| 1. |
- Cannizzaro, Gioacchino, et al.
(författare)
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Immediate loading of three (fixed-on-3) vs four (fixed-on-4) implants supporting cross-arch fixed prostheses: 1-year results from a multicentre randomised controlled trial.
- 2018
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Ingår i: European journal of oral implantology. - 1756-2406. ; 11:3, s. 323-333
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate the outcome of three (fixed-on-3 = Fo3) vs four (fixed-on-4 = Fo4) implants immediately restored with metal-resin screw-retained cross-arch prostheses in fully edentulous jaws.Forty-eight edentulous or to be rendered edentulous patients were randomised in six centres (eight patients per centre) to the Fo3 group (24 patients: 12 maxillae and 12 mandibles) and to the Fo4 group (24 patients: 12 maxillae and 12 mandibles) according to a parallel group design. To be immediately loaded, implants had to be inserted with a minimum torque of 40 Ncm. Outcome measures were prosthesis and implant failures, complications and peri-implant marginal bone level changes evaluated up to 1 year post-loading.One maxillary prosthesis per group was delayed loaded because implants could not be placed with a torque of at least 40 Ncm. Ten patients in the Fo3 group and four in the Fo4 group had implants placed flapless. One year after loading no drop out occurred. One patient of the Fo3 group lost three implants vs three patients of the Fo4 group who lost four implants, the difference being no statistically significant (risk difference = -0.08; 95% CI: -0.27 to 0.10; Fisher's exact test P = 0.609). One mandibular Fo3 and one maxillary Fo4 prosthesis failed. Six Fo3 patients were affected by complications vs three Fo4 patients (risk difference = 0.12; 95% CI: -0.10 to 0.34; Fisher's exact test; P = 0.461). Both groups lost marginal bone in a statistically significant way (0.22 ± 0.20 mm for Fo3 patients and 0.40 ± 0.21 mm for Fo4 patients), with Fo3 group showing less marginal peri-implant bone loss than Fo4 group (estimate of the difference = -0.18 (standard error: 0.06) mm; 95% CI: -0.30 to -0.06; P = 0.005). There were no differences in clinical outcomes between the six operators.These preliminary results suggest that immediately loaded cross-arch prostheses of both jaws can be supported by only three dental implants at least up to 1 year post-loading, though longer follow-ups are definitively needed.
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| 2. |
- Esposito, Marco, 1965, et al.
(författare)
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Endodontic retreatment versus dental implants of teeth with an uncertain endodontic prognosis: 3-year results from a randomised controlled trial.
- 2018
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Ingår i: European journal of oral implantology. - 1756-2406. ; 11:4, s. 423-438
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Tidskriftsartikel (refereegranskat)abstract
- To ascertain whether in the presence of a previously endodontically treated tooth with periapical pathology and/or symptoms and an uncertain prognosis, it is better to endodontically retreat it or to replace the tooth with a single-implant-supported crown.Twenty patients requiring the treatment of a previously endodontically treated tooth, with periapical pathology and/or symptoms of endodontic origin and an uncertain prognosis, as judged by the recruiting investigator, were randomly allocated to endodontic retreatment (Endo group, 10 patients) or tooth extraction and replacement with an implant-supported crown (Implant group, 10 patients) according to a parallel-group design at a single centre. Patients were followed to 3 years after completion of the treatment. Outcome measures were: failure of the procedure, complications, marginal bone level changes at both teeth and implants, endodontic radiographic success (teeth only), number of patients' visits and days to complete the treatment, patients' chair time, costs, aesthetics assessed using the pink aesthetic score (PES) for the soft tissues and the white aesthetic score (WES) for the tooth/crown recorded by independent assessors.No patient dropped out. One endodontically retreated tooth fractured and another had a crown loosening. There were no statistically significant differences for treatment failure or complications (difference in proportions = 0.10; 95% CI: -0.09 to 0.29; P (Fisher exact test) = 1.000). The mean marginal bone levels at endodontic retreatment/implant insertion were 2.10 ± 0.66 mm for the Endo group and 0.05 ± 0.15 mm for the Implant group. Three years after completion of the treatment, teeth lost on average 0.23 ± 0.82 mm and implants 0.62 ± 0.68 mm, the difference not being statistically significant (mean difference = -0.39 mm; 95% confidence interval [CI]: -1.12 to 0.33; P (t test) = 0.267). Three years after completion of the endodontic retreatment, of the four teeth that originally had a periapical radiolucency, one was lost, two showed complete healing, and one showed radiographic improvement. There were no statistically significant differences for the number of patients' visits (Endo = 6.67 ± 0.71; Implant = 6.10 ± 0.74; mean difference = 0.57; 95% CI: -0.14 to 1.27; P (t test) = 0.106). It took significantly more days to complete the implant rehabilitation (Endo = 61 ± 12.97; Implant = 191.40 ± 75.04; mean difference = -130.40; 95% CI: -184.45 to -76.35; P (t test) < 0.001) but less patients' chair time (Endo = 629.44 ± 43.62 min; Implant = 326 ± 196.99 min; mean difference = 303.44; 95% CI: 160.87 to 446.02; P (t test) = 0.001). Implant treatment was significantly more expensive (Endo = €1,588.89 ± 300.81; Implant = €2,095 ± 158.90; mean difference = €-506.11; 95% CI: -735.41 to -276.82; P (t test) < 0.001). Three years after treatment completion, mean PES were 11.11 ± 1.97 and 6.50 ± 2.46 and mean WES were 7.78 ± 1.30 and 6.80 ± 2.39 in the Endo group and Implant group, respectively. Soft tissues aesthetics (PES) were significantly better at endodontically retreated teeth (mean difference 4.61; 95% CI: 2.44 to 6.78; P (t test) < 0.001) whereas no significant differences were observed for tooth aesthetics (WES) (mean difference 0.98; 95% CI: -0.89 to 2.85; P (t test) = 0.281) between treatments.The present preliminary results suggest that both endodontic retreatment and replacement of previously endodontically treated teeth with persisting pathology and a dubious endodontic prognosis provided similar short-term success rates. Aesthetics of the soft tissues and time needed to complete treatment were in favour of endodontic retreatment whereas implant rehabilitation required half of the chair time than endodontic retreatment, but was significantly more expensive. Much larger patient populations and longer follow-ups are needed to fully answer this question; however, in this scenario the less invasive endodontic retreatment could be the first therapeutic option to be considered.
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| 3. |
- Esposito, Marco, 1965, et al.
(författare)
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Endodontic retreatment vs dental implants of teeth with an uncertain endodontic prognosis: 1-year results from a randomised controlled trial.
- 2017
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Ingår i: European journal of oral implantology. - 1756-2406. ; 10:3, s. 293-308
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Tidskriftsartikel (refereegranskat)abstract
- To ascertain whether in the presence of a previously endodontically treated tooth with a periapical pathology and/or symptoms and an uncertain prognosis, it is better to endodontically retreat it or to replace the tooth with a single implant-supported crown.Forty patients requiring the treatment of a previously endodontically treated tooth, with a periapical pathology and/or symptoms of endodontic origin and an uncertain prognosis, as judged by the recruiting investigators, were randomly allocated to endodontic retreatment (endo group; 20 patients) or tooth extraction and replacement with an implant-supported crown (implant group; 20 patients) according to a parallel group design at two different centres. Patients were followed to 1 year after completion of the treatment. Outcome measures were: failure of the procedure, complications, marginal bone level changes at both teeth and implants, endodontic radiographic success (teeth only), number of patients' visits and days to complete the treatment, patients' chair time, costs, aesthetics assessed using the pink esthetic score (PES) for the soft tissues and the white esthetic score (WES) for the tooth/crown recorded by independent assessors.No patient dropped out and no complications occurred during the entire follow-up; however, one endodontically retreated tooth (5%) and one implant (5%) fractured, the difference for treatment failures being not statistically significant (difference in proportions = 0; 95% CI -0.14 to 0.14; P Fisher's exact test) = 1.000). The mean marginal bone levels at endo retreatment/implant insertion were 2.34 ± 0.88 mm for the endo and 0.23 ± 0.35 mm for the implant group, which was statistically significantly different (mean difference = 2.11 mm; 95% CI: 1.68 to 2.55; P (t-test) < 0.001). One year after completion of the treatment, teeth lost on average 0.32 ± 0.53 mm and implants 0.48 ± 0.72, the difference not being statistically significant (mean difference = -0.16 mm; 95% CI: -0.58 to 0.27; P (t-test) = 0.457). One year after completion of the endodontic retreatment, of the 13 teeth that originally had a periapical radiolucency, one was lost, six showed complete healing; four a radiographic improvement; and two showed no changes/worsening. Two of the teeth originally without a lesion developed a lesion. There were no statistically significant differences for the number of patients' visits (endo = 5.2 ± 1.8; implant = 5.5 ± 1.1; mean difference = -0.03 95% CI: -1.24 to 0.64; P (t-test) = 0.522). It took significantly more days to complete the implant rehabilitation (endo = 48.9 ± 19.5; implant = 158.5 ± 67.2; mean difference = -109.60; 95% CI: -141.26 to -77.94; P (t-test) < 0.001), but less patients' chair time (endo = 405.5 ± 230.3 min; implant = 260.0 ± 154.6 min; mean difference = 45.50; 95% CI: 19.35 to 271.65; P (t-test) = 0.025). Implant treatment was significantly more expensive (endo = 1195 ± 503.7 €; implant = 1907.5 ± 232.4 €; mean difference = -712.50; 95% CI: -963.59 to -461.41; P (t-test) < 0.001). One year after treatment completion, the mean PES was 10.92 ± 1.93 and 7.07 ± 2.87 and the mean WES was 7.67 ± 1.83 and 7.60 ± 2.32 in the endo group and implant group, respectively. Soft tissues aesthetics (PES) was significantly better at endodontically retreated teeth (mean difference 3.85; 95% CI 1.94 to 5.76; P (t-test) < 0.001) whereas no significant differences were observed for tooth aesthetics (WES) (mean difference 0.07; 95% CI -1.62 to 1.76; P (t-test) = 0.936) between treatments.The preliminary results suggest that both endodontic retreatment and replacement of previously endodontically treated teeth with persisting pathology and a dubious endodontic prognosis provided similar short-term success rates. Aesthetics of the soft tissues and time needed to complete treatment were in favour of endodontic retreatment, whereas implant rehabilitation required half of the chair time than endodontic retreatment, but was significantly more expensive. Although much larger patient populations and longer follow-ups are needed to fully answer this question, in this scenario the less invasive endodontic retreatment could be the first therapeutic option to be considered.
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| 4. |
- Alqutaibi, A. Y., et al.
(författare)
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Single vs two implant-retained overdentures for edentulous mandibles: A systematic review
- 2017
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 10:3, s. 243-261
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Forskningsöversikt (refereegranskat)abstract
- Purpose: To compare prosthesis and implant failure, patient satisfaction, prosthetic complications and peri-implant marginal bone loss of mandibular overdentures (IOD) supported by a single or two implants. Materials and methods: Manual and electronic database (PubMed and Cochrane) searches were performed to identify randomised controlled trials, without language restriction, comparing single vs two implant supported mandibular overdentures. Two investigators extracted data independently. The Cochrane tool was used for assessing the quality of included studies. Meta-analyses were performed for the included RCTs. Results: Six publications corresponding to four RCTs were identified. Three RCTs (corresponding to five publications) were included and one trial was excluded. Follow-ups in function were 1, 3 and 5 years after loading. All included studies were considered to be at a high risk of bias. The pooled result revealed more prosthesis failures at overdentures supported by two implants at 1 year (three trials) (P = 0.02; Risk Difference: -0.12, 95% CI: -0.22, -0.02), however, there were non-significant differences at 3 years (two trials) (P = 0.22; Risk Difference: -0.32, 95% CI: -0.83, 0.19) and at 5 years (one trial) (P = 0.95; Risk Difference: 0.01, 95% CI: -0.22, 0.24). Regarding implant failures, there were more implant losses in overdentures supported by two implants at 1 year (three trials) (P = 0.02; Risk Difference: -0.12, 95% CI: -0.22, -0.02) and at 5 years (one trial) (P = 0.95; Risk Difference: -0.15, 95% CI: -0.28, -0.02), however, there were non-significant difference at 3 years (two trials) (P = 0.2; Risk Difference: -0.33, 95% CI: -0.84, 0.18). After 5 years in function, meta-analyses revealed that there were nonsignificant differences regarding overall prosthetic complications when mandibular overdentures supported by a single implant were compared with overdentures supported by two implants (P = 0.43; RD: 0.04, 95% CI: -0.06, 0.15). Conclusion: Mandibular overdentures retained by a single implant have comparable results to those retained by two implants. However, this should be interpreted with caution as all the included studies were considered at a high risk of bias. Conflict of interest statement: None declared. © Quintessenz.
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| 5. |
- Arduino, P. G., et al.
(författare)
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Single preoperative dose of prophylactic amoxicillin versus a 2-day postoperative course in dental implant surgery: A two-centre randomised controlled trial
- 2015
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 8:2, s. 143-149
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate the difference between a single preoperative dose versus an additional two-day postoperative course of oral amoxicillin in patients undergoing conventional dental implant placement. Materials and methods: Two dentists in two different private practices conducted this study. One hour prior to surgery, patients had to take a single prophylactic antibiotic dose, consisting of 2 g of amoxicillin orally; after implant placement, patients were randomly allocated to two different groups: protocol A (no other antibiotic administration) and protocol B, (1 g of amoxicillin in the evening of the day of surgery and 1 g twice a day for the 2 days after). Outcome measures were prosthetic and implant failures, adverse events and early postoperative complications. Patients were followed up to 6 months after functional loading. Results: Three hundred and sixty patients were randomised and treated (192 patients in one centre and 168 in the other). Five hundred and sixty-seven implants were placed. Protocol A was applied to 180 patients (278 implants) and protocol B also to 180 patients (289 implants). Data for 17 patients, 14 from protocol A and three from protocol B, were not available. No statistically significant differences were found for the reported outcomes. Two patients of protocol B experienced a prosthetic failure, losing four implants, while no prosthetic failures were reported for protocol A (P = 0.4836; difference in proportions = -0.0110; 95% Cl: -0.0412 to 0.0119). Five patients (3.0%) of protocol A lost five implants versus 5 patients (2.8%) who lost eight implants in protocol B (P = 1.0000; difference in proportions = 0.0020; 95% Cl: -0.0384 to 0.0438). Three adverse events were observed in the total population, all occurring in protocol B (1.69%), with no statistically significant differences between the two groups (P = 0.1199; difference in proportions =-0.0170; 95% Cl: -0.0487 to 0.0059). However, one patient experienced a severe allergic reaction requiring therapy discontinuation and hospital admission. Early postoperative complications occurred in six patients of protocol A and in four patients of protocol B, with no statistically significant differences (P = 0.5170; difference in proportions = 0.0130; 95% Cl: -0.0254 to 0.0568). Conclusions: No statistically significant differences were observed between 2 g of preoperative amoxicillin and an additional 2-day postoperative course, although adverse events were reported only in the additional 2-day postoperative group. Based on these findings, it might be sufficient to routinely administer preoperatively 2 g of amoxicillin to patients undergoing routine dental implant placement procedures rather than administering additional postoperative doses.
