| 1. |
- Derks, Jan, 1977, et al.
(författare)
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Effectiveness of implant therapy analyzed in a Swedish population: Early and late implant loss
- 2015
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Ingår i: Journal of Dental Research. - : SAGE Publications. - 0022-0345 .- 1544-0591. ; 94
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Tidskriftsartikel (refereegranskat)abstract
- Treatment outcomes in implant dentistry have been mainly assessed as implant survival rates in small, selected patient groups of specialist or university clinical settings. This study reports on loss of dental implants assessed in a large and randomly selected patient sample. The results were aimed at representing evaluation of effectiveness of implant dentistry. Using the national data register of the Swedish Social Insurance Agency, 4,716 patients were randomly selected. All had been provided with implant-supported restorative therapy in 2003. Patient files of 2,765 patients (11,311 implants) were collected from more than 800 clinicians. Information on patients, treatment procedures, and outcomes related to the implant-supported restorative therapy was extracted from the files. In total, 596 of the 2,765 subjects, provided with 2,367 implants, attended a clinical examination 9 y after therapy. Implant loss that occurred prior to connection of the supraconstruction was scored as an early implant loss, while later occurring loss was considered late implant loss. Early implant loss occurred in 4.4% of patients (1.4% of implants), while 4.2% of the patients who were examined 9 y after therapy presented with late implant loss (2.0% of implants). Overall, 7.6% of the patients had lost at least 1 implant. Multilevel analysis revealed higher odds ratios for early implant loss among smokers and patients with an initial diagnosis of periodontitis. Implants shorter than 10 mm and representing certain brands also showed higher odds ratios for early implant loss. Implant brand also influenced late implant loss. Implant loss is not an uncommon event, and patient and implant characteristics influence outcomes
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| 2. |
- Derks, Jan, 1977, et al.
(författare)
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Effectiveness of Implant Therapy Analyzed in a Swedish Population: Prevalence of Peri-implantitis
- 2016
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Ingår i: Journal of Dental Research. - : SAGE Publications. - 0022-0345 .- 1544-0591. ; 95:1, s. 43-49
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Tidskriftsartikel (refereegranskat)abstract
- Peri-implantitis is an inflammatory disease affecting soft and hard tissues surrounding dental implants. As the global number of individuals that undergo restorative therapy through dental implants increases, peri-implantitis is considered as a major and growing problem in dentistry. A randomly selected sample of 588 patients who all had received implant-supported therapy 9 y earlier was clinically and radiographically examined. Prevalence of peri-implantitis was assessed and risk indicators were identified by multilevel regression analysis. Forty-five percent of all patients presented with peri-implantitis (bleeding on probing/suppuration and bone loss >0.5 mm). Moderate/severe peri-implantitis (bleeding on probing/suppuration and bone loss >2 mm) was diagnosed in 14.5%. Patients with periodontitis and with >= 4 implants, as well as implants of certain brands and prosthetic therapy delivered by general practitioners, exhibited higher odds ratios for moderate/severe peri-implantitis. Similarly, higher odds ratios were identified for implants installed in the mandible and with crown restoration margins positioned <= 1.5 mm from the crestal bone at baseline. It is suggested that peri-implantitis is a common condition and that several patient-and implant-related factors influence the risk for moderate/severe peri-implantitis (ClinicalTrials.gov NCT01825772).
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| 3. |
- Derks, Jan, 1977, et al.
(författare)
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Patient-reported outcomes of dental implant therapy in a large randomly selected sample
- 2015
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Ingår i: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 26:5, s. 586-591
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn addition to traditional clinical parameters, the need to include patient-reported assessments into dental implant research has been emphasized. AimThe aim of this study was to evaluate patient-reported outcomes following implant-supported restorative therapy in a randomly selected patient sample. Material and MethodsFour thousand seven hundred and sixteen patients were randomly selected from the data register of the Swedish Social Insurance Agency. A questionnaire containing 10 questions related to implant-supported restorative therapy was mailed to each of the individuals about 6years after therapy. Associations between questionnaire data, and (i) patient-related, (ii) clinician-related and (iii) therapy-related variables were identified by multivariate analyses. ResultsThree thousand eight hundred and twenty-seven patients (81%) responded to the questionnaire. It was demonstrated that the overall satisfaction among patients was high. Older patients presented with an overall more positive perception of the results of the therapy than younger patients and males were more frequently satisfied in terms of esthetics than females. While clinical setting did not influence results, patients treated by specialist dentists as opposed to general practitioners reported a higher frequency of esthetic satisfaction and improved chewing ability. In addition, patients who had received extensive implant-supported reconstructions, in contrast to those with small reconstructive units, reported more frequently on improved chewing ability and self-confidence but also to a larger extent on implant-related complications. ConclusionIt is suggested that patient-perceived outcomes of implant-supported restorative therapy are related to (i) age and gender of the patient, (ii) the extent of restorative therapy and (iii) the clinician performing the treatment.
