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- Grandfield, Kathryn, et al.
(author)
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Bone response to free form fabricated hydroxyapatite and zirconia scaffolds : a transmission electron microscopy study in the human maxilla
- 2012
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In: Clinical Implant Dentistry and Related Research. - : Wiley. - 1523-0899 .- 1708-8208. ; 14:3, s. 461-469
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Journal article (peer-reviewed)abstract
- Background: Understanding the interfacial reactions to synthetic bone regenerative scaffolds in vivo is fundamental for improving osseointegration and osteogenesis. Using transmission electron microscopy, it is possible to study the biological response of hydroxyapatite (HA) and zirconia (ZrO2) scaffolds at the nanometer scale.Purpose: In this study, the bone-bonding abilities of HA and ZrO2 scaffolds produced by free-form fabrication were evaluated in the human maxilla at 3 months and 7 months.Materials and Methods: HA and ZrO2 scaffolds (ø: 3 mm) were implanted in the human maxilla, removed with surrounding bone, embedded in resin, and sectioned. A novel focused ion beam (FIB) sample preparation technique enabled the production of thin lamellae for study by scanning transmission electron microscopy.Results: Interface regions were investigated using high-angle annular dark-field imaging and energy-dispersive X-ray spectroscopy analysis. Interfacial apatite layers of 80 nm and 50 nm thickness were noted in the 3- and 7-month HA samples, respectively, and bone growth was discovered in micropores up to 10 µm into the samples.Conclusions: The absence of an interfacial layer in the ZrO2 samples suggest the formation of a direct contact with bone, while HA, which bonds through an apatite layer, shows indications of resorption with increasing implantation time. This study demonstrates the potential of HA and ZrO2 scaffolds for use as bone regenerative materials.
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- Göthberg, Catharina, 1960, et al.
(author)
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Bone and soft tissue outcomes, risk factors, and complications of implant-supported prostheses: 5-Years RCT with different abutment types and loading protocols
- 2018
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In: Clinical Implant Dentistry and Related Research. - : Wiley. - 1523-0899 .- 1708-8208. ; 20:3, s. 313-321
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Journal article (peer-reviewed)abstract
- BackgroundData on risk factors and complications after long-term implant treatment is limited. The aims were to evaluate the role of various fixation modes and to analyze complications and risks that affect long-term use of implant-supported partial fixed dental prostheses. Materials and MethodsFifty partially edentulous subjects received three Branemark TiUnite implants. Superstructures were attached directly at implant level (IL) or via abutments: machined surface (AM) and an oxidized surface (AOX, TiUnite). Implants were immediately loaded (test) or unloaded for 3 months (control). Examinations occurred over a 5-year period. ResultsForty-four subjects were re-examined after 5 years. Cumulative survival rates in test and control groups were 93.9% and 97.0%, respectively. Marginal bone loss (MBL; Mean [SEM]) was significantly lower at superstructures connected to AM (1.61 [0.25] mm) than at sites with no abutment IL (2.14 [0.17] mm). Peri-implantitis occurred in 9.1% of subjects and in 4.0% of implants. Multiple linear regression indicated that increased probing pocket depth (PPD), periodontal disease experience, deteriorating health, and light smoking (10 cigarettes/day) predict greater MBL, whereas increased buccal soft tissue thickness and higher ISQ predict lower MBL. ConclusionsThe results show that MBL was influenced by the connection type. A machined abutment, instead of connecting the superstructure directly at the implant level, was beneficial. The following factors influenced MBL: PPD, periodontal disease experience, deteriorating health, light smoking, buccal soft tissue thickness, and ISQ. The results on peri-implantitis underscore the need for long-term maintenance care. Further, the abutment material surface properties constitute additional target for strategies to minimize MBL.
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- Göthberg, Catharina, 1960, et al.
(author)
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Immediately Loaded Implants with or without Abutments Supporting Fixed Partial Dentures: 1-Year Results from a Prospective, Randomized, Clinical Trial.
