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- Slotte, Christer, 1954, et al.
(author)
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Four-Millimeter Implants Supporting Fixed Partial Dental Prostheses in the Severely Resorbed Posterior Mandible: Two-Year Results.
- 2011
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In: Clinical implant dentistry and related research. - : Wiley. - 1708-8208 .- 1523-0899.
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Journal article (peer-reviewed)abstract
- Background: Reduced alveolar bone volume complicates implant dentistry. Purpose: In this prospective multicenter study, a new, 4-mm long Straumann SLActive implant (Ø 4.1mm) supporting a fixed dental prosthesis (FDP) in the severely resorbed posterior mandible was evaluated for two years. Material and Methods: Thirty-two patients (11 men, 21 women; mean age 64.1 years) participated. Ten to 12 weeks after single-stage surgery, a screw-retained FDP was attached to three or four 4-mm implants. Results and Discussion: One hundred implants were inserted. Three failed at surgery and four were lost before loading. Twenty-eight patients received FDPs (93 implants). Two patients were discontinued because of secondary exclusion criteria; therefore, 26 patients were followed up from baseline (BL). After 1 year, one patient insisted on removal of all implants and one patient died because of nonstudy-related complications. Twenty-four patients (87 implants) were eligible for examination 2 years post-loading. All implants were found to be stable [survival rate 95.7% (confidence interval, CI 88.8-98.3) after 1 year and 92.3% (CI 84.5-96.2) after 2 years]. The mean change from BL to 12 months was - 0.43mm (CI 0.31-0.59; p<.001) and from 12 to 24 months - 0.11mm (CI -0.01-0.23; p=.056). The survival rate is only slightly lower than in similar studies on 6 to 8.5mm implants. This may be related to high initial stability and effective use of the residual bone volume with high primary bone-to-implant contact in dense bone structures. The surgical handling of the tested implant was found to be similar to that of implants of common length. However, the preparation procedure must be done with great care to avoid overdrilling. Careful planning and design of the prosthetic construction is mandatory to prevent unfavorable occlusion and avoid harmful shear forces. Conclusion: This study showed that 4mm implants can support an FDP in severely resorbed posterior mandibles for at least 2 years and with healthy peri-implant conditions.
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2. |
- Slotte, Christer, 1954, et al.
(author)
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Four-Millimeter-Long Posterior-Mandible Implants: 5-Year Outcomes of a Prospective Multicenter Study.
- 2015
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In: Clinical implant dentistry and related research. - : Wiley. - 1708-8208 .- 1523-0899. ; 17:2
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Journal article (peer-reviewed)abstract
- There is lack of evidence on long-term success of short dental implants in reduced alveolar bone. Purpose In this prospective 5-year study, survival and marginal bone loss of 4-mm implants, which supported fixed dental prostheses (FDPs) in severely resorbed posterior mandibles, were evaluated. Material and Methods In 28 patients, evaluation of 86 osseointegrated 4-mm-long implants, which supported a 3- or a 4-unit FDP by crown splinting without the use of pontics or cantilevers, was performed over a 5-year period. Results Three subjects dropped out for non-study reasons: one subject had her three implants removed after 1 year and two subjects died (six implants). Five implants in three subjects were lost between 3 and 5 years. Twenty-four subjects and 71 implants were active at the 5-year follow-up (92.2% survival). After 1 year, significant (p<.001) mean (standard error of the mean [SEM]) 0.44-mm (0.05) marginal bone loss occurred. At 2, 3, and 5 years, mean (SEM) bone loss of 0.57mm (0.06), 0.55mm (0.07), and 0.53mm (0.08) occurred, respectively (no significant change after 1 year). At 5 years, average plaque levels were 13.3%; 69% of the implants were plaque free. On average, mucosal bleeding occurred at 8.1% of the implants. During 5 years, two subjects experienced uncomplicated bridge loosening. No other complications occurred during the study. Conclusion Four-millimeter implants can support FDPs in severely resorbed posterior mandibles for 5 years with healthy peri-implant conditions.
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3. |
- Aludden, Hanna, et al.