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| 6. |
- Atieh, Momen A, et al.
(författare)
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Interventions for replacing missing teeth: alveolar ridge preservation techniques for dental implant site development.
- 2015
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Ingår i: The Cochrane database of systematic reviews. - 1469-493X. ; :5
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Tidskriftsartikel (refereegranskat)abstract
- Alveolar bone changes following tooth extraction can compromise prosthodontic rehabilitation. Alveolar ridge preservation (ARP) has been proposed to limit these changes and improve prosthodontic and aesthetic outcomes when implants are used.To assess the clinical effects of various materials and techniques for ARP after tooth extraction compared with extraction alone or other methods of ARP, or both, in patients requiring dental implant placement following healing of extraction sockets.The following electronic databases were searched: the Cochrane Oral Health Group's Trials Register (to 22 July 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2014, Issue 6), MEDLINE via OVID (1946 to 22 July 2014), EMBASE via OVID (1980 to 22 July 2014), LILACS via BIREME (1982 to 22 July 2014), the Meta Register of Current Controlled Trials (to 22 July 2014), ClinicalTrials.gov (to 22 July 2014), the World Health Organization International Clinical Trials Registry Platform (to 22 July 2014), Web of Science Conference Proceedings (1990 to 22 July 2014), Scopus (1966 to 22 July 2014), ProQuest Dissertations and Theses (1861 to 22 July 2014) and OpenGrey (to 22 July 2014). A number of journals were also handsearched. Trial authors were contacted to identify unpublished randomised controlled trials. There were no restrictions regarding language and date of publication in the searches of the electronic databases.We included all randomised controlled trials (RCTs) on the use of alveolar ridge preservation techniques with at least six months of follow-up. Outcome measures were: changes in the bucco-lingual/palatal width of alveolar ridge, changes in the vertical height of the alveolar ridge, complications, the need for additional augmentation prior to implant placement, aesthetic outcomes, implant failure rates, peri-implant marginal bone level changes, changes in probing depths and clinical attachment levels at teeth adjacent to the extraction site, and complications of future prosthodontic rehabilitation.Two review authors extracted data independently and assessed risk of bias for each included trial. Corresponding authors were contacted to obtain missing information. Results were combined using random-effects models with mean differences (MD) for continuous outcomes and risk ratios (RR) for dichotomous outcomes, with 95% confidence intervals (95% CI). We constructed 'Summary of findings' tables to present the main findings.A total of 50 trials were potentially eligible for inclusion, of which 42 trials were excluded. We included eight RCTs with a total of 233 extraction sites in 184 participants. One trial was judged to be at unclear risk of bias and the remaining trials were at high risk of bias. From two trials comparing xenograft with extraction alone (70 participants, moderate quality evidence), there was some evidence of a reduction in loss of alveolar ridge height (MD -2.60 mm; 95% CI -3.43 to -1.76) and width (MD -1.97 mm; 95% CI -2.48 to -1.46). This was also found in one trial comparing allograft with extraction (24 participants, low quality evidence): ridge height (MD -2.20 mm; 95% CI -0.75 to -3.65) and width (MD - 1.40 mm; 95% CI 0.00 to -2.80) and height. From two RCTs comparing alloplast versus xenograft no evidence was found that either ridge preservation technique caused a smaller reduction in loss of ridge height (MD -0.35 mm; 95% CI -0.86 to 0.16) or width (MD -0.44 mm; 95% CI -0.90 to 0.02; two trials (55 participants); moderate quality evidence). There was insufficient evidence to determine whether there are clinically significant differences between different ARP techniques and extraction based on the need for additional augmentation prior to implant placement, complications, implant failure, or changes in peri-implant marginal bone levels and probing depths of neighbouring teeth. We found no trials which evaluated parameters relating to clinical attachment levels, specific aesthetic or prosthodontic outcomes.There is limited evidence that ARP techniques may minimise the overall changes in residual ridge height and width six months after extraction. There is also lack of evidence of any differences in implant failure, aesthetic outcomes or any other clinical parameters due to the lack of information or long-term data. There is no convincing evidence of any clinically significant difference between different grafting materials and barriers used for ARP. Further long term RCTs that follow CONSORT guidelines (www.consort-statement.org) are necessary.
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| 7. |
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| 8. |
- Barausse, Carlo, et al.
(författare)
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POSTERIOR JAW REHABILITATION USING PARTIAL PROSTHESES SUPPORTED BY IMPLANTS 4.0 X 4.0 MM OR LONGER: THREE-YEAR POST-LOADING RESULTS OF A MULTICENTRE RANDOMISED CONTROLLED TRIAL
- 2019
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Ingår i: Clinical Trials in Dentistry. - 2784-9015 .- 2785-3039. ; 1, s. 25-36
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE. To evaluate whether 4.0 x 4.0-mm dental implants could be viable alternatives to implants of length at least 8.5 mm when placed in posterior jaws with adequate bone volumes. MATERIALS AND METHODS. One hundred and fifty patients with posterior (premolar and molar areas) jaws having at least 12.5 mm bone height above the mandibular canal or 11.5 mm below the maxillary sinus, as applicable, were randomised according to a paral-lel-group design and received one to three 4.0 mm-long implants or one to three implants which were at least 8.5 mm-long at three treatment centres. All implants had a diameter of 4.0 mm. Implants were loaded with permanent screw-retained prostheses after 4 months. Patients were followed-up until 3-year post-loading, and outcome measures considered were prosthesis and implant failure, any complications, and changes in pe-ri-implant marginal bone levels. RESULTS. Seventy-five patients were randomly allocated to each group. Drop-outs at 3-year post-loading assessment were five patients from the long implant group and three from the short implant group. Up to 3 years post-loadings, three patients lost one 4.0 mm-long implant each, in comparison to two patients who lost one long implant each (difference in proportion =-0.013; 95% CI:-0.079 to 0.054; P = 1). All failures occurred before loading; failed implants were replaced, delaying delivery of two prostheses in each group by several months (difference in proportion = 0; 95% CI:-0.061 to 0.062; P = 1). Five short-implant patients experienced six complications versus the three complications seen in three long implant patients (difference in proportion =-0.026; 95% CI:-0.103 to 0.053; P = 0.719). There were no statistically significant differences between groups in prosthesis failures, implant failures or complications. Patients with short implants lost on average 0.55 mm of peri-implant bone, and patients with longer implants lost 0.61 mm. There were no statistically significant differences between short and long implants in bone level changes up to 3 years (mean difference = 0.05 mm; 95% CI:-0.05 to 0.16; P = 0.221). CONCLUSIONS. Outcomes 3 years after loading were similar with 4.0 x 4.0 mm-long implants and 8.5 x 4.0 mm or longer implants in posterior jaws, in the presence of adequate bone volumes. However, 5 to 10-year post-loading data will be necessary before reliable recommendations can be made. CONFLICT OF INTEREST STATEMENT. Global D (Brignais, France) partially supported this trial and donated the implants and prosthetic components. OsteoBiol (Tecnoss, Giaveno, Italy) donated the biomaterials used for bone augmentation. However, the data property belonged to the authors and neither Global D nor OsteoBiol interfered in any way with the conduct of the trial or the publication of the results.
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| 9. |
- Bolle, C., et al.
(författare)
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4 mm long vs longer implants in augmented bone in posterior atrophic jaws: 1-year post-loading results from a multicentre randomised controlled trial
- 2018
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 11:1, s. 31-47
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate whether 4.0 mm short dental implants could be an alternative to augmentation with xenographs in the maxilla and placement of at least 10.0 mm long implants in posterior atrophic jaws. Materials and methods: A group of 40 patients with atrophic posterior (premolar and molar areas) mandibles with 5.0 mm to 6.0 mm bone height above the mandibular canal and 40 patients with atrophic maxillas having 4.0 mm to 5.0 mm below the maxillary sinus, were randomised according to a parallel group design to receive between one and three 4.0 mm long implants or one to three implants of at least 10.0 mm long in augmented bone, at two centres. All implants had a diameter of 4.0 mm or 4.5 mm. Mandibles were vertically augmented with inter-positional equine bone blocks and resorbable barriers. Implants were placed 4 months after the inter-positional grafting. Maxillary sinuses were augmented with particulated porcine bone via a lateral window covered with resorbable barriers, and implants were placed simultaneously. Implants were not submerged and were loaded after 4 months with provisional screw-retained reinforced acrylic restorations replaced after another 4 months by definitive screw-retained metal-composite prostheses. Patients were followed up to 1 year post-loading. Outcome measures were: prosthesis and implant failures, any complication, and peri-implant marginal bone level changes. Results: Three patients dropped out; one from the maxillary augmented group, one from the mandibular augmented group, and one from the maxillary short implant group. In six augmented mandibles (30%) it was not possible to place implants of at least 10.0 mm, so shorter implants were placed instead. In mandibles, one implant from the augmented group failed vs two 4.0 mm implants in two patients from the short implant group. In maxillae, three short implants failed in two patients vs seven long implants in four patients (two long implants and one short implant dropped into the maxillary sinus). Two prostheses on short implants (one mandibular and one maxillary) were placed at a later stage because of implant failures, vs six prostheses (one mandibular and five maxillary) at augmented sites (one mandibular prosthesis not delivered, three maxillary prostheses delivered with delays, one not delivered, and one failed) at augmented sites. In particular, three patients in the augmented group (one mandible and two maxillae) were not wearing a prosthesis. There were no statistically significant differences in implant failures (P (chi-square test) = 0.693; difference in proportion = 0.03; CI 95% -0.11 to 0.17) or prostheses failures (P (chi-square test) = 0.126; difference in proportion = 0.10; CI 95% -0.03 to 0.24). At mandibular sites, nine augmented patients were affected by complications vs two patients treated with short implants (P (chi-square test) = 0.01; difference in proportion = 0.37; CI 95% 0.11 to 0.63), the difference being statistically significant. No significant differences were found for maxillae: nine sinus-lifted patients vs four short implant patients were affected by complications (P (chi-square test) = 0.091; difference in proportion = 0.25; CI 95% -0.03 to 0.53). At 1-year post-loading, average peri-implant bone loss was 0.51 mm at 4 mm long mandibular implants, 0.77 mm at 10 mm or longer mandibular implants, 0.63 mm at short maxillary implants and 0.72 mm at long maxillary implants. The difference was statistically significant in mandibles (mean difference -0.26 mm, 95% CI -0.39 to -0.13, P (ANCOVA) < 0.001), but not in maxillae (mean difference -0.09 mm, 95% CI -0.24 to 0.05, P (ANCOVA) = 0.196). Conclusions: One year after loading 4.0 mm long implants achieved similar results, if not better, than longer implants in augmented jaws, but were affected by fewer complications. Short implants might be a preferable choice over bone augmentation, especially in mandibles, since the treatment is less invasive, faster, cheaper, and associated with less morbidity. However, 5 to 10 years post-loading data are necessary before making reliable recommendations. © 2002-2018 Quintessence Publishing Group.
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| 10. |
- Bressan, Eriberto, et al.
(författare)
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The influence of repeated abutment changes on peri-implant tissue stability: 3-year post-loading results from a multicentre randomised controlled trial.
- 2017
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Ingår i: European journal of oral implantology. - 1756-2406. ; 10:4, s. 373-390
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate the influence of at least three abutment disconnections in conventional loaded implants against placement of a definitive abutment in immediately non-occlusal loaded implants on hard and soft tissue changes. A secondary aim was to evaluate whether the presence of less than 2 mm of keratinised mucosa is associated with increased peri-implant marginal bone loss and soft tissue recessions.Eighty patients requiring one single crown or one fixed partial prosthesis supported by a maximum of three implants were randomised, after implants were placed with more than 35 Ncm, according to a parallel group design to receive definitive abutments that were loaded immediately (definitive abutment or immediate loading group) or transmucosal abutments, which were delayed loaded after 3 months and removed at least three times: 1. At impression taking (3 months after implant placement); 2. When checking the zirconium core on titanium abutments at single crowns or the fitting the metal structure at prostheses supported by multiple implants; 3. At delivery of the definitive prostheses (repeated disconnection or conventional loading group). Patients were treated at four centres and each patient contributed to the study, with only one prosthesis followed for 3 years after initial loading. Outcome measures were: prosthesis failures, implant failures, complications, pink aesthetic score (PES), buccal recessions, patient satisfaction, peri-implant marginal bone level changes and height of the keratinised mucosa.Forty patients were randomly allocated to each group according to a parallel group design. Six patients from the definitive abutment group dropped out or died, and one left from the repeated disconnection group. One implant, from the repeated disconnection group, fractured (difference = 3%; CI 95%: -2%, 8%; P = 1). Four provisional crowns and one definitive single crown had to be remade because of poor fitting, and one definitive crown and one definitive prosthesis because of ceramic and implant fracture, respectively, in the repeated disconnection group vs one provisional prosthesis from the definitive abutment group due to frequent debondings (difference = 15%; CI 95%: 2%, 28%; P = 0.060). Five patients from the definitive abutment group and four patients from the repeated disconnection group were affected by complications (difference = 4%; CI 95%: -11%, 20%; P = 0.725). PES scores assessed at 3 years post-loading were 11.7 (standard deviation = 1.8) mm for the definitive abutment group and 11.3 (1.5) mm for the repeated abutment changes group (difference = 0.4; CI 95%: -0.4, 1.2; P = 0.315). However, there was a difference of 0.26 out of a maximum score of 2 in favour of the definitive abutment group for soft tissue contour only. Buccal recessions at 3 years post-loading amounted to -0.1 (0.8) mm for the definitive abutment group and -0.1 (1.2) mm for the repeated abutment changes group (it was actually a soft tissue gain; difference = 0.01 mm CI 95%: -0.48, 0.50; P = 0.965). All patients declared being very satisfied or satisfied with the function and aesthetics of the prostheses and said they would undergo the same procedure again, with the exception of one patient from the repeated disconnection group who was uncertain regarding function. Mean peri-implant marginal bone loss 3 years after loading was 0.07 (0.18) mm for the definitive abutment group and 0.50 (0.93) mm for the repeated abutment changes group (difference = 0.43 mm; CI 95%: 0.13, 0.74; P = 0.007). The height of keratinised mucosa at 3 years post-loading was 2.8 (1.3) mm for the definitive abutment group and 2.8 (1.6) mm for the repeated abutment changes group (difference = 0.03; CI 95%: -0.67, 0.73; P = .926). Up to 3 years after initial loading there were no statistically significant differences between the two procedures, with the exception of 0.4 mm more marginal bone loss at implants subjected to three abutment disconnections. There were no significantly increased marginal bone loss (difference = 0.1 mm, CI 95%: -0.3, 0.5, P = 0.590) or buccal recessions (difference = 0.1 mm, CI 95%: -0.4, 0.7, P = 0.674) at implants with less than 2 mm of keratinised mucosa at loading.Three-year post-loading data showed that repeated abutment disconnections significantly increased bone loss of 0.43 mm, but this difference may not be considered clinically relevant; therefore clinicians can use the procedure they find more convenient for each specific patient. Immediately non-occlusally loaded dental implants are a viable alternative to conventional loading and no increased bone loss or buccal recessions were noticed at implants with less than 2 mm of keratinised mucosa. Conflict of interest statement: This trial was partially funded by Dentsply Sirona Implants, the manufacturer of the implants and other products evaluated in this investigation. However, data belonged to the authors and by no means did the manufacturer interfere with the conduct of the trial or the publication of the results, with the exception of rejecting a proposal to change the protocol, after the trial was started, allowing the use of indexed abutments.
