| 1. |
- Cecchinato, D., et al.
(author)
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Bone loss at implants and teeth in the same inter-proximal unit: A radiographic study
- 2018
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In: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 29:4, s. 375-380
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Journal article (peer-reviewed)abstract
- ObjectiveThis study was performed to determine whether the distance between an implant and a tooth present in an inter-proximal unit influenced the amount of marginal bone loss that occurred at the two facing (adjacent) surfaces. Materials and methodsOne hundred and eighty patients with a total of 278 inter-proximal units were included. Radiographs of implants that also included adjacent (facing) natural tooth/teeth were digitalized, and various linear measurements were performed using a software program. The marginal bone level and the bone level change that had occurred during a mean of 5.8years were assessed as well as distance between the implant and the adjacent tooth/teeth. ResultsThe mean amount of additional marginal bone loss that took place during the observation period was about 0.4mm at both implants and adjacent tooth surfaces. The horizontal distance between an implant and the facing tooth did not influence the amount of marginal bone loss that had occurred. In most inter-proximal units, more advanced bone loss (>1mm, >2mm) had ensued either at the implant or at the facing tooth surface. Advanced additional bone loss occurred at both the implant and the tooth in only about 3% of the examined subjects. ConclusionBone loss at implants and teeth appears to be a site-specific phenomenon and not dependent on the inter-proximal distance.
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| 2. |
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| 3. |
- Cecchinato, D., et al.
(author)
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A cross-sectional study on the prevalence of marginal bone loss among implant patients
- 2013
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In: Clinical Oral Implants Research. - : Wiley. - 0905-7161. ; 24:1, s. 87-90
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Journal article (peer-reviewed)abstract
- Objective The aim of the present cross-sectional retrospective study was to determine bone loss in a sample of subjects restored with implant-supported prostheses and the prevalence and severity of peri-implantitis in a sub-sample. Material and methods A total of 139 patients who had attended a follow-up visit in 2007 were considered for inclusion. Subjects with implants that had been in function for less than 3 years or had poor quality radiographs were excluded. The final study population comprised 133 subjects with a total of 407 implants. Radiographic measurements identified subjects who had =1 implant site exhibiting marginal bone loss of >0.5 mm; 40 subjects met this criterion and were recalled for a clinical examination. Of the 40 subjects that were recalled for the clinical examination, 30 attended. The following parameters were recorded at mesial, distal, buccal, and lingual/palatal aspects of all implants: oral hygiene standard (plaque), bleeding on probing, probing pocket depth (PPD). Results The mean interval between the baseline (1-year post-loading) and the follow-up radiographs was 4.8 +/- 2.3 years. In the total subject sample (133 subjects and 407 implants), the mean amount of marginal bone loss that had occurred was 0.2 +/- 1.2 mm. Ninety-three subjects with 246 implant sites exhibited no bone level alteration (group A), whereas 40 subjects with 161 implant sites (group B) displayed marginal bone loss of >0.5 mm at =1 implant (loser site). Sixty-eight implant sites in group B exhibited bone loss of >0.5 mm. However, only 20% of subjects and 11% of sites had lost >1 mm marginal bone, and 8% of subjects and 4% of sites had lost >2 mm bone. The total amount of bone loss that had occurred in group B was (i) 0.88 +/- 1.5 mm and (ii) among the loser sites 2.1 +/- 1.4 mm. Thirty subjects from group B were exposed to a clinical examination; out of 37 sites with bone loss >0.5 mm in this subgroup, 29 sites had a PPD value of =4 mm. Conclusion Marginal bone loss (>0.5 mm) at implants was observed in 30% of subjects and 16% of implant sites. More advanced loss of marginal bone occurred in much fewer subjects and sites. Sites with marginal bone loss was in the sub-sample characterized by bleeding on probing, but only occasionally with deep (=6 mm) pockets.
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| 4. |
- Cecchinato, D., et al.