(author)
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Histological and histomorphometrical outcome after lateral guided bone regeneration augmentation of the mandible with different ratios of deproteinized bovine bone mineral and autogenous bone. A preclinical in vivo study
- 2020
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In: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 31:10, s. 1025-1036
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Journal article (peer-reviewed)abstract
- © 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Objective: To test the hypotheses of no differences in (I) percentage of bone (POB), non-mineralized tissue (NMT), and deproteinized bovine bone mineral (DBBM), and (II) ingrowth of mineralized bone after lateral guided bone regeneration (GBR) augmentation of the mandible with different ratios of DBBM and particulate autogenous bone (PAB) at different time points. Material and methods: Twenty-four minipigs were randomly allocated into three groups. Lateral augmentation in 96 sites (4 in each animal) was performed unilaterally with a standardized quantity of grafting material in each animal with different ratios of DBBM and PAB (50:50, 75:25, 100:0) and autogenous bone block in combination with DBBM and covered with a collagen membrane. The percentage of different tissues in the graft and ingrowth of mineralized bone was assessed by histomorphometrical and histological analyses after 10, 20, and 30weeks, respectively. Results: The POB was 54% (50:50), 50% (75:25), and 48% (100:0) after 10weeks, 60% (50:50), 61% (75:25), and 60% (100:0) after 20weeks, and 63% (50:50), 62% (75:25), and 62% (100:0) after 30weeks. There was no significant difference between the groups at any time points. There was a significant increase in POB and a significant decrease in NMT for 75:25 and 100:0 from 10 to 30weeks. All ratios demonstrated a non-complete ingrowth of mineralized bone into the graft after 10weeks and complete mineralization after 30weeks. Conclusion: Within the limitations of the present study, it seems like addition of autogenous bone to DBBM for LRA did not affect the bone formation nor graft incorporation after 10–30weeks of healing. However, a prolonged healing time seems to result in an increased POB for all ratios.
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4. |
- Aludden, Hanna, 1984, et al.
(author)
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Histological and radiological outcome after horizontal guided bone regeneration with bovine bone mineral alone or in combination with bone in edentulous atrophic maxilla: A randomized controlled trial
- 2024
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In: CLINICAL ORAL IMPLANTS RESEARCH. - 0905-7161 .- 1600-0501.
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Journal article (peer-reviewed)abstract
- ObjectiveTo assess the radiological and histological outcome after horizontal guided bone regeneration (GBR) with deproteinized bovine bone mineral (DBBM) alone or in combination with particulate autogenous bone (PAB).Materials and MethodsEighteen edentulous patients with an alveolar ridge of <= 4 mm were included in this split-mouth randomized controlled trial. Horizontal GBR with a graft composition of 100% DBBM (100:0) on one side and 90% DBBM and 10% PAB (90:10) on the other side were conducted in all patients. Cone beam computed tomography (CBCT) was obtained preoperatively, immediately postoperative, and after 10 months of healing. Width and volumetric changes in the alveolar process were measured on CBCT. Implants were placed after 10 months of graft healing where biopsies were obtained for histomorphometrical evaluation.ResultsThe gained widths were 4.9 (+/- 2.4) mm (100:0) and 4.5 (+/- 2.0) mm (90:10) at 3 mm from the top of the crest, and 5.6 (+/- 1.3) mm (100:0) and 4.6 (+/- 2.1) mm (90:10) at 6 mm from the top of the crest. The mean volumetric reductions were 32.8% (+/- 23.8) (100:0) and 38.2% (+/- 23.2) (90:10). Histomorphometry revealed that mean percentages of bone were 50.8% (+/- 10.7) (100:0) and 46.4% (+/- 11.3) (90:10), DBBM were 31.6% (+/- 12.6) (100:0) and 35.4% (+/- 14.8) (90:10), and non-mineralized tissue were 17.6% (+/- 11.7; 100:0) and 18.2% (+/- 18.2) (90:10). No significant differences were evident between in any evaluated parameters.ConclusionsThere were no additional effects of adding PAB to DBBM regarding bone formation, width changes, or volumetric changes after 10 months of graft healing.
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5. |
- Aludden, H., et al.