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| 11. |
- Cannizzaro, G., et al.
(författare)
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Immediate loading of bimaxillary total fixed prostheses supported by five flapless-placed implants with machined surfaces: A 6-month follow-up prospective single cohort study
- 2016
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 9:1, s. 67-74
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate the clinical outcome of fully edentulous patients rehabilitated with immediately loaded bimaxillary screw-retained metal-resin prostheses supported by five implants placed flapless: two in the mandible and three in the maxillae. Materials and methods: Twenty-five consecutively treated patients were recruited. To be immediately loaded, implants had to be inserted with a minimum torque of 80 Ncm. Outcome measures were prosthesis and implant failures, and complications. Results: Six months after loading no patients dropped out and no prosthesis or implant failed. Two maxillary prostheses were loaded early at 8 weeks because implants were inserted with a torque inferior to 45 Ncm. Three complications occurred in two patients but they were all successfully treated. Conclusions: Six months after loading, immediately loaded bimaxillary cross-arch prostheses can be supported by only two mandibular and three maxillary flapless-placed dental implants. Longer follow-ups of approximately 10 years are needed to understand the prognosis of this treatment modality.
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| 12. |
- Cannizzaro, Gioacchino, et al.
(författare)
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Immediate loading of fixed cross-arch prostheses supported by flapless-placed 5 mm or 11.5 mm long implants: 5-year results from a randomised controlled trial.
- 2018
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Ingår i: European journal of oral implantology. - 1756-2406. ; 11:3, s. 295-306
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Tidskriftsartikel (refereegranskat)abstract
- To compare the outcome of cross-arch prostheses supported either by 5 mm long or 11.5 mm long implants placed flapless and immediately restored with a metal-resin screw-retained cross-arch prostheses.Thirty patients with edentulous or to-be- rendered edentulous mandibles, and 30 with edentulous maxillas, having sufficient bone to allow the placement of four and six implants respectively, of at least 11.5 mm long, were randomised according to a parallel group design into two equal groups and received either 5 mm or 11.5 mm long implants at one centre. Implants had a diameter of 5 mm, were to be placed flapless, and with an insertion torque of at least 50 Ncm. Mandibles received four implants between the mental foramina. Implants were to be immediately loaded with metal-resin definitive prostheses the same day as implant placement. Patients were followed to 5 years post-loading and the outcome measures were: prosthesis and implant failures, complications, and peri-implant marginal bone level changes.Four patients per group dropped out. Two prostheses were remade, one on short maxillary implants and one on long mandibular implants (difference in proportions = 0; 95% CI: -0.15 to 0.15; P = 1.000). Three patients lost six short implants vs three patients who lost four long implants (difference in proportions = 0; 95% CI: -0.19 to 0.19; P = 1.000). Four short implant patients were affected by complications vs five patients with long implants (difference in proportions = 0.04; 95% CI: -0.17 to 0.25; P = 1.000). There were no statistically significant differences for prostheses failures, implant failures and complications. Patients with mandibular short implants lost on average 0.22 mm of peri-implant bone at 5 years while patients with long mandibular implants lost 0.83 mm. Patients with maxillary short implants lost on average 0.30 mm of peri-implant bone at 5 years and patients with long maxillary implants lost 0.89 mm. Short implants showed less bone loss when compared with long implants and the differences up to 5 years were statistically significant both in maxillae (mean difference = 0.59 mm, 95% CI: 0.33 to 0.86 mm, P < .0001) and in mandibles (mean difference = 0.61 mm, 95% CI: 0.36 to 0.86 mm, P < 0.0001).Flapless-placed 5 mm long implants achieved similar results as 11.5 mm long implants when supporting immediately loaded cross-arch prostheses both in maxillae and mandibles up to 5 years after loading. These results must be confirmed by other trials, and 10 years post-loading data is necessary before making reliable recommendations.
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| 13. |
- Cannizzaro, G., et al.
(författare)
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Immediate loading of fixed cross-arch prostheses supported by flapless-placed supershort or long implants: 1-year results from a randomised controlled trial
- 2015
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 8:1, s. 27-36
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare the outcome of cross-arch prostheses supported either by supershort (5 mm) or long (11.5 mm) implants, placed flapless and immediately restored with metal-resin screw-retained cross-arch prostheses. Materials and methods: Thirty patients with edentulous (or to be rendered edentulous) mandibles and 30 with edentulous maxillas, who had sufficient bone to allow the placement of four and six implants respectively, which were at least 11.5 mm-long, were randomised according to a parallel group design into 2 equal groups, where they received either 5 mm or 11.5 mm-long implants at one centre. Implants with a diameter of 5 mm, were to be placed flapless with an insertion torque of at least 50 Ncm. Mandibles received four implants between the mental foramina. Implants were to be immediately loaded with metal-resin-definitive prostheses on the same day of implant placement. Patients were followed up to 1 year after loading and the outcome measures were: prosthesis and implant failures, complications, and pen-implant marginal bone level changes. Results: No patients dropped-out. Two prostheses were remade, one on short maxillary implants and one on long mandibular implants. Two 5 mm maxillary implants which did not achieve 50 Ncm torque in soft bone of one patient, but were immediately loaded anyway, failed after 3 weeks compared to one mandibular 11.5 mm-long implant that failed after 60 days. Two complications occurred in each group. There were no statistically significant differences for prosthesis failures, implant failures and complications. Patients with mandibular short implants lost on average 0.08 mm of pen-implant bone at 1 year and patients with long mandibular implants lost 0.51 mm. Patients with short maxillary implants lost on average 0.15 mm of pen-implant bone at 1 year and patients with long maxillary implants lost 0.62 mm. Short implants showed less bone loss when compared to long implants and the differences up to 1 year were statistically significant both in maxillae (mean difference = 0.48 mm, 95% CI 0.22 to 0.73, P = 0.0011) and in mandibles (mean difference = 0.44 mm, 95% CI 0.21 to 0.66, P = 0.0009). Conclusions: Flapless-placed 5 mm-long implants achieved similar results as 11.5 mm-long implants when supporting immediately loaded cross-arch prostheses both in maxillae and mandibles up to 1 year after loading. These preliminary results must be confirmed by other trials, and 5- to 10-year post-loading data is necessary before making reliable recommendations.
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| 14. |
- Cannizzaro, Gioacchino, et al.
(författare)
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Immediate loading of one (fixed-on-1) versus two (fixed-on-2) implants placed flapless supporting mandibular screw-retained cross-arch fixed prostheses: 10-month results from an explanatory randomised controlled trial.
- 2019
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Ingår i: International journal of oral implantology (New Malden, London, England). - 2631-6439. ; 12:1, s. 89-102
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate the outcome of one (fixed-on-1, Fo1) versus two (fixed-on-2, Fo2) implants placed flapless in fully edentulous mandibles and immediately restored with metal-resin screw-retained cross-arch prostheses.Twenty patients with edentulous or to be rendered edentulous mandibles were randomised to the Fo1 group (10 patients who received three intraforaminal implants but only the mesial implant was actually loaded) and to the Fo2 group (10 patients who received two intraforaminal implants) according to a parallel-group design. To be immediately loaded implants had to be inserted with a minimum torque of 60 Ncm. Outcome measures were prosthesis and implant failures, complications and patient satisfaction for function and aesthetics evaluated up to 10 months post-loading.Flaps were raised in three patients of the Fo1 group and one of the Fo2 group. Two prostheses in each group were delayed loaded at 2 and 3 months, because implants could not be inserted with a torque superior to 60 Ncm. Patients of the Fo2 group received prostheses with 12 teeth whereas Fo1 patients with 8 or 10 teeth. Ten months after loading no drop-out or implant failure occurred, but one Fo2 prosthesis had to be remade because the patient complained it was too short (risk difference = 0.1; 95% CI: -0.19 to 0.40; Fisher's exact test P = 1.000). Three patients were affected by complications in each group (risk difference = 0.0; 95% CI: -0.359 to 0.359; Fisher's exact test; P = 1.000). There were no statistically significant differences for prosthetic failures and complications between groups. Four months after loading, patients of the Fo1 group were less satisfied for function than those of the Fo2 group (difference between the medians [Hodges-Lehmann estimation] = 1; 95% CI: 0 to 2; P = 0.043). No differences were observed for aesthetics (difference between the medians [Hodges-Lehmann estimation] = 0; 95% CI: -1 to 0; P = 0.481), and two Fo1 patients would not undergo the same procedure again (difference in proportions: 0.2; 95% CI: -0.11 to 0.51; P = 0.474).Preliminary results suggest that immediately loaded cross-arch screw-retained fixed prostheses with 8 to 10 teeth can be supported by only one dental implant at least up to 10 months post-loading; however, the clinical application and usefulness of such a procedure remains questionable.
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| 15. |
- Cannizzaro, G., et al.
(författare)
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Immediate loading of two (fixed-on-2) versus three (fixed-on-3) implants placed flapless supporting cross-arch fixed prostheses: One-year results from a randomised controlled trial
- 2016
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 9:2, s. 143-153
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate the outcome of two (fixed-on-2 = FO2) versus three (fixed-on-3 = FO3) implants placed flapless in fully edentulous jaws and immediately restored with metal-resin screw-retained crossarch prostheses. Materials and methods: Forty edentulous or to be rendered edentulous patients (20 in the maxilla and 20 in the mandible) were randomised to the FO2 group (20 patients: 10 in the maxilla and 10 in the mandible) and to the FO3 group (20 patients: 10 in the maxilla and 10 in the mandible) according to a parallel group design. To be immediately loaded, implants had to be inserted with a minimum torque of 60 Ncm. Outcome measures were prosthesis and implant failures, complications and peri-implant marginal bone level changes evaluated up to 1-year post-loading. Results: Flaps were raised in four patients and two prostheses were loaded early at 8 weeks in the FO2 group. One year after loading no dropout or implant failure occurred, however one FO2 maxillary prosthesis had to be remade because of repeated screw-loosening (risk difference = 0.05; 95% CI: -0.05 to 0.15; Fisher's exact test P = 1.000). Three FO2 patients were affected by complications versus five FO3 patients (risk difference = -0.1; 95% CI: -0.35 to 0.15; Fisher's exact test; P = 0.695). There were no statistically significant differences for prosthetic failures and complications between groups. There were no statistically significant differences for marginal peri-implant bone levels between the two groups (estimate of the difference = 0.031 mm; 95% Cl: -0.22 to 0.28; P (ancova) = 0.803), with both groups losing marginal bone in a statistically significant way (0.27 mm for FO2 patients and 0.24 mm for FO3 patients). Conclusions: These preliminary results suggest that immediately loaded cross-arch prostheses can be supported by only two or three dental implants at least up to 1-year post-loading. Longer follow-ups are needed to properly evaluate both these therapeutic options.
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| 16. |
- Cannizzaro, G., et al.
(författare)
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Immediate loading of two (fixed-on-2) vs four (fixed-on-4) implants placed with a flapless technique supporting mandibular cross-arch fixed prostheses: 3-year results from a pilot randomised controlled trial
- 2017
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 10:2, s. 133-145
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate the outcome of two vs four implants placed flapless in fully edentulous mandibles and immediately restored with metal-resin screw-retained cross-arch prostheses. Materials and Methods: A total of 60 patients from two different centres were randomised: 30 to the fixed-on-2 group and 30 to the fixed-on-4 group according to a parallel group design. To be immediately loaded implants had to be inserted with a minimum torque of 40 Newton/cm (Ncm). Outcome measures were prosthesis and implant failures, complications, and marginal bone level changes. Results: Flaps were raised in 18 patients. Two implants in two patients did not reach the planned insertion torque and were replaced immediately by larger diameter ones. Three years after loading, two patients dropped out from the fixed-on-2 group and one from the fixed-on-4 group. No implant failure or prosthetic failure occurred. A total of 12 fixed-on-2 patients were affected by one complication each vs 13 fixed-on-4 patients. There were no statistically significant differences for complications between groups (difference in proportion = -0.03; 95% CI -29 to 0.22; P [Fisher's exact test] = 1.000). There were no statistically significant differences for marginal peri-implant bone loss between the two groups (mean difference = 0.14; CI 95% -0.17 to 0.45; P [ANCOVA] = 0.356), with both groups losing marginal bone in a statistically significant way (1.70 mm for fixed-on-2 implants and 1.56 mm for fixed-on-4 implants). There were statistically significant differences between the two centres, with more bone being lost for the Bologna centre (2.18 vs 1.13 mm; P (ANCOVA) < 0.001). Conclusions: Up to 3 years after loading, these preliminary results suggest that immediately loaded mandibular cross-arch fixed prostheses can be supported by only two dental implants. Longer follow-ups (about 10 years) are needed to properly evaluate this therapeutic option.
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| 17. |
- Cannizzaro, G., et al.