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| 4. |
- Derks, Jan, 1977, et al.
(författare)
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Peri-implantitis - onset and pattern of progression.
- 2016
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Ingår i: Journal of clinical periodontology. - : Wiley. - 1600-051X .- 0303-6979. ; 43:4, s. 383-388
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Tidskriftsartikel (refereegranskat)abstract
- While information on the prevalence of peri-implantitis is available, data describing onset and progression of the disease are limited.
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| 5. |
- Karlsson, Karolina, 1975, et al.
(författare)
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Interventions for peri-implantitis and their effects on further bone loss: A retrospective analysis of a registry-based cohort
- 2019
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Ingår i: Journal of Clinical Periodontology. - : Wiley. - 0303-6979 .- 1600-051X. ; 46:8, s. 872-879
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Tidskriftsartikel (refereegranskat)abstract
- Objective The aim of the present study was to assess interventions and their consequences with regard to further bone loss at sites diagnosed with peri-implantitis. Materials and Methods In 2017, records of 70 patients diagnosed with moderate/severe peri-implantitis at >= 1 implant sites 4 years earlier were obtained. Changes of marginal bone levels during the study period assessed on radiographs and predictors of disease progression were identified by Cox regression and mixed linear modelling. Patient files were analysed for professional interventions related to the treatment of peri-implantitis. Results Mean bone loss (+/- SD) at implants diagnosed with moderate/severe peri-implantitis was 1.1 +/- 2.0 mm over the observation period of 3.3 years. While non-surgical measures including submucosal and/or supra-mucosal cleaning of implants were provided to almost all patients, surgical treatment of peri-implantitis was limited to a subgroup (17 subjects). Surgically treated implant sites demonstrated a mean bone loss of 1.4 +/- 2.4 mm prior to surgical intervention, while only minor changes (0.2 +/- 1.0 mm) occurred after therapy. Clinical parameters (bleeding/suppuration on probing and probing depth) assessed at diagnosis were statistically significant predictors of disease progression. Conclusions Non-surgical procedures were insufficient to prevent further bone loss at implant sites affected by moderate/severe peri-implantitis. Surgical treatment of peri-implantitis markedly diminished the progression of bone loss. Clinical assessments of bleeding on probing and probing depth at diagnosis predicted further bone loss.
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| 6. |
- Karlsson, Karolina, 1975, et al.
(författare)
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Technical complications following implant-supported restorative therapy performed in Sweden
- 2018
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Ingår i: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 29:6, s. 603-611
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveThe aim of this study was to evaluate the occurrence and consequences of technical complications in implant-supported restorative therapy. Material & MethodsThe occurrence and consequences of technical complications in implant-supported restorative therapy over a mean follow-up period of 5.3years were assessed based on documentation in files from 2,666 patients. Risk indicators were identified by the use of survival models, considering repeated events. Results were expressed as hazard ratios (HR) including 95% confidence intervals. ResultsTechnical complications occurred in 24.8% of the patients. Chipping and loss of retention were the most common, affecting 11.0% and 7.9% of supraconstructions, respectively, while implant-related complications (e.g., implant fracture) were rare. More than 50% of the affected patients experienced technical complications more than once and almost all reported complications led to interventions by a dental professional. The extent of the supraconstruction was the strongest risk indicator for both chipping (HR<0.2) and loss of retention (HR>3). ConclusionOver a 5-year period, technical complications in implant-supported restorative therapy occurred frequently and their management required professional intervention.
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| 7. |
- Carcuac, Olivier, 1974, et al.