(author)
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Histomorphometric analyses of area fraction of different ratios of Bio-Oss((R)) and bone prior to grafting procedures - An in vitro study to demonstrate a baseline
- 2018
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In: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 29:2, s. 185-191
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Journal article (peer-reviewed)abstract
- ObjectiveThe objective of this study was to estimate the area fraction of different ratios of Bio-Oss((R)) and bone, prior to grafting in an in vitro model to demonstrate a histomorphometric baseline. MethodsBio-Oss((R)) particles were mixed with autogenous bone from pig jaw in three different ratios (50:50, 80:20 and 100:0) and packed in rice paper in a standardized procedure. Histomorphometric analyses were performed in 25 specimens and 74 regions of interest. The area percentage of Bio-Oss((R)), bone, and non-mineralized tissue (NMT) were calculated. Results were reported as mean values and 95% confidence interval (CI). ResultsThe mean area fraction of Bio-Oss((R)) was 20.6% (CI: 18.2-23) in the 50:50 mixture, 33.6% (CI: 29.7-37.6) in the 80:20 mixture, and 43.4% (CI: 40.5-46.3) in the 100:0 mixture. The mean area fraction of NMT was 60.5% (CI: 57.9-63.1) in the 50:50 mixture, 59.6% (CI: 56.4-62.7) in the 80:20 mixture, and 56.6% (CI: 53.7-59.5) in the 100:0 mixture. The mean area fraction of bone was 18.9% (CI: 16.9-20.9) in the 50:50 mixture and 6.8% (CI: 5-8.6) in the 80:20 mixture. ConclusionThere is a great difference in the clinically estimated percentage and the histomorphometrically evaluated percentage of Bio-Oss((R)) at baseline, prior to grafting. The area fraction of different tissues presented in this study may be beneficial as guidance for histomorphometrical baseline calculations when different mixtures of Bio-Oss((R)) and autogenous bone are used as grafting materials.
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6. |
- Aludden, Hanna, et al.
(author)
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Osteotome-Mediated Sinus Floor Elevation With or Without a Grafting Material : A Systematic Review and Meta-analysis of Long-term Studies (>= 5-Years)
- 2018
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In: Implant Dentistry. - : Lippincott Williams & Wilkins. - 1056-6163 .- 1538-2982. ; 27:4, s. 488-497
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Research review (peer-reviewed)abstract
- Objective: To test the hypothesis of no difference in the long-term treatment outcome after osteotome-mediated sinus floor elevation with or without a grafting material. Materials and Methods: A MEDLINE/PubMed, Cochrane Library, and EMBASE search in combination with a hand-search of relevant journals was conducted, including human studies published in English from January 1, 1986 to December 1, 2017. Results: One comparative and 7 noncomparative studies fulfilled the inclusion criteria. Survival of suprastructures had never been compared within the same study. Meta-analysis demonstrated an overall estimated patient-based implant survival of 94%. Gain in vertical alveolar bone height was similar with the 2 treatment modalities. Noncomparative studies demonstrated high long-term survival rate of suprastructures and implants with the 2 treatment modalities, as well as limited periimplant marginal bone loss. Conclusion: High long-term implant survival was demonstrated after osteotome-mediated sinus floor elevation with or without a grafting material. However, long-term randomized controlled trials comparing the 2 treatment modalities are sparse. Hence, conclusions drawn from this systematic review should be interpreted with caution.
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7. |
- Aludden, H., et al.