(författare)
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Immediate loading of two flapless placed mandibular implants supporting cross-arch fixed prostheses: A 5-year follow-up prospective single cohort study
- 2016
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 9:2, s. 165-177
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate the clinical outcome of two implants placed flapless in fully edentulous mandibles and immediately restored with metal-resin screw-retained cross-arch prostheses 5 years after loading. Materials and methods: Eighty consecutive patients were recruited. To be immediately loaded, implants had to be inserted with a minimum torque of 80 Ncm. Forty-six laser-welded titanium and 34 cast silver-palladium frameworks with resin teeth were initially delivered within 8 and 48 h, respectively. Outcome measures, evaluated by two independent assessors included prosthesis and implant failures, complications, marginal bone level changes, implant stability quotient (ISQ) values and patient satisfaction. Results: Five years after loading one patient did not return to the control and 10 prostheses were remade. Two implants failed early in two patients, but they were successfully replaced. Thirty-six complications occurred in 28 patients but were all successfully treated. After 5 years, mean marginal bone loss was 0.69 mm, mean ISQ values decreased from 75.4 to 73.8, and all patients were fully satisfied with the therapy. A post-hoc comparison between the outcome of laser-welded and cast frameworks showed that laser-welded frameworks were affected by significantly more complications (19 patients out of 46 and 6 patients out of 34, respectively; difference in proportion = 0.23, 95% CI: 0.03 to 0.43; Pearson's chi-square test, P = 0.032), therefore such a framework construction should be considered as a long-term temporary prosthesis and not a definitive prosthesis. Conclusions: Immediately loaded mandibular cross-arch prostheses can be supported by only two implants up to 5 years, if made with a robust cast framework. Longer follow-ups (around 10 years) are still needed to know the prognosis of this treatment modality.
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| 18. |
- Cannizzaro, Gioacchino, et al.
(författare)
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Immediate vs early loading of 6.6 mm flapless-placed single implants: 9 years after-loading report of a split-mouth randomised controlled trial.
- 2018
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Ingår i: European journal of oral implantology. - 1756-2406. ; 11:2, s. 163-173
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate the long-term effectiveness of 6.6 mm long flapless-placed single implants loaded immediately or early loaded at 6 weeks.Thirty patients each received two single Nanotite External Hex Biomet 3i implants, which were then randomly allocated to be either immediately or early loaded, according to a split-mouth design. Implants had to be inserted with a torque superior to 40 Ncm. Provisional crowns were put in slight occlusal contact and replaced by definitive crowns 3 months after loading. Patients were followed for 9 years after loading. Outcome measures were implant failures, biological and biomechanical complications, peri-implant marginal bone level changes and patient preference.A total of 29 implants were immediately loaded, while 31 were early loaded. Nine years after loading, three patients dropped out. One implant failed in each group within 2 months after loading. One patient asked for the immediately loaded crown to be remade for aesthetic reasons and then again to have both metal-ceramic crowns replaced by full ceramic crowns. Another patient had his immediately loaded crown remade after repeated debonding. Six patients from each group experienced complications, the difference being not statistically significant (difference of proportions = 0.00; 95% CI -0.20 to 0.20, P = 1.000). Peri-implant bone loss was 0.60 mm for patients with immediately loaded implants and 0.46 mm for early loaded ones, which was not significantly different (mean difference = 0.14 mm, 95% CI -0.13 to 0.41, P = 0.283). All but one patient had no preference for either procedure after 9 years.Flapless-placed 6.6 mm long single implants can be immediately loaded and remain successful up to 9 years after loading. Conflict-of-interest statement:
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| 19. |
- Cannizzaro, G., et al.
(författare)
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Machined versus roughened immediately loaded and finally restored single implants inserted flapless: Preliminary 6-month data from a split-mouth randomised controlled trial
- 2016
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 9:2, s. 155-163
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare the outcome of immediately loaded single implants with a machined or a roughened surface. Materials and methods: Fifty patients had two implant sites randomly allocated to receive flapless-placed single Syra implants (Sweden & Martina), one with a machined and one with a roughened surface (sand-blasted with zirconia powder and acid etched), according to a split-mouth design. To be loaded immediately, implants had to be inserted with a torque superior to 50 Ncm. Implants were restored with definitive crowns in direct occlusal contact within 48 h. Patients were followed for 6 months after loading. Outcome measures were prosthetic and implant failures and complications. Results: Two machined implants and four roughened implants were not loaded immediately. Six months after loading no dropout occurred. One implant loaded late, which had a rough implant surface, failed 20 days after loading (P (McNemar test) = 0.625; difference in proportions = -0.04; 95% CI: -0.15 to 0.07). Three crowns had to be remade on machined implants and four on roughened implants (P (McNemar test) = 1.000; difference in proportions = -0.02; 95% CI: -0.12 to 0.08). Three machined and five roughened implants experienced complications (P (McNemar test) = 0.625; difference in proportions = -0.04; 95% CI: -0.15 to 0.07). There were no statistically significant differences between groups for crown and implant losses as well as complications. Conclusions: Up to 6 months after loading both machined and roughened flapless-placed and immediately loaded single implants provided good and similar results, however, longer follow-ups are needed to evaluate the long-term prognosis of implants with different surfaces.
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| 20. |
- Cannizzaro, Gioacchino, et al.
(författare)
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Two or three machined vs roughened surface dental implants loaded immediately supporting total fixed prostheses: 1-year results from a randomised controlled trial.
- 2017
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Ingår i: European journal of oral implantology. - 1756-2406. ; 10:3, s. 279-291
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Tidskriftsartikel (refereegranskat)abstract
- To compare implants with machined vs roughened surfaces placed flapless in totally edentulous jaws and immediately restored with metal-resin screw-retained cross-arch prostheses. Mandibles were rehabilitated with two implants (Fixed-on-2 or Fo2) and maxillae with three implants (Fixed-on-3 or Fo3).Forty edentulous or to be rendered edentulous patients (20 in the mandible and 20 in the maxilla) were randomised to the machined group (20 patients: 10 mandibles and 10 maxillae) and to the roughened group (20 patients: 10 mandibles and 10 maxillae) according to a parallel group design. To be immediately loaded implants had to be inserted with a minimum torque of 60 Ncm. Outcome measures were prosthesis and implant failures, complications and peri-implant marginal bone level changes evaluated up to 1 year post-loading.Flaps were raised in four patients from the machined group. Four prostheses on machined implants and three on roughened implants were delayed for loading because a sufficient insertion torque was not obtained. There were no dropouts 1 year after loading. Two maxillary machined implants were lost in two patients (difference in proportions = 0.10; 95% CI = -0.03 to 0.23; P (Fisher's exact test) = 0.487); one maxillary Fo3 prosthesis on machined implants and one mandibular Fo2 prosthesis on roughened implants had to be remade (difference in proportions = 0; 95% CI = -0.14 to 0.14; P (Fisher's exact test) = 1.000). Five patients with machined implants had six complications vs seven patients who had eight complications at roughened implants (difference in proportions = -0.10; 95% CI = -0.38 to 0.18; P (Fisher's exact test) = 0.731). There were no statistically significant differences for implant failures, prosthetic failures or complications between groups. There were no statistically significant differences for marginal peri-implant bone levels between the two groups (estimate of the difference = -0.06 mm; 95% CI = -0.23 to 0.10; P (ANCOVA) = 0.445), with both groups losing marginal bone in a statistically significant way (0.35 ± 0.23 mm for machined and 0.42 ± 0.27 mm for roughened surface).These preliminary results suggest that immediately loaded cross-arch prostheses can be supported by only two mandibular or three maxillary dental implants at least up to 1 year post-loading, independently of the type of implant surface used. Longer follow-ups are needed to understand whether one of the two-implant surfaces is preferable.
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| 21. |
- Checchi, V., et al.
(författare)
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Wide diameter immediate post-extractive implants vs delayed placement of normal-diameter implants in preserved sockets in the molar region: 1-year postloading outcome of a randomised controlled trial
- 2017
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 10:3, s. 263-278
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare the effectiveness of 6.0 to 8.0 mm-wide diameter implants, placed immediately after tooth extraction, with conventional 4.0 or 5.0 mm diameter implants placed in a preserved socket after a 4-month period of healing in the molar region. Materials and Methods: Just after extraction of one or two molar teeth, and with no vertical loss of the buccal bone in relation to the palatal wall, 100 patients requiring immediate post-extractive implants were randomly allocated to immediate placement of one or two 6.0 to 8.0 mm-wide diameter implants (immediate group; 50 patients) or for socket preservation using a porcine bone substitute covered by a resorbable collagen barrier (delayed group; 50 patients), according to a parallel group design in one centre. Bone-to-implant gaps were filled with autogenous bone retrieved with a trephine drill used to prepare the implant sites for the immediate wide diameter post-extractive implants. Four months after socket preservation, one to two 4.0 or 5.0 mm-wide delayed implants were placed. Implants were loaded 4 months after placement with fixed provisional restorations in acrylic, and replaced after 4 months by fixed, definitive, metal-ceramic restorations. Patients were followed to 1 year after loading. Outcome measures were: implant failures, complications, aesthetics assessed using the pink esthetic score (PES), peri-implant marginal bone level changes, patient satisfaction, number of appointments and surgical interventions recorded, when possible, by blinded assessors. Results: Three patients dropped out 1 year after loading from the immediate group vs six from the delayed group. Five implants out of 47 failed in the immediate group (10.6%) vs two out 44 (4.6%) in the delayed group, the difference being not statistically significant (difference in proportion = 6.0%, 95% CI: -8.8% to 20.8%, P = 0.436). In the immediate group 10 patients were affected by 10 complications, while in the delayed group four patients were affected by four complications. The difference was not statistically significant (difference in proportion = 12%, 95% CI: -2% to 26%, P = 0.084). At delivery of the definitive prostheses, 4 months after loading, the mean total PES score was 9.65 ± 1.62 and 10.44 ± 1.47 in the immediate and delayed groups, respectively. At 1 year after loading, the mean total PES score was 9.71 ± 2.71 and 10.86 ± 1.37 in the immediate and delayed groups, respectively. The Total PES score was statistically significantly better at delayed implants both at 4 months (mean difference = 0.79; 95% CI: 0.05 to 1.53; P = 0.03) and at 1 year (mean difference = 1.15; 95% CI: 0.13 to 2.17; P = 0.02). Marginal bone levels at implant insertion (after bone grafting) were 0.04 mm for immediate and 0.11 mm for delayed implants, which was statistically significantly different (mean difference = 0.07; 95% CI: 0.02 to 0.12; P < 0.0001). One year after loading, patients in the immediate group lost on average 1.06 mm and those from the delayed group 0.63 mm, the difference being statistically significant (mean difference = 0.43 mm; 95% CI: 0.15 to 0.61; P < 0.0001). All patients were fully or partially satisfied both for function and aesthetics, and would undergo the same procedure again both at 4 months and 1 year after loading. Patients from the immediate group required on average 7.48 ± 1.45 visits to the clinician and 2.14 ± 0.49 surgical interventions and to have their definitive prostheses delivered vs 10.30 ± 0.99 visits and 3.08 ± 0.40 surgical interventions for the delayed group, the difference being statistically significant (P < 0.001 for visits, and P < 0.001 for surgical interventions). Conclusions: Preliminary 1 year follow-up data suggest that immediate placement of 6.0 to 8.0 mm wide diameter implants in molar extraction sockets yielded inferior aesthetic outcomes than ridge preservation and delayed placement of conventional 4.0 to 5.0 mm diameter implants. Conflict of interest statement: This trial was partially funded by the manufacturer of the implants evaluated in his investigation (MegaGen Implant Co, Gyeongbuk, South Korea). However, data belonged to the authors and in no way did the manufacturer interfere with the conduct of the trial or the publication of its results. © Quintessenz.
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| 22. |
- Davó, Rubén, et al.
(författare)
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Immediately loaded zygomatic implants vs conventional dental implants in augmented atrophic maxillae: 1-year post-loading results from a multicentre randomised controlled trial.
- 2018
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Ingår i: European journal of oral implantology. - 1756-2406. ; 11:2, s. 145-161
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Tidskriftsartikel (refereegranskat)abstract
- To compare the clinical outcome of immediately loaded cross-arch maxillary prostheses supported by zygomatic implants vs conventional implants placed in augmented bone.In total, 71 edentulous patients with severely atrophic maxillas without sufficient bone volumes for placing dental implants, or when it was possible to place only two implants in the anterior area (minimal diameter 3.5 mm and length of 8 mm) and less than 4 mm of bone height subantrally, were randomised according to a parallel group design to receive zygomatic implants (35 patients) to be loaded immediately vs grafting with a xenograft, followed after 6 months of graft consolidation by placement of six to eight conventional dental implants submerged for 4 months (36 patients). For immediate loading, zygomatic implants had to be inserted with an insertion torque superior to 40 Ncm. Screw-retained metal reinforced acrylic provisional prostheses were provided, to be replaced by definitive Procera Implant Bridge Titanium prostheses (Nobel Biocare, Göteborg, Sweden), with ceramic or acrylic veneer materials 4 months after initial loading. Outcome measures were: prosthesis, implant and augmentation failures, any complications, quality of life (OHIP-14), patients' number of days with total or partial impaired activity, time to function and number of dental visits, assessed by independent assessors. Patients were followed up to 1 year after loading.No augmentation procedure failed. Five patients dropped out from the augmentation group. Six prostheses could not be delivered or failed in the augmentation group vs one prosthesis in the zygomatic group, the difference being statistically significant (difference in proportions = -16.5%; P = 0.045; 95% CI: -0.34 to -0.01). Eight patients lost 35 implants in the augmentation group vs two patients who lost four zygomatic implants, the difference being statistically significant (difference in proportions = -20.1%; P = 0.037; 95% CI: -0.38 to -0.02). A total of 14 augmented patients were affected by 22 complications, vs 28 zygomatic patients (40 complications), the difference being statistically significant (difference in proportions = 34.8%; P = 0.005; 95% CI: 0.12 to 0.54). The 1-year OHIP-14 score was 3.93 ± 5.86 for augmented patients and 3.97 ± 4.32 for zygomatic patients with no statistically significant differences between groups (mean difference = 0.04; 95% CI: -2.56 to 2.65; P = 0.747). Both groups had significantly improved OHIP-14 scores from before rehabilitation (P < 0.001 for both augmented and zygomatic patients). On average, the number of days of total infirmity was 7.42 ± 3.17 for the augmented group and 7.17 ± 1.96 for the zygomatic group, the difference not being statistically significant (mean difference = -0.25; 95% CI: -1.52 to 1.02; P = 0.692). The number of days of partial infirmity were on average 14.24 ± 4.64 for the augmented group and 12.17 ± 3.82 for the zygomatic group, the difference being statistically significant (mean difference = -2.07; 95% CI: -4.12 to -0.02; P = 0.048). The mean number of days that needed to have a functional prosthesis was 444.32 ± 207.86 for augmented patients and 1.34 ± 2.27 for zygomatic patients, the difference being statistically significant (mean difference = -442.98; 95% CI: -513.10 to -372.86; P < 0.001). The average number of dental visits was 19.72 ± 12.22 for augmented patients and 15.12 ± 5.76 for zygomatic patients, the difference not being statistically significant (mean difference = -4.61; 95% CI: -9.31 to 0.92; P = 0.055).Preliminary 1-year post-loading data suggest that immediately loaded zygomatic implants were associated with statistically significantly fewer prosthetic failures (one vs six patients), implant failures (two vs eight patients) and time needed to functional loading (1.3 days vs 444.3 days) when compared to augmentation procedures and conventionally loaded dental implants. Even if more complications were reported for zygomatic implants, they proved to be a better rehabilitation modality for severely atrophic maxillae. Long-term data are absolutely needed to confirm or dispute these preliminary results.