- 2014
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In: Clinical implant dentistry and related research. - : Wiley. - 1708-8208 .- 1523-0899. ; 16:4, s. 487-500
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Journal article (peer-reviewed)abstract
- PURPOSE: To evaluate 1-year implant survival and marginal bone loss around implants that support fixed partial dentures loaded immediately or after 3 months, and effects from abutment usage. MATERIALS AND METHODS: In this 2005 to 2009 randomized, parallel-group, clinical trial, 50 partially edentulous patients each received three Brånemark TiUnite™ implants (Nobel Biocare®, Göteborg, Sweden), mostly in the posterior maxilla. Two implants were fitted with abutments: a TiUnite™ surface and a machine-milled surface; the suprastructure was attached directly at implant level for the third implant. After randomized allocation, implants were immediately loaded with a fixed temporary bridge (test group) or left unloaded for 3 months (control group). A permanent fixed suprastructure replaced the temporary bridge after 6 months (test). Hard and soft tissues were examined during pretreatment and surgery plus 2 days, 14 days, 4 weeks, 3 months, and 1 year after surgery. RESULTS: After 1 year, four implants were lost in the test and two in the control groups (1-year survival rates of 94.9% [test] and 97.2% [control], with no significant intergroup difference). Resonance frequency analysis values indicated a similar pattern in both groups, with implant stability quotient (ISQ) reduction between 2 and 4 weeks. The test group had a significantly lower ISQ than the control group at these appointments. After 1 year, marginal bone losses around the implants were, on average, 1.32mm (test, standard error of the mean [SEM] 0.08) and 1.24mm (control, SEM 0.08), with no significant intergroup difference. Significantly larger marginal bone loss was observed at implants without abutment compared with implants with abutment. CONCLUSIONS: For both groups, this study showed similar implant survival rates and marginal bone loss. Larger bone loss was found at implants loaded without attached abutments.
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- Lundgren, Dan, et al.
(author)
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A Novel Type of Dental Tube Implant for Areas with Limited Bone Height. Clinical and Radiographic Data from Three Patients with 5-Year Follow-Up.
- 2013
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In: Clinical implant dentistry and related research. - : Wiley. - 1708-8208 .- 1523-0899. ; 15:3, s. 509-516
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Journal article (peer-reviewed)abstract
- Background: Alternative implant designs may reduce the need for complicated and costly bone augmentation procedures in situations with limited bone height. Purpose: Wide dental tube implants have been manufactured and tested in three patients and followed for 5 years to evaluate if such implants are capable to support fixed prosthetic constructions with good prognosis in areas with limited bone height. Materials and Methods: Four machined-tube implants with a height of 6mm, an outer diameter of 7.4mm, and an inner diameter of 6.0mm were placed in three patients. After a healing period of 3 months, ceramometal suprastructures were constructed to supply the implants. Annual clinical and radiographical follow-ups were done up to 5 years. At the 5-year follow-up, all three patients were examined with a cone beam computed tomography technique. Results: All implants and the suprastructures were clinically stable after 5 years. In one patient, vertical bone loss and a 6-mm deep pocket appeared after 1 year. The pocket has remained throughout the observation period and has been regularly debrided and kept it free from clinical signs of inflammation. In the other two patients, the soft tissue surrounding the implants was in good health with no or only slight inflammation throughout all observations. Pocket probing revealed no or slight bleeding and pocket depths amounting to less than 3mm. Conclusion: It was shown that this new type of implant will function excellent during follow-up times of several years. Further studies should be done to explore in more detail indications for such implants.
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- Malmström, Johan, 1975, et al.
