficient to provide reliable results. Conclusions: Due to the low quality of evidence found in the included studies, further research with a higher quality of evidence is recommended to better understand the outcomes of treatment for patients with maxillary and/or mandibular edentulism. Int J Prosthodont 2012;25:553-567
  •  
46.
  • Roos, Johan, et al. (författare)
  • A qualitative and quantitative method for evaluating implant success: a 5-year retrospective analysis of the Brånemark implant.
  • 1997
  • Ingår i: The International journal of oral & maxillofacial implants. - 0882-2786. ; 12:4, s. 504-14
  • Tidskriftsartikel (refereegranskat)abstract
    • A proposed protocol and differentiated success criteria for long-term evaluation of oral implants are presented. The protocol and criteria were applied to a retrospective patient material treated during a 1-year period and followed for 5 years. The protocol comprised a two-stage analysis of the collected clinical data. First, a quantitative analysis of the outcome was made using a life table. Based on the information obtained during the follow-up, each implant was categorized into one of three groups: unaccounted for, failure, or survival. A qualitative analysis of the survival group was then performed by active testing against defined criteria. Depending on the modes of clinical and radiographic examinations and their results, surviving implants were either further assigned to one of three success grades or remained in the survival group. The data are presented in a four-field table at one level of success. Strict success criteria together with individual stability testing and radiographic examination of each consecutive implant should be used when a new implant system is evaluated or when a new application is explored. Radiography alone and more moderate success criteria may be used to document routine treatments, provided that an already well-documented implant system is studied.
  •  
47.
  • Sennerby, Lars, 1960, et al. (författare)
  • Soft-tissue response to clinically retrieved titanium cover screws reimplanted in the rat abdominal wall.
  • 1989
  • Ingår i: The International journal of oral & maxillofacial implants. - 0882-2786. ; 4:3, s. 233-9
  • Tidskriftsartikel (refereegranskat)abstract
    • Clinically retrieved titanium implant cover screws (Brånemark implant system), rinsed in saline or subjected to ultrasonic cleaning and sterilization, as well as unused sterile screws were studied by scanning electron microscopy and implanted in the rat abdominal wall for 6 weeks. Irrespective of cleaning procedure, the heads of the clinically retrieved screws were covered by numerous contaminants not present on the unused screws. The reimplanted screws elicited a different tissue response than the unused screws. The tissue response to the contaminated screws was characterized by a significantly thicker fibrous capsule and by a significantly larger number of macrophages located close to the implant. Moreover, judging from their ultrastructure, studied with transmission electron microscopy, the macrophages appeared to be in a more active state when compared to those located adjacent to unused screws.
  •  
48.
  • Sennerby, Lars, 1960, et al. (författare)
  • Structure of the bone-titanium interface in retrieved clinical oral implants.
  • 1991
  • Ingår i: Clinical oral implants research. - : Wiley. - 0905-7161. ; 2:3, s. 103-11
  • Tidskriftsartikel (refereegranskat)abstract
    • 7 clinically stable, "osseointegrated", titanium implants, inserted in human jaws for 1-16 years, were retrieved for morphological analysis of the bone-titanium interface, using 3 different preparation techniques. The bone-titanium interface varied as judged from light microscopy of ground sections. The threads of the implants were well filled (79-95%) with dense lamellar bone as quantified with morphometry. A large fraction of the implant surface (56-85%) appeared to be in direct contact with the mineralized bone. In general, the non-bone areas consisted of pockets with osteocytes, bone marrow tissue and/or vessels. Sections were prepared for light microscopy and transmission electron microscopy using a fracture technique, where the implant was separated from the embedded tissue before sectioning, and an electropolishing technique, where the bulk part of the implant was electrochemically removed. In areas judged as direct mineralized bone-titanium contact in the light microscope, the interfacial structure varied at the ultrastructural level. In areas along the interface, unmineralized tissue was present either as a narrow 0.5-1 micron wide zone containing collagen fibril or as deeper pockets containing osteocytes or vessels. In areas with mineralized bone contact, an amorphous granular layer (100-400 nm wide) with no mineral was observed in the innermost interface bordering the mineralized bone, with an electron-dense lamina limitans-like line (approximately 50 nm thick). It is concluded that the bone-titanium interface of the 7 clinically retrieved titanium oral implants examined in the present study bone was heterogenous. In areas of a direct mineralized bone-titanium contact at the ultrastructural level, mineralized bone reached close to the implant surface, but was separated by an amorphous layer, being 100-400 nm thick.
  •  
49.
  • Sennerby, Lars, 1960, et al. (författare)
  • The soft tissue response to titanium abutments retrieved from humans and reimplanted in rats. A light microscopic study.
  • 1993
  • Ingår i: Clinical oral implants research. - : Wiley. - 0905-7161. ; 4:1, s. 23-7
  • Tidskriftsartikel (refereegranskat)abstract
    • In order to test the soft tissue response to contaminated titanium components, 20 clinically retrieved abutment cylinders were inserted in the abdominal wall of 5 rats. Prior to insertion, 10 of the abutments had been contaminated for 1 min and the remaining components for 2 weeks. Five abutments of either group were ultrasonically cleaned in butanol and ethanol, whereas the remaining abutments were only rinsed in saline before being implanted. As controls, 5 newly manufactured abutments were used. After 6 weeks of healing, specimens were prepared of the components and surrounding tissues for morphological analysis. This showed an accumulation of macrophages and a reduction of the number of fibroblasts around the abutments that had been contaminated, irrespective of cleaning procedure, compared with the controls. It was concluded that the contaminated components induced an altered tissue response and that a similar reaction may occur in the clinical situation.
  •  
50.
  • Sennerby, Lars, 1960, et al. (författare)
  • Tissue reactions towards titanium implants inserted in growing jaws. A histological study in the pig.
  • 1993
  • Ingår i: Clinical oral implants research. - : Wiley. - 0905-7161. ; 4:2, s. 65-75
  • Tidskriftsartikel (refereegranskat)abstract
    • In this investigation, the tissue reactions towards titanium implants inserted in growing jaws of pigs were studied by means of histology. At the age of 12 weeks, 5 test pigs each received 4 Brånemark System titanium implants (fixtures). The fixtures were inserted immediately after extraction of the mesial root of the second deciduous premolar (P2) and the deciduous canine (C) on one side of the mandible and the mesial root of the first deciduous premolar (P1) on the other side. The fourth implant was placed after extraction of the deciduous lateral incisor (L) on one side in the upper jaw. Furthermore, 1 pig in which no extractions or fixture installations were performed served as a control. All pigs were followed for 165 days with clinical, radiographic and biometric examinations, the results of which have been previously presented. In this study, 10-microns-thick ground sections were produced for histology after the jaws had been fixed by immersion in formalin and further processed and embedded in plastic resin. Six of the fixtures originally inserted were lost during the experimental period, and the remaining implants were found to be involved with mineralized bone to varying degrees. Regarding the fixture-to-teeth relationship, it was found that, in the premolar region of the lower jaw, the teeth were positioned superior to and buccally angulated in relation to the fixtures. In the upper jaw, the implants were positioned below the adjacent teeth but centrally in the alveolar process. Tooth germs adjacent to the fixture had a displaced eruption path, buccally or lingually to the fixture. If the bud developed in close contact with the fixture, a changed morphology of the germ could be observed.
  •  
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