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| 23. |
- Esposito, Marco, 1965, et al.
(författare)
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Clinical evaluation of a novel dental implant system as single implants under immediate loading conditions-4-month post-loading results from a multicentre randomised controlled trial
- 2016
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 9:4, s. 367-379
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate the safety and clinical effectiveness of a novel dental implant system (GENESIS Implant System, Keystone Dental, Massachusetts, USA) using another dental implant system by the same manufacturer as a control (PRIMA Implant System, Keystone Dental). Materials and methods: A total of 53 patients requiring at least two single crowns had their sites randomised according to a split-mouth design to receive both implant systems at six centres. If implants could be placed with a torque superior to 40 Ncm they were to be loaded immediately with provisional crowns, otherwise after 3 months of submerged healing. Provisional crowns were replaced by definitive crowns 4 months after initial loading, when the follow-up period for the initial part of this study was completed. Outcome measures were crown/implant failures, complications, pink esthetic score (PES), peri-implant marginal bone level changes, plaque score, marginal bleeding, patients and preference of the clinician. Results: In total 53 PRIMA and 53 GENESIS implants were placed. Three patients dropped out but all of the remaining patients were followed up to 4-months post-loading. No PRIMA implant failed whereas four GENESIS implants failed. Only two complications were reported for PRIMA implants. There were no statistically significant differences for crown/implant failures (difference in proportions = 0.080; P (McNemar test) = 0.125) and complications (difference in proportions = -0.04; P (McNemar test) = 0.500) between the implant systems. There were no differences at 4-months post-loading for plaque (difference = -0.54, 95% CI:-3.01 to 1.93; P (Paired t-test) = 0.660), marginal bleeding (difference = -3.8, 95% CI: -7.63 to 0.019; P (Paired t-test) = 0.051), PES (difference = 0.47, 95% CI:-0.56 to 1.50; P (Paired t-test) = 0.365) and marginal bone level changes (difference in mm = -0.04, 95% CI: -0.33 to 0.26; P (Paired t-test) = 0.795). The majority of the patients (46) had no preference regarding the two implant systems evaluated. Three operators preferred GENESIS implants, two had no preference and one preferred GENESIS in medium and soft bone and PRIMA in hard bone. Conclusions: No statistically significant differences were observed between the systems' implant types, although four GENESIS implants failed versus none of the PRIMA type. Longer follow-ups of wider patient populations are needed to better understand whether there is an effective advantage with one of the two implant designs.
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| 24. |
- Esposito, Marco, 1965, et al.
(författare)
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Conventional drills vs piezoelectric surgery preparation for placement of four immediately loaded zygomatic oncology implants in edentulous maxillae: results from 1-year split-mouth randomised controlled trial.
- 2017
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Ingår i: European journal of oral implantology. - 1756-2406. ; 10:2, s. 147-158
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Tidskriftsartikel (refereegranskat)abstract
- To compare the outcome of site preparation for zygomatic oncology implants using conventional preparation with rotary drills or piezoelectric surgery with dedicated inserts for placing two zygomatic implants per zygoma according to a split-mouth design.Twenty edentulous patients with severely atrophic maxillas not having sufficient bone volume for placing dental implants and less than 4mm of bone height subantrally had their hemi-maxillas randomised according to a split-mouth design into implant site preparation with conventional rotational drills or piezoelectric surgery. Two zygomatic oncology implants (unthreaded coronal portion) were placed in each hemi-maxilla. Implants that achieved an insertion torque superior to 40Ncm were immediately loaded with screw-retained metal reinforced acrylic provisional prostheses. Outcome measures were: prosthesis and implant failures, any complications, time to place the implants, presence of post-operative haematoma, and patient's preference by independent assessors. All patients were followed up to 1 year after loading.In two patients drills had also to be used at the piezoelectric surgery side to enable implant sites to be prepared. One implant for the conventional drill group did not achieve an insertion torque superior to 40Ncm since it fractured the zygoma. No patients dropped out and two distal oncology implants failed in the same patient (one per group), who was not prosthetically rehabilitated. Six complications occurred at drilled sites and three at piezoelectric surgery sites (two patients had bilateral complications), the difference being not statistically significant (P (McNemar's test)=0.375; odds ratio=4.00; 95% CI of odds ratio: 0.45 to 35.79). Implant placement with convention drills took on average 14.35±1.76min and with piezoelectric surgery 23.50±2.26min, implant placement time being significantly shorter with conventional drilling (difference=9.15±1.69min; 95%CI: 8.36 to 9.94min; P<0.001). Post-operative haematomas were more frequent at drilled sites (P=0.001), and 16 patients found both techniques equally acceptable, while four preferred piezoelectric surgery (P=0.125).Both drilling techniques achieved similar clinical results, but conventional drilling required 9min less and could be used in all instances, although it was more aggressive. These results may be system-dependent, therefore they cannot be generalised to other zygomatic systems with confidence. Conflict-of-interest statement: This study was partially supported by Southern Implants (Irene, South Africa), the manufacturer of the zygomatic implants and the conventional drills evaluated in this study. However, data property belonged to the authors and by no means did the manufacturer interfere with the conduct of the trial or the publication of its results. Drs Felice and Pistilli developed the piezoelectric surgery zygomatic insert used in the present study.
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| 25. |
- Esposito, Marco, 1965, et al.
(författare)
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Dental implants with internal versus external connections: 1-year post-loading results from a pragmatic multicenter randomised controlled trial
- 2015
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 8:4, s. 331-344
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate advantages and disadvantages of identical implants with internal or external connections. Materials and methods: Two hundred patients with any type of edentulism (single tooth, partial and total edentulism) requiring one implant-supported prosthesis were randomly allocated in two equal groups to receive either implants with an external connection (EC) or implants of the same type but with an internal connection (IC) (EZ Plus, Mega Gen Implant, Gyeongbuk, South Korea) at seven centres. Due to slight differences in implant design/components, IC implants were platform switched while EC were not. Patients were followed for 1 year after initial loading. Outcome measures were prosthesis/implant failures, any complication, marginal bone level changes and clinician preference assessed by blinded outcome assessors. Results: One hundred and two patients received '173 EC implants and 98 patients received 154 IC implants. Six patients dropped out with 11 EC implants and 3 patients with four IC implants, but all remaining patients were followed up to 1-year post-loading. Two centres did not provide any periapical radiographs. Two prostheses supported by EC implants and one supported by IC implants failed (P = 1.000, difference = -0.01, 95% CI: -0.05 to 0.04). Three EC implants failed in 3 patients versus two IC implants in 1 patient (P = 0.6227, difference = -0.02, 95% CI: -0.07 to 0.03). EC implants were affected by nine complications in 9 patients versus six complications of IC implants in 6 patients (P = 0.5988, difference = -0.02, 95% CI: -0.10 to 0.06). There were no statistically significant differences for prosthesis/implant failures and complications between the implant systems. One year after loading, there were no statistically significant differences in marginal bone level changes between the two groups (difference = 0.24, 95% CI: -0.01 to 0.50, P =0.0629) and both groups lost bone from implant placement in a statistically significant manner: 0.98 mm for the EC implants and 0.85 mm for the IC implants. Five operators had no preference and two preferred IC implants. Conclusions: Within the limitations given by the difference in neck design and platform switching between EC and IC implants, preliminary short-term data (1-year post-loading) did not show any statistically significant differences between the two connection types, therefore clinicians could choose whichever one they preferred.
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| 26. |
- Esposito, Marco, 1965, et al.
(författare)
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Dental implants with internal versus external connections: 5-year post-loading results from a pragmatic multicenter randomised controlled trial
- 2016
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 9:2, s. 129-141
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate advantages and disadvantages of identical implants with internal or external connections. Materials and methods: One hundred and twenty patients with any type of edentulism (single tooth, partial and total edentulism), requiring one implant-supported prosthesis were randomly allocated in two equal groups to receive either implants with an external connection (EC) or implants of the same type with an internal connection (IC) (EZ Plus, MegaGen Implant, Gyeongbuk, South Korea), at four centres. Due to slight differences in implant design and components, IC implants were platformswitched while EC were not. Patients were followed for 5 years after initial loading. Outcome measures were prosthesis/implant failures, any complication, marginal bone level changes and clinician preference, assessed by blinded outcome assessors. Results: Sixty patients received 96 EC implants and 60 patients received 107 IC implants. Three patients dropped out with four EC implants and five patients with ten IC implants, but all remaining patients were followed up to 5-year post-loading. One prosthesis supported by EC implants and two by IC implants failed (P = 0.615, difference = -0.02, 95% CI: -0.08 to 0.04). One EC implant failed versus three IC implants in two patients (P = 0.615, difference = -0.02, 95% CI: -0.08 to 0.04). Ten complications occurred in 10 EC patients versus nine complications in 9 IC patients (P = 1.000, difference = 0.01, 95% CI: -0.13 to 0.15). There were no statistically significant differences for prosthesis and implant failures and complications between the different connection types. Five years after loading, there were no statistically significant differences in marginal bone level estimates between the two groups (difference = 0.14 mm, 95% CI: -0.28 to 0.56, P (ancova) = 0.505) and both groups lost bone from implant placement in a statistically significant way: 1.13 mm for the EC implants and 1.21 mm for the IC implants. Two operators had no preference and two preferred IC implants. Conclusions: Within the limitations given by the difference in neck design and platform switching between EC and IC implants, 5-year post-loading data did not show any statistically significant differences between the two connection types, therefore clinicians could choose whichever they preferred.
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| 27. |
- Esposito, Marco, 1965, et al.
(författare)
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Do repeated changes of abutments have any influence on the stability of peri-implant tissues ? One-year post-loading results from a multicentre randomised controlled trial
- 2017
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 10:1, s. 57-72
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate the influence of at least three abutment changes in conventionally loaded implants against placement of a definitive abutment in immediately non-occlusal loaded implants on hard and soft tissue changes. Materials and methods: Eighty patients requiring one single crown or one fixed partial prosthesis supported by a maximum of three implants were randomised, after implants were placed with more than 35 Ncm, according to a parallel group design to receive definitive abutments which were loaded immediately (definitive abutment or immediate loading group) or transmucosal abutments. These were delayed loaded after 3 months and were removed at least three times: 1) at impression taking (3 months after implant placement); 2) when checking the zirconium core on titanium abutments at single crowns or the fitting the metal structure at prostheses supported by multiple implants; 3) at delivery of the definitive prostheses (repeated disconnection or conventional loading group). Patients were treated in four centres and each patient contributed to the study with only one prosthesis followed for 1 year after initial loading. Outcome measures were: prosthesis failures, implant failures, complications, pink esthetic score (PES), buccal recessions, patient satisfaction, peri-implant marginal bone level changes and height of the keratinised mucosa. Results: Forty patients were randomly allocated to each group according to a parallel group design. Two patients dropped out from the definitive abutment group but no implant failed. Four provisional and one definitive single crowns had to be remade (due of misfitting) and one definitive crown (due to ceramic fracture) in the repeated disconnection group versus one provisional prosthesis of the immediate loading group due to frequent debondings (difference = 12%; Cl95%: 0%, 25%; P = 0.109). Eight patients were affected by complications: four patients from each group (difference = 1 %; Cl95%: -13%, 14%; P= 1). PES scores assessed at 1 year post-loading were 11.4 (1.5) mm for the definitive abutment group and 11.0 (2.0) mm for the repeated abutment changes group (difference = 0.4; Cl95%: -0.4, 1.2; P = 0.289). Buccal recessions at 1 year post-loading amounted to 0.07 (0.35) mm for the definitive abutment group and 0.12 (0.65) mm for the repeated abutment changes group (actually it was a soft tissue gain; difference = 0.05 Cl 95%: -0.19, 0.29; P = 0.659). All patients declared to be very satisfied or satisfied with the function and aesthetics of the prostheses and would undergo the same procedure again. Mean peri-implant marginal bone loss at 1 year after loading was 0.06 (0.12) mm for the definitive abutment group and 0.23 (0.49) mm for the repeated abutment changes group (difference = -0.16; Cl95%: -0.33,-0.00; P = 0.046). The height of the keratinised mucosa at 1 year post-loading was 2.8 (1.5) mm for the definitive abutment group and 2.8 (1.7) mm for the repeated abutment changes group (difference = -0.0; CI 95%: -0.8, 0.7); P = 0.966. Up to 1 year after initial loading, there were no statistically significant differences between the two procedures, with the exception of 0.16 mm more marginal bone loss at implants subjected to three abutment removals. Conclusions: One-year post-loading data showed that repeated abutment changes significantly increased bone loss of 0.16, but this difference cannot be considered clinically relevant, therefore clinicians can use the procedure they find more convenient for their specific patient. In addition, immediately non-occlusally loaded dental implants are a viable alternative to conventional loading.
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| 28. |
- Esposito, Marco, 1965, et al.
(författare)
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Editorial.
- 2018
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Ingår i: European journal of oral implantology. - 1756-2406. ; 11:Suppl 1
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 29. |
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| 30. |
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| 31. |
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| 32. |
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| 33. |
- Esposito, Marco, 1965, et al.