(author)
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Bone response to free form-fabricated hydroxyapatite and zirconia scaffolds : A histological study in the human maxilla
- 2009
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In: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 20:4, s. 379-385
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Journal article (peer-reviewed)abstract
- Objectives: Synthetic and biological materials are increasingly used to provide temporary or permanent scaffolds for bone regeneration. This study evaluated the effect of material chemistry and microporosity on bone ingrowth and osseointegration of zirconia (ZrO2) and hydroxyapatite (HA) scaffolds in the human maxilla.Material and methods: Twelve patients subjected to dental implant placement were enrolled in the study. Scaffolds of ZrO 2 and HA were placed in the maxilla of each subject, using a randomization protocol. After 3 months of healing, biopsies were harvested comprising the scaffolds and surrounding bone tissue. The biopsies were processed for histological evaluation and morphometric analysis (bone ingrowth and bone-to-scaffold contact).Results: Healing was uneventful in all cases. All scaffolds demonstrated a measurable bone response using light microscopy and scanning electron microscopy. Microporous HA scaffolds revealed four times larger bone ingrowth and seven times larger bone contact as compared with ZrO2 scaffolds.Conclusion: The results show that chemistry and microporosity of HA promote bone ingrowth and bone contact of ceramic scaffolds in human maxilla.
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- Najim, U., et al.
(author)
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Prevalence of furcation-involved molars in a Swedish adult population. A radiographic epidemiological study
- 2016
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In: Clinical and Experimental Dental Research. - : Wiley. - 2057-4347. ; 2:2, s. 104-111
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Journal article (peer-reviewed)abstract
- The purpose of this study was to identify the prevalence of molars with furcation involvements grades II and III in adults participating in the Jonkoping Oral Health Study 2003. The second aim was to study correlations between different variables and the presence of furcation involvement in these individuals. The present study was performed using bitewing and apical radiographs from 329 subjects. Furcations were considered healthy if the furcation was filled with bone up to the fornix. Two thousand fourteen molars fulfilled the inclusion criteria. The prevalence of molars with furcation involvements was 8.3%. Univariate analysis showed that plaque, age, and presence of periodontal pockets were significantly correlated with furcation-involved molar/s (P 0.0001). Gingivitis and education were also significantly correlated to the presence of furcation involvement (P 0.006) and (P <= 0.01), respectively. Gender had no association with presence of involvements. Multivariate analysis showed that age and presence of periodontal pockets were significantly correlated with furcation involvement (P 0.0001). Smoking was also found to be associated with furcation involvement (P 0.04). The tooth most frequently and least likely displaying furcation involvement was the maxillary first molar and the mandibular second molar, respectively. Periodontal pockets, age, and smoking were risk indicators for furcation involvement.
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- Sayardoust, Shariel, et al.
(author)
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Implant survival and marginal bone loss at turned and oxidized implants in periodontitis-susceptible smokers and never-smokers : A retrospective, clinical, radiographic case-control study
- 2013
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In: Journal of Periodontology. - : John Wiley & Sons. - 0022-3492 .- 1943-3670. ; 84:12, s. 1775-1782
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Journal article (peer-reviewed)abstract
- Background: Little is known about the long-term outcome of oxidized surface oral implants, especially in periodontitis-susceptible smokers. The aim of this study is to determine implant survival and marginal bone loss at turned and oxidized implants in smokers and never-smokers with periodontitis.Methods: Forty smokers and 40 never-smokers with experience of advanced periodontal disease, treated with implants 5 years previously, are included in this study. Groups were matched for sex, oral hygiene, and implant distribution, and patients were subgrouped by implant surface type (turned or oxidized).Results: The overall implant survival rate was 96.9% in never-smokers and 89.6% in smokers. Compared with oxidized implants, turned implants failed more frequently in smokers. In smokers, mean (standard error of the mean) marginal bone loss at 5 years was 1.54 (0.21) mm at turned and 1.16 (0.24) mm at oxidized implants. In never-smokers, significantly greater bone loss was found at oxidized implants, 1.26 (0.15) mm, than at turned implants, 0.84 (0.14) mm. Oxidized implants demonstrated similar bone loss for both groups. Turned implants lost significantly more bone in smokers. Compared with never-smokers, the smokers' likelihood ratio for implant failure was 4.68, 6.40 for turned and 0.00 for oxidized implants.Conclusions: The results of the study underscore the need for prevention and cessation of smoking. Turned implants failed more frequently and lost more marginal bone in smokers. In contrast, oxidized implants showed similar failure rates and bone loss in smokers and never-smokers. Turned implants displayed less bone loss than oxidized implants in never-smokers. Oxidized surface implants are more suitable for patients susceptible to periodontitis who smoke.
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