(author)
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Bone loss at implants and teeth in thesame segment of the dentition in partially dentate subjects
- 2017
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In: Clinical Oral Implants Research. - : Wiley. - 0905-7161. ; 28:5, s. 626-630
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Journal article (peer-reviewed)abstract
- BackgroundSome studies have indicated that marginal bone loss at implants and at teeth are similar, while results from other studies showed that implants lost more bone than teeth in the same dentition. AimTo determine the amount of progressive marginal bone loss that had occurred at implants and teeth in the same segment of the dentition following implant placement in partially dentate subjects. Material and MethodsA total of 217 patients with a total of 573 implants and 318 teeth present in the same segments of the dentition were included. Radiographs were available from 1year (baseline) and 3years after loading. ResultsThe mean bone loss that occurred between the two examinations was at implants 0.420.68mm and at teeth 0.44 +/- 0.52mm. Thirty-eight subjects (18%) had 1 implant exhibiting >1mm bone loss. Bone loss at the 148 implants in this category of patients was 1.30 +/- 1.04mm with a corresponding loss at the 69 teeth of 0.53 +/- 0.62mm. Eighteen subjects (8%) had 1 tooth that exhibited >1mm bone loss. The mean amount of bone loss in this sample was 1.37 +/- 0.87mm (38 teeth) and 0.29 +/- 0.31mm (56 implants). ConclusionsThis study showed that marginal bone loss at implants and teeth in many partially dentate subjects might be independent phenomena.
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| 5. |
- Cecchinato, D., et al.
(author)
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Mucosal inflammation and incidence of crestal bone loss among implant patients: a 10-year study
- 2014
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In: Clinical Oral Implants Research. - : Wiley. - 0905-7161. ; 25:7, s. 791-796
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Journal article (peer-reviewed)abstract
- Objective: The objective of this prospective study was to determine the prevalence and incidence of marginal bone loss and, in addition, peri-implantitis in subjects and implant sites after 10 years in function. Material and Methods: One hundred and thirty-three subjects with a total of 407 implants that had been in function for about 5 years attended a follow-up visit in 2007 (visit 2; V2). 100 of the 133 subjects returned for a new clinical and radiographic examination in 2012 (visit 3; V3). The clinical examination included assessment of "bleeding on probing" (BoP+) and "probing pocket depth." Subjects with implant sites that in the radiograph exhibited crater-shaped marginal bone loss of >0.5 mm were identified as losers. Results: During the interval between V2 and V3 (about 5 years), 13 implants in 7 subjects exhibited progressive bone loss and were removed. The overall amount of crestal bone loss that had occurred at the remaining implants between visit 1 (V1; >= 1 year of loading) and V3 (10 years) was small (0.36 +/- 1.4 mm). The bone-level reduction was twice as great between V2 and V3 as between V1 and V2. Forty subjects and 75 (26%) implant sites exhibited marginal bone loss of >0.5 mm between V1 and V3. In the interval between V2 and V3, 37 new implant sites lost significant amounts of bone. During the entire 10-year period (V1-V3), 12% of patients and 5% of implants displayed signs of peri-implantitis (bone loss >0.5 mm, BoP+, PPD >= 6 mm), while in the V2-V3 interval, the corresponding numbers were 10% (patients) and 4% (implant sites). Conclusion: Sites with marginal bone loss of >= 1 mm were not common among implant patients. Peri-implantitis occurred in about 10% of patients and 4% of implant sites.
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| 6. |
- Cecchinato, D., et al.
(author)
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Occurrence of complications in patients restored with implants
- 2022
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In: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 33:9, s. 913-920
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Journal article (peer-reviewed)abstract
- Objectives To determine the occurrence and clustering of complications in subjects restored with fixed implant-supported prostheses. Methods In the present retrospective case series, 241 subjects treated at one clinical centre and provided with 729 implants were included. A clinical and radiographic examination was performed after a mean follow-up period of 4.8 +/- 2.0 years. Additional information on occurrence of technical (chipping, loss of retention, fracture of components) and biological complications (marginal bone loss, implant loss) during follow-up was extracted from patient records. For each type of complication and complications overall, regression analyses were performed to identify potential risk factors. Cox regression analyses were used to evaluate time to event for implant loss and technical complications. Results In all, 30% of the 241 patients presented with at least one complication of technical and/or biological character during the follow-up period. Technical complications affected 19.5% of subjects, while 14.1% presented with marginal bone loss >2 mm. Implant loss occurred in 4.6% of subjects. While technical complications were noted already early during the maintenance period (<1200 days), implant loss typically occurred during a later phase. A small subgroup of subjects (7.9%) experienced more than one type of complication. Conclusions Complications occurred frequently and the most common type of complication was of technical character. Technical and biological complications occurred independently of each other.