(författare)
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Four mm-long versus longer implants in augmented bone in atrophic posterior jaws: 4-month post-loading results from a multicentre randomised controlled trial
- 2016
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 9:4, s. 393-409
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate whether 4-mm long dental implants could be an alternative to augmentation with equine bone blocks and the placement of at least 10-mm long implants in atrophic posterior jaws. Materials and methods: Forty patients with atrophic posterior (premolar and molar areas) mandibles having 5 to 6 mm bone height above the mandibular canal and 40 patients with atrophic maxillae having 4 to 5 mm below the maxillary sinus, were randomised according to a parallel group design to receive one to three 4.0 mm-long implants or one to three implants, which were at least 10 mm long, in augmented bone at two centres. All implants had a diameter of 4.0 or 4.5 mm. Mandibles were vertically augmented with interpositional equine bone blocks and resorbable barriers. Implants were placed 4 months after interpositional grafting. Maxillary sinuses were augmented with particulated porcine bone via a lateral window covered with resorbable barriers, and implants were placed simultaneously. Implants were not submerged and were loaded after 4 months with provisional prostheses. Four months later, screw-retained reinforced acrylic restorations were delivered, and then replaced after 4 months by definitive screw-retained metal-composite prostheses. Patients were followed up to 4-months post-loading. Outcome measures included prosthesis and implant failures, any complication and peri-implant marginal bone level changes. Results: No patient dropped out. In six augmented mandibles (30%), it was not possible to place implants which were at least 10.0-mm long, therefore shorter implants had to be placed instead. In particular, one mandible fractured and the patient did not want to go ahead with the treatment. One implant of the patient with the mandible fracture from the augmented group failed versus two 4.0 mm implants in two patients from the short implant group. In the maxillae, three short implants failed in two patients versus five long implants in three patients (two long implants and one short implant dropped into the maxillary sinus). Two prostheses on short implants (one mandibular and one maxillary) were placed at a later stage because of implant failures versus four prostheses (one mandibular and three maxillary) at augmented sites. In particular, three patients of the augmented group (one mandible and two maxillary) were not prosthetically rehabilitated. There were no statistically significant differences in implant failures (P (chi-square test) = 1.000; difference in proportion = 0; 95% CI:-0.13 to 0.13 or prostheses failures (P (chi-square test) = 0.399; difference in proportion = 0.05; 95% CI:-0.06 to 0.16). At mandibular sites, nine augmented patients were affected by complications versus one patient treated with short implants (P (chi-square test) = 0.003; difference in proportion = 0.40; 95% CI: 0.16 to 0.64), with the difference being statistically significant. No significant differences were found for the maxillae: eight sinus lift patients versus three patients rehabilitated with maxillary short implants were affected by complications (P (chi-square test) = 0.077; difference in proportion = 0.25; 95% CI:-0.02 to 0.52). Patients with mandibular short implants lost on average 0.40 mm of peri-implant bone at 4 months and patients with 10 mm or longer mandibular implants lost 0.52 mm. Patients with short maxillary implants lost on average 0.48 mm peri-implant bone at 4 months and patients with 10 mm or longer maxillary implants lost 0.50 mm. The difference was statistically significant in the mandibles (mean difference: -0.12 mm, 95% CI: -0.20 to -0.04, P (ANCOVA) = 0.006), but not in the maxillae (mean difference: -0.02 mm, 95% CI: -0.10 to 0.07, P (ANCOVA) = 0.711). Conclusions: Four months after loading 4.0 mm-long implants achieved similar results, if not better, than longer implants in augmented jaws, but were affected by fewer complications. Short implants might be a preferable choice to bone augmentation, especially in mandibles, since the treatment is less invasive, faster, cheaper, and associated with less morbidity; however, 5- to 10-year post-loading data is necessary before making reliable recommendations.
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| 34. |
- Esposito, Marco, 1965, et al.
(författare)
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Immediate, early (6 weeks) and delayed loading (3months) of single implants: 4-month post-loading from a multicenter pragmatic randomised controlled trial.
- 2016
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Ingår i: European journal of oral implantology. - 1756-2406. ; 9:3, s. 249-260
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Tidskriftsartikel (refereegranskat)abstract
- To compare the clinical outcome of single, partial and full fixed implant-supported prostheses immediately loaded (within 48h), early loaded at 6weeks and conventionally loaded at 3months (delayed loading).Eighty-one patients (27 requiring single implants, 27 requiring partial fixed prostheses and 27 requiring total fixed cross-arch prostheses) were randomised in equal numbers in three private practices to immediate loading (27 patients), early loading (27 patients) and conventional loading (27 patients) according to a parallel group design with three arms. To be immediately or early loaded, implants had to be inserted with a torque superior to 40Ncm. Implants were initially loaded with provisional prostheses and replaced after 4months by definitive ones. Outcome measures were prosthesis and implant failures and complications.No patient dropped out up to 4-months post-loading. No implant or prosthesis failed or any complications occurred.All loading strategies were highly successful and no differences could be observed for implant survival and complications when loading implants immediately, early or conventionally. Conflict-of-interest statement: This trial was partially funded by MegaGen, the manufacturer of the implants evaluated in this investigation, however data belonged to the authors and by no means did the manufacturer interfere with the conduct of the trial or the publication of its results.
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| 35. |
- Esposito, Marco, 1965, et al.
(författare)
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Immediate, immediate-delayed (6 weeks) and delayed (4 months) post-extractive single implants: 1-year post-loading data from a randomised controlled trial
- 2017
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 10:1, s. 11-26
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare the clinical outcome of single implants placed immediately after tooth extraction with implants placed 6 weeks after tooth extraction (immediate-delayed placement), and with implants placed after 4-month extraction and socket healing (delayed placement). Materials and methods: Two-hundred and ten (210) patients requiring a single implant-supported crown to replace a tooth to be extracted were randomised to receive immediate post-extractive implants (70 patients), immediate-delayed implants at 6 weeks (70 patients), and delayed implants after 4 months of healing (70 patients) according to a parallel group design. When needed, patients of the immediate and immediate-delayed group had the socket grafted with a bone substitute and covered with a resorbable membrane at implant placement. Sockets randomised to delayed implants were grafted in the same manner if poorly preserved or in the aesthetic areas (from second upper to second upper premolars). Implants inserted with at least 25 Ncm torque were left to heal unloaded for 4 months, whereas those inserted with less than 25 Ncm were left to heal unloaded for 6 months. Temporary crowns were delivered and were to be replaced by definitive ones after 4 months. Outcome measures were crown and implant failures, complications, peri-implant marginal bone level changes, aesthetically assessed using the pink esthetic score (PES), and patient satisfaction recorded by blinded assessors. Patients were followed up to 1 year post-loading. Results: One year after loading, three patients dropped out from the immediate group, five from the immediate-delayed group, and six from the delayed group. Four implants (6%) failed in the immediate, four (6.2%) in the immediate-delayed, and one (1.6%) from the delayed group (P (chisquare test) = 0.369). Apart from the crowns (which failed due to implant losses), no other crown had to be remade. Six immediate, six immediate-delayed and four delayed implants were affected by one complication each (P (chi-square test) = 0.792). Mean peri-implant marginal bone loss after 1 year was-0.25 +/- 0.17 mm (CI 95%-0.29; -0.20) at immediate,-0.29 +/- 0.14 mm (CI 95% -0.32; -0.25) at immediate-delayed, and-0.31 +/- 0.16 mm (Cl 95%-0.35; -0.27) at delayed placed implants (P (Kruskal-Wallis test) = 0.015). One year after loading, the mean total aesthetic score was 12.52, 12.49 and 11.78 at the immediate, immediate-delayed and delayed groups, respectively (P (Kruskal-Wallis test) < 0.001). All patients were fully satisfied both with function and aesthetics, and would undergo the same procedure again, with four exceptions (one from the immediate, one from the immediate-delayed and two from the delayed group), who were only partially satisfied with aesthetics (P = 0.785). Conclusions: No statistically significant differences for failures, complications and patient satisfaction were observed when placing single implants immediately, 6 weeks or 4 months after tooth extraction; nevertheless, failures were more frequent at immediate and immediate-delayed placed implants. Bone level changes were similar between the different procedures, but aesthetics were better results at immediate and immediate-delayed implants.
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| 36. |
- Esposito, Marco, 1965, et al.
(författare)
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Immediate loading of occluding definitive partial fixed prostheses vs non-occluding provisional restorations - 3-year post-loading results from a pragmatic multicentre randomised controlled trial.
- 2018
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Ingår i: European journal of oral implantology. - 1756-2406. ; 11:3, s. 309-320
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Tidskriftsartikel (refereegranskat)abstract
- To compare the clinical outcome of dental implants restored with definitive occluding partial fixed prostheses within 1 week after implant placement with immediate non-occluding provisional restorations to be replaced by definitive prostheses after 4 months.Forty partially edentulous patients treated with one to three dental implants, at least 8.5 mm long and 4.0 mm wide, inserted with a torque of at least 35 Ncm, were randomised in two groups of 20 patients each, to be immediately loaded with partial fixed prostheses. Patients in one group received one definitive screw-retained, metal-ceramic prosthesis in occlusion within 1 week after placement. Patients in the other group received one non-occluding provisional acrylic reinforced prosthesis within 24 h of implant placement. Provisional prostheses were replaced by definitive ones after 4 months. The follow-up for all patients was 3 years post-loading. Outcome measures were prosthesis and implant failures, any complications, peri-implant marginal bone level changes, aesthetic evaluation by a dental practitioner, patient satisfaction, chair time and number of visits at the dental office from implant placement to delivery of definitive restorations.Three patients dropped out, one from the non-occlusal group and two from the occlusal group. Two immediately occlusally loaded implants with their related definitive prostheses failed early (difference in proportions = 0.10; 95% CI = -0.03 to 0.23; P = 0.488). Five patients from the occlusally loaded group were affected by six complications vs three patients (three complications) in the non-occlusally loaded group. The difference in proportions was not statistically significant (difference in proportions = 0.08; 95% CI = -0.17 to 0.34; P = 0.697). Three years after loading, patients subjected to occlusal loading lost an average of 1.13 mm of peri-implant bone vs 1.03 mm of patients restored with non-occluding definitive partial fixed prostheses. There were no statistically significant differences for marginal bone level changes between the two groups (mean difference = 0.10 mm; 95% CI -0.62 to 0.82; P = 0.779). No significant were the differences for pink aesthetic scores (7.09 vs 6.90; P = 0.873); for aesthetics evaluated by patients (Mann-Whitney U test P = 0.799) and function satisfaction (Mann-Whitney U test P = 0.578). Significantly less chair time (mean difference -38.00; 95% CI -58.96 to -17.04; P = 0.001) and number of visits (mean difference -2.15; 95% CI -2.77 to -1.53; P < 0.001) were required for the immediate definitive prosthesis group.This study did not provide a conclusive answer, but suggests that immediate occlusal loading by manufacturing immediate definitive partial fixed prostheses decreases chair time and number of visits.
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| 37. |
- Esposito, Marco, 1965, et al.
(författare)
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Immediate loading of post-extractive versus delayed placed single implants in the anterior maxilla: outcome of a pragmatic multicenter randomised controlled trial 1-year after loading
- 2015
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 8:4, s. 347-358
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare the effectiveness of immediate post-extractive single implants with delayed implants, placed in preserved sockets after 4 months of healing. Implants that achieved an insertion torque of at least 35 Ncm were immediately non-occlusally loaded. Materials and methods: Just after tooth extraction, and in the presence of less than 4 mm of vertical loss of the buccal bone in relation to the palatal wall, 106 patients requiring a single immediate post-extractive implant in the maxilla from second to second premolar were randomly allocated to immediate implant placement (immediate group; 54 patients) or to socket preservation using anorganic bovine bone covered by a resorbable collagen barrier (delayed group; 52 patients), according to a parallel group design at three different centres. Bone-to-implant gaps were to be filled with anorganic bovine bone, however this was not carried out in 17 patients (corresponding to 40% of those who should have been grafted). Four months after socket preservation, delayed implants were placed. Implants inserted with an insertion torque of at least 35 Ncm were immediately loaded with non-occluding provisional single crowns, then replaced after 4 months by definitive crowns. Patients were followed up to 1 year after loading. Outcome measures were implant failures, complications, aesthetics assessed using the pink esthetic score (PES), pen-implant marginal bone level changes and patient satisfaction recorded by blinded assessors. Results: Nineteen (35%) implants were not immediately loaded in the immediate group versus 39 (75%) implants in the delayed placement group because an insertion torque superior to 35 Ncm could not be obtained. Six patients dropped out 4 months after loading from the delayed group versus none in the immediate group. Two implants failed in the immediate group (6%) versus none in the delayed group, with the difference showing no statistical significance (difference in proportions = 0.04; 95% Cl: -0.03 to 0.11; P = 0.187). Eight minor complications occurred in the immediate group and one in the delayed group, and this was statistically significant (difference in proportions = 0.13; 95% Cl: 0.03 to 0.23; P = 0.028). At delivery of definitive crowns, 4 months after loading, the mean aesthetic score was 12.8 and 12.6 in the immediate and delayed groups, respectively. At 1 year after loading, the mean aesthetic score was 13.0 and 12.8 in the immediate and delayed groups, respectively. There was no statistically significant difference at 4 months (P = 0.500) and at 1 year (P = 0.615). Marginal bone levels at implant insertion (after bone grafting) were 0.10 mm for immediate implants and 0.02 mm for delayed implants, which did not have a statistically significantly difference (mean difference = 0.08; 95% Cl: 0.04 to 0.12; P < 0.001). One year after loading, patients of the immediate group lost on average 0.23 mm and those in the delayed group lost 0.29 mm, the difference being statistically significant (mean difference = -0.06; 95% Cl: -0.11 to -0.01; P = 0.036). Patients of both groups were equally satisfied at 4 months as well as at 1 year after loading. Conclusions: There are more complications with immediate post-extractive implants in comparison to delayed implants. It seems more difficult to obtain an implant insertion torque superior to 35 Ncm in sockets preserved with anorganic bovine bone after a 4-month healing period than with post-extractive sites. The aesthetic outcome appears to be similar for both groups.
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| 38. |
- Esposito, Marco, 1965, et al.
(författare)
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Immediately loaded machined versus rough surface dental implants in edentulous jaws: One-year post-loading results of a pilot randomised controlled trial
- 2015
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 8:4, s. 387-396
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare the effectiveness of immediately loaded total prostheses supported by implants with a roughened surface versus implants with a machined/turned surface. Materials and methods: Fifty edentulous or to-be-rendered edentulous patients requiring an implant-supported cross-arch prosthesis, were randomised either to receive four to eight implants with a roughened surface (25 patients) or with a machined/turned surface (25 patients). Provisional metal-reinforced acrylic prostheses were delivered 48 h after implant placement. Provisional prostheses were replaced after 4 months, by definitive screw-retained metal-resin cross-arch restorations. Outcome measures were prosthesis and implant failures, any complications and pen-implant marginal bone level changes. Patients were followed 1 year after loading. Results: One year after loading no patient dropped out. No prosthesis failed, but two machined implants were found to be mobile at definitive impression taking in 1 patient (Fisher's exact test: P = 0.312; difference in proportions = 4%; 95% Cl: -10 to 18). No complications occurred. Both groups presented a significant pen-implant marginal bone loss at 1 year after loading (P < 0.0001), -0.64 0.20 mm for rough implants and -0.68 0.23 mm for turned implants, respectively, with no statistically significant differences between the two groups (P = 0.482; mean difference = 0.04 mm; 95% Cl: -0.17 to 0.25). Conclusions: Up to 1 year after immediate loading, both implant surfaces provided good and similar results, however; the only two implants which failed early in the same patient had a machined surface. These preliminary results must be confirmed by larger trials with longer follow-ups.
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| 39. |
- Esposito, Marco, 1965, et al.