(author)
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Radiographic changes in height and volume after lateral GBR procedures with different ratios of deproteinized bovine bone mineral and autogenous bone at different time points. An experimental study
- 2021
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In: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 32:2, s. 167-179
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Journal article (peer-reviewed)abstract
- Objective Estimate changes in augmentation height and volume after lateral guided bone regeneration (GBR) augmentation with different ratios of deproteinized bovine bone mineral (DBBM) and particulate autogenous bone (PAB) and autogenous bone block (ABB), at different time points. Material and methods Twenty-four minipigs were randomly allocated into three healing periods. Lateral augmentation in 96 sites with standardized quantity of graft material was performed with different ratios of DBBM and PAB (50:50, 75:25, and 100:0) and ABB in combination with DBBM, covered by a collagen membrane. Changes in augmentation height and volume were assessed on CT volumes acquired 10, 20, and 30 weeks after surgery. Results Reduction in bone augmentation height was as follows: 50:50-1.7 mm (-33.1%), 75:25-1.8 mm (-37.8%), 100:0-1.7 mm (-35.8%), and ABB - 0.2 mm (-3.7%), after 30 weeks. The augmentation height was significantly better preserved with ABB compared to 50:50, 75:25, and 100:0, while no significant difference was present among particulate grafts. No significant difference in volumetric reduction was found among 50:50, 75:25, 100:0 and ABB after 30 weeks, while 100:0 presented significant less reduction compared to 50:50, 75:25 and ABB after 10 and 20 weeks. Conclusions Augmentation height following GBR was better preserved with ABB covered with DBBM. Addition of PAB to DBBM did not affect the changes in height of the graft. The volumetric stability seems to be comparable for ABB covered by DBBM and all particulate grafts after 30 weeks. However, DBBM alone revealed significant less volume reduction in the early healing phase.
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8. |
- Hallman, Mats, et al.
(author)
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A retrospective 5-year follow-up study of two different titanium implant surfaces used after interpositional bone grafting for reconstruction of the atrophic edentulous maxilla.
- 2005
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In: Clinical implant dentistry and related research. - 1523-0899. ; 7:3, s. 121-6
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Journal article (peer-reviewed)abstract
- BACKGROUND: Long-term comparative follow-up studies of dental implants placed in augmented bone are rare. Variations in design and surface roughness have been found to be important for bone integration of implants. However, there is no clinical evidence that such variations lead to an improved clinical outcome. PURPOSE: To compare two different implant systems used after interpositional bone grafting of the severely resorbed maxilla with a modified augmentation technique using fibrin glue. MATERIALS AND METHODS: Twenty-two consecutive patients presenting with severe maxillary atrophy underwent reconstruction with Le Fort I osteotomies and interpositional bone grafting. Before placement of bone blocks, the floors of the maxillary sinuses were packed with bone chips mixed with a fibrin glue, to stabilize the graft. After 6 months of graft healing, the first 11 consecutive patients received Brånemark System implants with a turned surface (Nobel Biocare AB, Göteborg, Sweden). The following 11 consecutive patients were treated with Astra Tech implants with a blasted titanium surface (Astra Tech AB, Mölndal, Sweden). All patients received fixed prostheses. Marginal bone resorption and donor and recipient site morbidity were evaluated. All patients were clinically and radiographically observed throughout 5 years of functional loading. RESULTS: In the Brånemark group, 11 (13%) of 84 placed implants were lost, compared to 4 (5.5%) of 72 placed implants in the Astra Tech group. The difference was not significant. All patients retained fixed constructions after 5 years of loading. The mean marginal bone loss was 2.3+/-0.8 mm (range, 0-5.0 mm) in the Brånemark group and 2.4+/-1.4 mm (range, 0-7.0 mm) in the Astra Tech group although again no statistical difference was found. A larger number of implants in the Astra Tech group had a marginal bone resorption of>or=3 mm, and implant success in that group was lower than in the Brånemark group (52% vs 70%). Conclusion: In this study, reconstruction of the severely resorbed maxilla with Le Fort I osteotomy, interpositional bone grafting, and delayed placement of dental implants was found to be a predictable long-term procedure. Although more implants with a turned surface were lost during the follow-up period, there were no statistically significant differences between turned and titanium blasted implants.
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10. |
- Hallman, Mats, et al.
(author)
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Benersättning vid implantatkirurgi
- 2007
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In: Tandläkartidningen. - 0039-6982. ; 99:3, s. 48-55
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Journal article (peer-reviewed)abstract
- Resorption av käkbenet efter tandförlust är vanligt. I många fall måste käkbenet rekonstrueras innan implantatet kan sättas in. Vanligast är då att patientens eget ben används. Nackdelar med kroppseget ben har dock lett till att olika benersättningsmaterial börjat användas allt mer. Den här översiktsartikeln går igenom olika benersättningsmaterial på marknaden med fokus på funktion och indikation. Artikeln är baserad på litteratur och egna erfarenheter.
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