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| 7. |
- Cecchinato, D, et al.
(author)
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Submerged or non-submerged healing of endosseous implants to be used in the rehabilitation of partially dentate patients.
- 2004
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In: Journal of clinical periodontology. - 0303-6979. ; 31:4, s. 299-308
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To evaluate bone-level alterations that occurred at implants of the Astra Tech(R) System that were placed in the load carrying, posterior parts of the dentition using either a submerged (two-stage) or a non-submerged (one-stage) installation protocol. MATERIAL AND METHODS: Eighty-four patients that required 115 fixed partial dentures (FPDs or cases) entered the prospective study. All subjects were assigned one patient and > or =one case numbers. For the randomization of cases, a custom-made program based on balanced random permuted blocks was utilized. The cases were assigned to two treatment groups, namely one-stage installation procedure, non-submerged technique (group A) and two-stage installation procedure, submerged technique (group B). Several subjects contributed with cases to both groups A and B. Periodontal, endodontal and open caries lesions were treated prior to implant installation. All patients received careful oral hygiene instruction and training in self-performed plaque control measures. The surgical technique used for fixture installation followed the outline described in the manual for the Astra Tech System. The FPDs were placed 3 months (mandible) and 6 months (maxilla) following implant installation. Immediately following FPD placement, a baseline examination was performed that included assessment of plaque, soft-tissue inflammation and bone level. Clinicians who were otherwise not involved in the study performed the radiographic measurements. Clinical and radiographical examinations were repeated once a year after the baseline examination. DATA ANALYSIS: The primary outcome variable was the change in the bone level at the implants from the time of placement of the bridge (FPD) to the 1- and 2-year reexaminations. Fisher's permutation test was used to test if differences existed between groups A and B, and between patients (men/women, smokers/non-smokers, age), sites (maxilla/mandible) and implants (length, diameter). Pitman's test was used to study correlations between bone shape and quality data and different radiographic bone-level data. RESULTS: It was demonstrated that tissue healing following implant installation appeared to be independent of the surgical protocol, i.e. whether the marginal portions of the implants during surgery were fully or only partly submerged under the ridge mucosa. Thus, (i) in both treatment groups the number of implants that failed to osseointegrate (early failures) was small (<2%); (ii) at the end of the recommended periods of bone healing prior to loading, - in both groups, maxilla=6 months and mandible=3 months - the level of the marginal bone was close to the coronal rim of the fixture; group A: 1.54+/-0.92 mm, group B: 1.31+/-0.77 mm. The current study also demonstrated that irrespective of surgical protocol (two-stage, one-stage), implants supporting the FPDs exhibited only small amount of radiographic bone loss during the first year of function (group A: 0.02+/-038 mm, group B: 0.17+/-0.64 mm). Moreover, during the second year of function, the amount of additional bone loss that occurred in the two treatment groups was close to zero. CONCLUSION: Periimplant bone-level change during function seemed to be unrelated to whether initial soft- and hard-tissue healing following implant installation had occurred under submerged or non-submerged conditions.
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| 8. |
- Lindhe, Jan, 1935, et al.
(author)
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Ridge preservation with the use of deproteinized bovine bone mineral
- 2014
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In: Clinical Oral Implants Research. - : Wiley. - 0905-7161. ; 25:7, s. 786-790
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Journal article (peer-reviewed)abstract
- Objective: The aim was to examine the tissue composition of extraction sockets that had been grafted with deproteinized bovine bone mineral and allowed to heal for 6 months. Material and methods: Twenty-five subjects with one tooth each scheduled for extraction and replacement with dental implants were recruited. The assigned teeth were carefully removed. The site/patient was thereafter allocated to a test or a control group. In the test group patients, Bio-Oss (R) Collagen was placed to fill the fresh extraction socket while in the controls no grafting was performed. After about 6 months of healing, a biopsy was sampled from the center of the extraction site. The specimens were decalcified, embedded in paraffin, sectioned, and stained in HTX. The proportions occupied by mineralized bone, osteoid, bone marrow, fibrous tissue, and Bio-Oss (R) particles were determined by morphometric point counting. Results: Mineralized bone made up 57.4 +/- 12.4% of the control sites (C) and 48.9 +/- 8.5% of the T1 sites (graft material not included). The amount of bone marrow (C: 7.1 +/- 6.1%, T1: 2.1 +/- 3.1%) and osteoid (C: 7.3 +/- 4.9%, T1: 1.9 +/- 2.1%) was about five times greater in the control than in the test sites. Fibrous tissue comprised 23.1 +/- 16.3% (C) and 40.0 +/- 11.9% (T1). I n the T2 sites (graft material included), the percentage mineralized bone was 39.9 +/- 8.6 while the proportions of bone marrow and osteoid were 1.8 +/- 2.5% and 1.6 +/- 1.8%. Fibrous tissue occupied 32.4 +/- 9.2% and Bio-Oss (R) particles 19.0 +/- 6.5% of the T2 sites. Conclusion: Placement of the biomaterial in the fresh extraction socket retarded healing. The Bio-Oss (R) particles were not resorbed but became surrounded by new bone. This may explain why grafted extraction sites may fail to undergo dimensional change.