(författare)
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Adjunctive Systemic and Local Antimicrobial Therapy in the Surgical Treatment of Peri-implantitis: A Randomized Controlled Clinical Trial
- 2016
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Ingår i: Journal of Dental Research. - : SAGE Publications. - 0022-0345 .- 1544-0591. ; 95:1, s. 50-57
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present randomized controlled clinical trial was to investigate the adjunctive effect of systemic antibiotics and the local use of chlorhexidine for implant surface decontamination in the surgical treatment of peri-implantitis. One hundred patients with severe peri-implantitis were recruited. Surgical therapy was performed with or without adjunctive systemic antibiotics or the local use of chlorhexidine for implant surface decontamination. Treatment outcomes were evaluated at 1 y. A binary logistic regression analysis was used to identify factors influencing the probability of treatment success, that is, probing pocket depth <= 5 mm, absence of bleeding/suppuration on probing, and no additional bone loss. Treatment success was obtained in 45% of all implants but was higher in implants with a nonmodified surface (79%) than those with a modified surface (34%). The local use of chlorhexidine had no overall effect on treatment outcomes. While adjunctive systemic antibiotics had no impact on treatment success at implants with a nonmodified surface, a positive effect on treatment success was observed at implants with a modified surface. The likelihood for treatment success using adjunctive systemic antibiotics in patients with implants with a modified surface, however, was low. As the effect of adjunctive systemic antibiotics depended on implant surface characteristics, recommendations for their use in the surgical treatment of peri-implantitis should be based on careful assessments of the targeted implant (ClinicalTrials.gov NCT01857804).
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| 8. |
- Carcuac, Olivier, 1974, et al.
(författare)
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Surgical treatment of peri-implantitis: 3-year results from a randomized controlled clinical trial.
- 2017
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Ingår i: Journal of clinical periodontology. - : Wiley. - 1600-051X .- 0303-6979. ; 44:12, s. 1294-1303
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Tidskriftsartikel (refereegranskat)abstract
- This study reports on the 3-year follow-up of patients enrolled in a randomized controlled clinical trial on surgical treatment of advanced peri-implantitis.A total of 100 patients with advanced peri-implantitis were randomly assigned to one of four treatment groups. Surgical therapy aiming at pocket elimination was performed and, in three test groups, supplemented by either systemic antibiotics, use of an antiseptic agent for implant surface decontamination or both. Outcomes were evaluated after 1 and 3years by means of clinical and radiological examinations. Differences between groups were explored by regression analysis.Clinical examinations at 3years after treatment revealed (i) improved peri-implant soft tissue health with a mean reduction in probing depth of 2.7mm and a reduction in bleeding/suppuration on probing of 40% and (ii) stable peri-implant marginal bone levels (mean bone loss during follow-up: 0.04mm). Implant surface characteristics had a significant impact on 3-year outcomes, in favour of implants with non-modified surfaces. Benefits of systemic antibiotics were limited to implants with modified surfaces and to the first year of follow-up.It is suggested that surgical treatment of peri-implantitis is effective and that outcomes of therapy are affected by implant surface characteristics. Potential benefits of systemic antibiotics are not sustained over 3years.
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| 9. |
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| 10. |
- Ramberg, Per, 1949, et al.
(författare)
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A randomized controlled cross-over study of the effect of alcohol-free chlorhexidine and essential oils on interleukin-1 levels in crevicular fluid
- 2016
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Ingår i: Swedish Dental Journal. - 0347-9994. ; 40:2, s. 143-152
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Tidskriftsartikel (refereegranskat)abstract
- Aim of the study was to determine the effect of an alcohol-free chlorhexidine mouth rinse and an essential oils containing mouth rinse on pro-inflammatory cytokine levels in gingival crevicular fluid in participants who continue to perform their regular mechanical oral hygiene regimes and normal dietary practice. Twenty adult volunteers (mean age: 59 years) participated in the double-blind randomised controlled cross-over study. Three mouth rinses were used during 16-day periods as an adjunctive to regular mechanical oral hygiene: a solution with alcohol-free chlorhexidine (CHX; Paroex (R)), a solution with essential oils (EO; Listerine (R)), and water (negative control).The mouth rinse periods were separated by 3-month washout periods. At days o (baseline) and 17 (end) of each mouth rinse period, gingival crevicular fluid (GCF) was collected at different tooth sites and analyzed with ELISA technique for IL-1 alpha, IL-1 beta and IL-1ra levels. No significant correlations between clinical parameters (OHI and GI) and cytokine concentrations were observed, regardless of mouth rinse regimen.The generalized linear models revealed that none of the mouth rinses had a statistically significant impact on IL-1 concentrations in GCF. Large inter-individual variations were observed for the levels of IL-1 alpha, IL-1 beta and IL-1ra. Also the changes in concentrations between day o and day17 for the mouthrinses showed large intra-individual variations. It can be concluded that neither the alcohol-free chlorhexidine nor the mouth rinse containing essential oils reduced the levels of IL-1 alpha, IL-1 beta and IL-1ra in GCF.
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