(författare)
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Immediately loaded zygomatic implants vs conventional dental implants in augmented atrophic maxillae: 4 months post-loading results from a multicentre randomised controlled trial
- 2018
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 11:1, s. 11-28
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare the clinical outcome of immediately loaded cross-arch maxillary prostheses supported by zygomatic implants vs conventional implants placed in augmented bone. Materials and methods: A total of 71 edentulous patients with severely atrophic maxillas, who did not have sufficient bone volume to place dental implants or when it was possible to place only two implants in the front area (minimal diameter 3.5 mm and length of 8 mm) and less than 4.0 mm of bone height subantrally, were randomised according to a parallel group design. They (35 patients) received zygomatic implants to be loaded immediately vs grafting with a xenograft, followed, after 6 months of graft consolidation, by the placement of six to eight conventional dental implants, submerged for 4 months (36 patients). To be loaded immediately, zygomatic implants had to be inserted with an insertion torque superior to 40 Ncm. Screw-retained, metal-reinforced, acrylic provisional prostheses were provided to be replaced by definitive Procera Implant Bridge Titanium prostheses (Nobel Biocare, Göteborg, Sweden) with ceramic or acrylic veneer materials 4 months after initial loading. Outcome measures were: prosthesis, implant and augmentation failures, any complications, quality of life (OHIP-14), the number of days that patients experienced total or partial impaired activity, time to function, and number of dental visits, assessed by independent assessors. Patients were followed up to 4 months after loading. Results: No augmentation procedure failed. Three patients dropped out from the augmentation group. Six prostheses could not be delivered or failed in the augmentation group vs one prosthesis in the zygomatic group, the difference being statistically significant (difference in proportions = 15.32%; P = 0.04; 95% CI: 0.23 to 31.7). Eight patients lost 35 implants in the augmentation group vs three implants in one patient from the zygomatic group, the difference being statistically significant (difference in proportions = 21.38%; P = 0.001; 95% CI: 3.53 to 39.61). In total, 14 augmented patients were affected by 20 complications vs 26 zygomatic patients (35 complications), the difference being statistically significant (difference in proportions = 31.87%; P = 0.008; 95% CI: 6.48 to 53.37). The OHIP-14 score was 3.68 ± 5.41 for augmented patients and 4.97 ± 5.79 for zygomatic patients, with no statistically significant differences between groups (mean difference = 1.29; 95%CI -1.60 to 4.18; P = 0.439). Both groups had significantly improved OHIP-14 scores from before rehabilitation (P < 0.001 for both augmented and zygomatic patients). The number of days of total infirmity was, on average, 7.42 ± 3.17 for the augmented group and 7.17 ± 1.96 for the zygomatic group, the difference not being statistically significant (mean difference = -0.25; 95% CI: -1.52 to 1.02; P = 0.692). Days of partial infirmity were on average 14.24 ± 4.64 for the augmented group and 12.17 ± 3.82 for the zygomatic group, the difference being statistically significant (mean difference = -2.07; 95% CI: -4.12 to -0.02; P = 0.048). The mean number of days to have a functional prosthesis was 444.32 ± 207.86 for augmented patients and 1.34 ± 2.27 for zygomatic patients, the difference being statistically significant (mean difference = -442.9; 95% CI: -513.10 to -372.86; P < 0.001). The average number of dental visits was 16.79 ± 10.88 for augmented patients and 12.58 ± 5.21 for zygomatic patients, the difference not being statistically significant (mean difference = -4.21; 95% CI -8.48 to 0.06; P = 0.053). Conclusions: Preliminary 4-months post-loading data suggest zygomatic implants were associated with statistically significantly less prosthetic (one vs six patients) and implant failures (one patient lost three implants versus 35 implants in eight patients) as well as time needed to functional loading (1.3 days vs 444.3 days) when compared with augmentation procedures and conventionally loaded dental implants. Even if more complications were reported for zygomatic imp ants, which were solved spontaneously or could be handled, zygomatic implants proved to be a better rehabilitation modality for severely atrophic maxillae. Long-term data are essential to confirm or dispute these preliminary results. Conflict of interest statement: This study was originally supported by Nobel Biocare, the manufacturer of the implants, and the provisional and definitive prosthetic components used in this study, which were provided free for the patients. However, before any results were known, Nobel Biocare withdrew the financial support and recruitment had to be stopped. Tecnoss (Giaveno, Torino, Italy) kindly donated the bone substitutes and the membranes, whereas Global D (Brignais, France) donated the osteosynthesis screws. Data property belonged to the authors and by no means did the manufacturers interfere with the publication of the results. © 2002-2018 Quintessence Publishing Group.
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| 40. |
- Esposito, Marco, 1965, et al.
(författare)
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Posterior atrophic jaws rehabilitated with prostheses supported by 5 x 5 mm implants with a nanostructured calcium-incorporated titanium surface or by longer implants in augmented bone. Five-year results from a randomised controlled trial
- 2019
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 12:1, s. 39-54
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate whether 5 x 5 mm dental implants with a novel nanostructured calcium-incorporated titanium surface could be an alternative to implants at least 10-mm long placed in bone augmented with bone substitutes in posterior atrophic jaws. Materials and methods: Forty patients with atrophic posterior (premolar and molar areas) mandibles having 5- to 7-mm bone height above the mandibular canal, and 40 patients with atrophic maxillae having 4- to 6-mm bone height below the maxillary sinus, were randomised according to a parallel-group design to receive one to three 5-mm implants or one to three at least 10-mm long implants in augmented bone at two centres. All implants had a diameter of 5 mm. Mandibles were vertically augmented with interpositional bovine bone blocks covered with resorbable barriers. Implants were placed after 4 months. Maxillary sinuses were augmented with particulated porcine bone via a lateral window covered with resorbable barriers and implants were placed simultaneously. All implants were submerged and loaded after 4 months with provisional prostheses. Four months later, definitive screw-retained or provisionally cemented metal-ceramic or zirconia prostheses were delivered. Patients were followed to 5 years post-loading and the outcome measures were: prosthesis and implant failures, any complication and pen-implant marginal bone level changes. Results: Sixteen patients dropped out before the 5-year evaluation (four short mandibles, three short maxillae, six augmented mandibles and three augmented maxillae). In mandibles, two grafted patients were not prosthetically rehabilitated because of multiple complications, and three implants failed in the same patient (one was a replacement implant) versus one patient who lost his short implant and crown 2 years after loading. In maxillae one short implant failed with its provisional crown 3 months post-loading. There were no statistically significant differences in prostheses (difference in proportion = -0.003; 95% CI: -0.14 to 0.13; P= 1.000) and implant failures (difference in proportion = -0.03; 95% CI: -0.17 to 0.09; P = 0.609) up to 5 years after loading. Significantly more complications occurred at mandibular grafted sites: 17 augmented patients were affected by complications versus nine patients treated with short implants in mandibles (difference in proportion = 0.39; 95% CI: 0.10 to 0.62; P = 0.013). In the maxilla seven sinus-elevated patients versus two patients treated with short implants were affected by complications, the difference not being statistically significant (difference in proportion = 0.25; 95% CI: -0.04 to 0.49; P = 0.128). Patients with mandibular short implants lost on average 1.22 mm of peri-implant bone at 5 years and patients with 10-mm or longer mandibular implants lost 1.70 mm. Patients with maxillary short implants lost on average 1.25 mm of peri-implant bone at 5 years and patients with 10-mm or longer maxillary implants lost 1.73 mm. Longer implants showed a greater bone loss up to 5 years after loading than short implants both in maxillae (mean difference: -0.48 mm; 95% CI: -0.89 to -0.07 mm; P = 0.024) and in mandibles (mean difference: -0.48 mm; 95% CI: -0.79 to -0.18 mm; P = 0.004). Conclusions: Five years after loading, 5 x 5 mm implants achieved similar results to longer implants placed in augmented bone. Short implants might be a preferable choice to bone augmentation especially in posterior mandibles since the treatment is faster, cheaper and associated with less morbidity; however, 10-year post-loading data are necessary before making reliable recommendations.
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| 41. |
- Esposito, Marco, 1965, et al.
(författare)
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Posterior jaws rehabilitated with partial prostheses supported by 4.0 x 4.0 mm or by longer implants: Four-month post-loading data from a randomised controlled trial.
- 2015
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Ingår i: European journal of oral implantology. - 1756-2406. ; 8:3, s. 221-30
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate whether 4.0 x 4.0 mm dental implants could be an alternative to implants at least 8.5 mm long, which were placed in posterior jaws in the presence of adequate bone volumes.One hundred and fifty patients with posterior (premolar and molar areas) mandibles having at least 12.5 mm bone height above the mandibular canal or 11.5 mm bone height below the maxillary sinus, were randomised according to a parallel group design, in order to receive one to three 4.0 mm-long implants or one to three implants which were at least 8.5 mm long, at three centres. All implants had a diameter of 4.0 mm. Implants were loaded after 4 months with definitive screw-retained prostheses. Patients were followed up to 4-month post-loading and outcome measures were prosthesis and implant failures, any complications and peri-implant marginal bone level changes.No patients dropped-out before the 4-month evaluation. Three patients experienced the early failures of one 4.0 mm-long implant each, in comparison to two patients who lost one long implant each (difference in proportion = 0.01; 95% CI -0.06 to 0.09; P = 0.50). Consequently, two prostheses in each group could not be delivered as planned (difference in proportion = 0; 95% CI -0.07 to 0.07; P = 0.69), and one patient from each group is still waiting to have their prostheses delivered. Three short implant patients experienced three complications versus two long implant patients (difference in proportion = 0.01; 95% CI -0.06 to 0.09; P = 0.50). There were no statistically significant differences in prosthesis failures, implant failures and complications. Patients with short implants lost on average 0.38 mm of peri-implant bone at 4 months and patients with long mandibular implants lost 0.42 mm. There were no statistically significant differences in bone level changes up to 4 months between short and long implants (mean difference = 0.04 mm; 95% CI: -0.041 to 0.117; P = 0.274).Four months after loading, 4.0 x 4.0 mm implants achieved similar results as 8.5 x 4.0 mm-long or longer implants in posterior jaws, however 5 to 10 years post-loading data are necessary before reliable recommendations can be made.
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| 42. |
- Esposito, Marco, 1965, et al.
(författare)
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Safety and efficacy of a biomimetic monolayer of permanently bound multiphosphonic acid molecules on dental implants: 3 years post-loading results from a pilot quadruple-blinded randomised controlled trial
- 2017
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 10:1, s. 43-54
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate the safety and clinical efficacy of a novel surface treatment (SurfLink, Nano Bridging Molecules, Gland, Switzerland) on titanium dental implants. SurfLink consists of a monolayer of permanently bound multiphosphonic acid molecules, which mimics the surface of naturally occurring hydroxyapatite. Materials and methods: Twenty-three patients requiring at least two single dental implants had their sites randomised according to a split-mouth design to receive one titanium grade 4 implant treated with SurfLink and one untreated control implant. Additional SurfLink-treated implants were placed if needed. Implants were submerged for 3 months in mandibles and 6 months in maxillae, then loaded with definitive metal-ceramic crowns and followed for 3 years after loading. Outcome measures were crown/implant failures, any complication, radiographic peri-implant marginal bone level changes and marginal bleeding. Results: Three patients dropped out but all remaining patients were followed up to 3-years postloading. No implant failed. Complications were reported for three patients, affecting both types of implant in two patients and only SurfLink implant in one patient. No differences for complications between the two implant types was observed (McNemar test, P = 1, difference in proportions = -0.04, 95% Cl: -0.22 to 0.14). No bleeding was observed when a periodontal probe was run in the peri-implant soft tissues around any of the implants, with the exception of three implants affected by peri-implantitis. There were no statistically significant differences in marginal bone level changes between the two groups (at 3 years post-loading P = 0.86, mean difference = -0.05; SD = 1.15; 95% Cl: -0.56 to 0.47). Conclusions: Medium-term data (3-years post-loading) of implants with a biomimetic monolayer of permanently bound multiphosphonic acid molecules (SurfLink surface treatment) presented no safety issues. Clinical healing in both control and SurfLink-treated implant groups was uneventful and did not differ significantly. More challenging clinical situations need to be investigated to evaluate the real effectiveness of this surface treatment.
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| 43. |
- Esposito, Marco, 1965, et al.
(författare)
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Short implants versus bone augmentation for placing longer implants in atrophic maxillae: One-year post-loading results of a pilot randomised controlled trial.
- 2015
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Ingår i: European journal of oral implantology. - 1756-2406. ; 8:3, s. 257-68
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate whether short (5.0 to 8.5 mm) dental implants could be a suitable alternative to longer (at least 11.5 mm-long) implants placed in atrophic maxillae augmented with autogenous bone for supporting dental prostheses.Twenty-eight patients with fully edentulous atrophic maxillae, whom had 5 to 9 mm of residual crestal bone height which was at least 5 mm thick, measured using computerised tomography (CT) scans, were randomised into two groups either to receive 4 to 8 short (5.0 to 8.5 mm) implants (15 patients) or autogenous bone from the iliac crest to allow the placement of at least 11.5 mm-long implants (13 patients). Bone blocks and the windows at the maxillary sinuses were covered with rigid resorbable barriers. Grafts were left to heal for 4 months before placing implants which were submerged. After 4 months, provisional reinforced acrylic prostheses or bar retained overdentures were delivered. Provisional prostheses were replaced, after 4 months, by definitive screw-retained metal-resin cross-arch restorations. Outcome measures were prosthesis and implant failures, any complications, peri-implant marginal bone level changes and patient satisfaction. Patients were followed up to 1 year after loading.All patients were rehabilitated with implant-supported prostheses but two patients dropped out from the augmented group. One bilateral sinus lift procedure failed for infection, although short implants could be placed. One implant failed in the augmented group versus two short implants in two patients (Fishers exact test P = 1.00; difference in proportions = 0.06; 95% CI -0.28 to 0.17). All failures occurred before loading. Significantly more complications occurred in augmented patients: eight complications occurred in 5 augmented patients (all of them complained of pain 1 month after bone harvesting from the iliac crest) versus no complications in the short implant (Fisher's exact test P = 0.013; difference in proportions = 0.38; 95% CI 0.11 to 0.65). Both groups presented a significant peri-implant marginal bone loss at 1 year after loading (P < 0.0001); -1.05 (0.20) mm for short implants and -1.01 (0.16) mm for the augmented group, respectively, with no statistically significant differences between the two groups (mean difference -0.04 mm; 95% CI -0.22 to 0.14; P = 0.59). All patients were fully satisfied with the treatment and would have it again.This pilot study suggests that short implants may be a suitable, cheaper and faster alternative to longer implants placed in bone augmented with autogenous bone for rehabilitating edentulous atrophic maxillae, however, these preliminary results need to be confirmed by larger trials with follow-ups of at least 5 years.