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| 9. |
- Sanz, M., et al.
(author)
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Implants placed in fresh extraction sockets in the maxilla: clinical and radiographic outcomes from a 3-year follow-up examination
- 2014
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In: Clinical Oral Implants Research. - : Wiley. - 0905-7161. ; 25:3, s. 321-327
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Journal article (peer-reviewed)abstract
- AimThe aim of this prospective, randomized, controlled multicenter study was to determine the 3-year efficacy and stability of the soft and hard tissues at implants with a different geometry that were placed in fresh extraction sockets. Material and methodsImplants with two different configurations, cylindrical (Group A) or conical/cylindrical (Group B) were installed, and healing abutments were attached. Sixteen weeks after implant placement, subjects returned for a re-entry procedure. Prosthetic restorations were delivered 22weeks after implant placement. Each subject was placed in a 3-year follow-up program, including examinations at yearly visits including various soft tissue and bone level parameters. ResultsThe percentage of sites that were considered inflamed during the follow-up period was stable and varied between 8.8% and 10.2%. The radiographic examinations documented improved bone levels at the final examination and the mean improvement from baseline (placement of permanent restoration; PR) amounted to 0.170.67mm. More than 70% (54 of 76) of the implants monitored in this study suffered no bone loss during the maintenance period. Moreover, there was an obvious gain of interproximal soft tissue volume and at the 3-year examination around 25% of all embrasure gaps were completely filled with papillae. ConclusionsBoth conical/cylindrical and cylindrical implants placed in fresh extraction sockets allowed proper soft and hard tissue healing to occur. At both types of implants, mucosal inflammation was infrequent, marginal bone levels were maintained, and soft tissue volume increased gradually after the placement of the permanent restoration.
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| 10. |
- Sanz, M., et al.
(author)
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The effect of placing a bone replacement graft in the gap at immediately placed implants: a randomized clinical trial
- 2017
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In: Clinical Oral Implants Research. - : Wiley. - 0905-7161. ; 28:8, s. 902-910
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Journal article (peer-reviewed)abstract
- Objective: To assess the added value of using a bone replacement graft in combination with immediate implants in reducing the bone dimensional changes occurring in the residual ridge. Material and methods: Randomized parallel controlled clinical trial to study the efficacy of grafting with demineralized bovine bone mineral with 10% collagen (DBBM-C) in the gap between the implant surface and the inner bone walls when the implants were immediately placed in the anterior maxilla. The changes between implant placement and 16 weeks later in the horizontal and vertical crestal bone changes in relation to the implant were evaluated through direct bone measurements using a periodontal probe. Mean changes were compared between the experimental and control sites using parametric statistics. Results: A total of 86 implant sites in 86 subjects were included in the analysis (43 in the test group and 43 in the control group). The horizontal crest dimension underwent marked changes during healing mainly at the buccal aspect of the alveolar crest where this reduction amounted to 1.1 (29%) in the test group and 1.6 mm (38%) in the control group, being these statistically significant (P = 0.02). This outcome was even more pronounced at sites in the anterior maxilla and with thinner buccal bone plates. Conclusions: In conclusion, the results from this clinical trial demonstrated that placing a DBBM-C bone replacement graft significantly reduced the horizontal bone resorptive changes occurring in the buccal bone after the immediate implantation in fresh extraction sockets.
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