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| 44. |
- Esposito, Marco, 1965, et al.
(författare)
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Short implants versus longer implants in vertically augmented atrophic mandibles: A systematic review of randomised controlled trials with a 5-year post-loading follow-up.
- 2019
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Ingår i: International journal of oral implantology (New Malden, London, England). - 2631-6439. ; 12:3, s. 267-280
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Tidskriftsartikel (refereegranskat)abstract
- To compare the clinical outcome of fixed prostheses supported by 4- to 8-mm-long implants with prostheses supported by longer implants placed in vertically augmented atrophic mandibles after a follow-up of 5 years in function.The Cochrane Central Register of Controlled Trials (CENTRAL) and MEDLINE were searched up to 1st September 2018 for randomised controlled trials (RCTs) with a follow-up of at least 5 years in function comparing fixed prostheses supported by 4- to 8-mm-long implants with prostheses supported by longer implants placed in vertically augmented atrophic mandibles. Outcome measures were prosthesis failure, implant failures, augmentation procedure failures, complications, and peri-implant marginal bone level changes. Screening of eligible studies, assessment of the risk of bias and data extraction were conducted in duplicate and independently by two review authors. The statistical unit of the analysis was the prosthesis. Results were expressed as random-effects models using mean differences for continuous outcomes and risk ratios (RR) for dichotomous outcomes with 95% confidence intervals (CIs).Four eligible RCTs that included originally 135 patients were included. Two RCTs had a parallel-group design and two a split-mouth design. Short implants were 5.0 to 6.6 mm long and were compared with longer implants placed in posterior mandibles augmented with interpositional blocks of bone substitutes. All trials were judged at unclear risk of bias. Twelve (14%) bone augmentation procedures failed to achieve the planned bone height to allow placement of implants with the planned length. Five years after loading, 28 patients (21%) had dropped out from the four RCTs. There were no differences for patients having prosthesis (RR = 1.46; 95% CI: 0.52 to 4.09; P = 0.47; I2 = 0%) or implant (RR = 1.00; 95% CI: 0.31 to 3.21; P = 1.00; I2 = 0%) failures between the two interventions, but there were more patients experiencing complications (RR = 4.72; 95% CI: 2.43 to 9.17; P < 0.00001; I2 = 0%) and peri-implant marginal bone loss (mean difference = 0.60 mm; 95% CI: 0.36 to 0.83; P < 0.00001; I2 = 45%) at longer implants in augmented bone.Five years after loading, prosthetic and implant failures were similar between the two interventions, but complications and peri-implant marginal bone loss were higher and more severe at longer implants placed in vertically augmented mandibles. Larger trials and longer follow-ups up to 10 years after loading are needed to confirm or reject the present preliminary findings. However in the meantime short implants could be the preferable option.
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| 45. |
- Esposito, Marco, 1965, et al.
(författare)
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The effectiveness of a resorbable bone substitute with a resorbable membrane in the treatment of periodontal infrabony defect - A multicenter randomised controlled trial.
- 2015
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Ingår i: European journal of oral implantology. - 1756-2406. ; 8:3, s. 233-44
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate the effectiveness of a bone substitute covered with a resorbable membrane versus open flap debridement for the treatment of periodontal infrabony defects.Ninety-seven patients with one infrabony defect, which was 3 mm or deeper and at least 2 mm wide were randomly allocated either to grafting with a bone substitute covered with a resorbable barrier (BG group) or open flap debridement (OFD group) according to a parallel group design in five European centres. Blinded outcome measures assessed tooth loss, complications, patient's satisfaction with treatment and aesthetics, changes in probing attachment levels (PAL), probing pocket depths (PPD), gingival recessions (REC), radiographic bone levels (RAD) on standardised periapical radiographs, plaque index (PI) and marginal bleeding index (MBI).49 patients were randomly allocated to the BG group and 48 to the OFD group. At baseline there were more mobile teeth in the BG group (29 versus 15). One year after treatment two patients dropped out from the BG group and no teeth were lost. Three complications (minor postoperative wound dehiscence) occurred in the BG group versus none in the OFD group, where the difference was not statistically significant. The BG group obtained significantly greater statistical PAL gain (mean difference = -0.8 mm, 95% CI [-1.51; -0.03], P = 0.0428), PPD reduction (mean difference = -1.1 mm, 95% CI [-1.84; -0.19], P = 0.0165) and RAD gain (mean difference = -1.2 mm, 95% CI [-2.0; -0.4], P = 0.0058) compared to the OFD group. No statistically significant differences between the groups were observed for gingival recession, or the patient's satisfaction with the treatment and aesthetics. There were some statistically significant differences between the centres for PAL and PPD with the Italian centres reporting better outcomes.The use of a bone substitute covered with a resorbable membrane yielded significantly better statistical clinical outcomes than open flap debridement in the treatment of periodontal infrabony defects deeper than 3 mm, with regard to PAL gain, PPD reduction and RAD gain.
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| 46. |
- Esposito, Marco, 1965, et al.
(författare)
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The role of dental implant abutment design on the aesthetic outcome: preliminary 3-month post-loading results from a multicentre split-mouth randomised controlled trial comparing two different abutment designs.
- 2018
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Ingår i: European journal of oral implantology. - 1756-2406. ; 11:1, s. 77-87
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate whether there are aesthetic and clinical benefits to using a newly designed abutment (Curvomax), over a conventional control abutment (GingiHue).A total of 49 patients, who required at least two implants, had two sites randomised according to a split-mouth design to receive one abutment of each type at seven different centres. The time of loading (immediate, early or delayed) and of prosthesis (provisional crowns of fixed prosthesis) was decided by the clinicians, but they had to restore both implants in a similar way. Provisional prostheses were replaced by definitive ones 3 months after initial loading, when the follow-up for the initial part of this study was completed. Outcome measures were: prosthesis failures, implant failures, complications, pink esthetic score (PES), peri-implant marginal bone level changes, and patient preference.In total, 49 Curvomax and 49 GingiHue abutments were delivered. Two patients dropped out. No implant failure, prosthesis failure or complication was reported. There were no differences at 3 months post-loading for PES (difference = -0.15, 95% CI -0.55 to 0.25; P (paired t test) = 0.443) and marginal bone level changes (difference = -0.02 mm, 95% CI -0.20 to 0.16; P (paired t test) = 0.817). The majority of the patients (30) had no preference regarding the two abutment designs; 11 patients preferred the Curvomax, while five patients preferred the GingiHue abutments (P (McNemar test) = 0.210).The preliminary results of the comparison between two different abutment designs did not disclose any statistically significant differences between the evaluated abutments. However the large number of missing radiographs and clinical pictures casts doubt on the reliability of the results. Longer follow-ups of wider patient populations are needed to better understand whether there is an effective advantage with one of the two abutment designs.
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| 47. |
- Esposito, Marco, 1965, et al.
(författare)
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Vertical osseodistraction with a new intraosseous alveolar distractor prototype for dental implant rehabilitation: A pilot study in dogs
- 2017
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Ingår i: International Journal of Oral and Maxillofacial Implants. - : Quintessence Publishing. - 0882-2786. ; 32:4, s. 838-848
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate in dogs a newly developed intraosseous alveolar distractor (Mozo-Grau Alveolar Distractor) for vertical bone augmentation to allow placement of dental implants. Materials and Methods: Four dogs had their posterior teeth removed, and sockets were left to heal for 20 weeks. The right and left sides of the posterior mandibles were randomly allocated, according to a split-mouth design, to receive either two distractors, distracting a 32-mm-long bone segment, or two distractors supporting one bony segment 20 mm long and one 8 mm long. Each side of the jaw was treated by a different operator. Eight days after placement, distractors were activated with one complete turn (corresponding to 0.75 mm of vertical distraction) per day for 8 days, followed by a latency period of 10 weeks. Distractors were removed, and seven dental implants of two randomly allocated designs were placed in each dog. Implants were submerged for 2 months, and the dogs were sacrificed. Outcome measures were: success of the augmentation procedure (defined as a vertical gain of at least 5 mm of bone), any complications, implant failure, bone-to-implant contact (BIC), and peri-implant marginal bone level changes. Results: One dog was withdrawn because of a mandible fracture. Eight complications occurred, and six osseodistractors were lost, but no implant failed. Only two segments in one dog achieved a vertical bone gain of at least 5 mm. The mean radiographic vertical bone gain was 2.28 mm, whereas the mean histologic vertical bone gain was 3.16 mm. Histologically, all the implants were osseointegrated. The mean BIC for implants placed in new distracted bone was 34.78% ± 11.60% and 35.66% ± 8.84% for those placed in native bone. The mean peri-implant marginal bone level loss was 0.56 ± 0.54 mm. Conclusion: It is possible to achieve vertical augmentation using intraosseous alveolar distractors to allow successful implantation of dental implants; however, the technique still requires surgical refinements and a dedicated training of the surgeons before being applied to humans. © 2017 by Quintessence Publishing Co Inc.
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| 48. |
- Felice, Pietro, et al.
(författare)
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Five-year results from a randomised controlled trial comparing prostheses supported by 5-mm long implants or by longer implants in augmented bone in posterior atrophic edentulous jaws.
- 2019
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Ingår i: International journal of oral implantology (New Malden, London, England). - 2631-6439. ; 12:1, s. 25-37
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate whether 5-mm short dental implants could be an alternative to augmentation with anorganic bovine bone and placement of at least 10-mm long implants in posterior atrophic jaws.Fifteen patients with bilateral atrophic mandibles (5 to 7 mm bone height above the mandibular canal) and 15 patients with bilateral atrophic maxillae (4 to 6 mm bone height below the maxillary sinus), and bone thickness of at least 8 mm, were randomised according to a split-mouth design to receive one to three 5-mm short implants or at least 10-mm long implants in augmented bone. Mandibles were vertically augmented with interpositional bone blocks and maxillary sinuses with particulated bone via a lateral window. Implants were placed after 4 months, submerged and loaded, after another 4 months, with provisional prostheses. Four months later, definitive provisionally cemented prostheses were delivered. Outcome measures were: prosthesis and implant failures, any complication and peri-implant marginal bone level changes.In five augmented mandibles the planned 10-mm long implants could not be placed and shorter implants (7.0 and 8.5 mm) had to be used instead. Five years after loading, six patients, five treated in the mandible and one in the maxilla, dropped out. Three prostheses (one mandibular and two maxillary) failed in the short-implant group versus none in the long-implant group. In mandibles one long implant failed versus two short implants in one patient. In maxillae one long implant failed versus three short implants in two patients. There were no statistically significant differences in implant (n = 26; P = 1.00, difference = 3.85%, 95% CI: -12.95% to 20.64%) and prosthetic (n = 26; P = 0.250, difference = 11.54%, 95% CI: -0.74% to 23.82%) failures. Eleven patients had 16 complications at short implants (one patient accounted for six complications) and 12 patients had 14 complications at long implants. There were no statistically significant differences in complications (n = 28; P = 1.00, difference = -3.57%, 95% CI: -30.65% to 23.51%). Five years after loading, patients with mandibular implants lost on average 1.72 mm at short implants and 2.10 mm at long implants of peri-implant marginal bone. This difference was statistically significant (difference = 0.37 ± 0.43 mm; 95% CI: 0.07 to 0.68 mm; P = 0.022). In maxillae, patients lost on average 1.31 mm at short implants and 1.79 mm at long implants. This difference was statistically significant (difference = 0.48 ± 0.43 mm; 95% CI: 0.22 to 0.74 mm; P = 0.002).Five years after loading, 5-mm short implants achieved similar results to longer implants in augmented bone. The choice of short implants might be preferable to vertical bone augmentation, especially in mandibles, since the treatment is faster and cheaper.
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- Felice, P., et al.
(författare)
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Immediate, immediate-delayed (6 weeks) and delayed (4 months) post-extractive single implants: 4-month post-loading data from a randomised controlled trial
- 2016
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Ingår i: European Journal of Oral Implantology. - 1756-2406. ; 9:3, s. 233-247
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare the clinical outcome of single implants placed immediately after tooth extraction with implants placed 6 weeks after tooth extraction (immediate-delayed placement), and with implants placed after 4 months of extraction and socket healing (delayed placement). Materials and methods: Two hundred and ten patients requiring a single implant-supported crown to replace a tooth to be extracted were randomised to receive immediate post-extractive implants (70 patients), immediate-delayed implants at 6 weeks (70 patients), and delayed implants after 4 months of healing (70 patients), according to a parallel group design. When needed, patients of the immediate and immediate-delayed group had the socket grafted with a bone substitute and covered with a resorbable membrane at implant placement. Sockets randomised to delayed implants were grafted in the same manner if poorly preserved or in the aesthetic areas (from second upper to second upper premolars). Implants inserted with at least 25 Ncm torque were left to heal unloaded for 4 months, whereas those inserted with less than 25 Ncm were left to heal unloaded for 6 months. Temporary crowns were delivered and were to be replaced by definitive ones after 4 months. Outcome measures were crown and implant failures, complications, periimplant marginal bone level changes, aesthetics assessed using the pink esthetic score (PES) and patient satisfaction recorded by blinded assessors. Results: Three patients dropped out from the immediate, five from the immediate-delayed and six from the delayed group up to 4-months post-loading. Four implants (6.0%) failed in the immediate, four (6.2%) in the immediate-delayed and one (1.6%) from the delayed group (P (chi-square test) = 0.369). Apart from the crown failures due to implant losses, no other crown had to be remade. Five immediate, six immediate-delayed and three delayed implants were affected by one complication each (P (chi-square test) = 0.601). Mean peri-implant marginal bone loss after 4 months was -0.17 +/- 0.11 mm (95% CI: -0.20; -0.15) at immediate, -0.20 +/- 0.09 mm (95% CI: -0.23; -0.18) at immediate-delayed, and -0.24 +/- 0.12 mm (95% CI: -0.27; -0.21) at delayed placed implants (P (Kruskal Wallis test) = 0.006). At delivery of definitive crowns, 4 months after loading, the mean total aesthetic score was 12.48, 12.38 and 11.71 in the immediate, immediate-delayed and delayed groups, respectively (P (Kruskal Wallis test) < 0.001). All patients were fully satisfied with both function and aesthetics, and would undergo the same procedure again, with four exceptions (one from the immediate, one from the immediate-delayed and two from the delayed group), who were partially satisfied with the aesthetics (P = 0.785). Conclusions: No statistically significant differences for failures, complications and patient satisfaction were observed when placing single implants immediately, 6 weeks or four months after tooth extraction; nevertheless failures and complications were more frequent for immediate and immediate-delayed placed implants. Bone level changes were similar between the different procedures, but the aesthetics showed better results for immediate and immediate-delayed implants.
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