| 1. |
- Cosyn, Jan, et al.
(author)
-
An Exploratory Case-Control Study on the Impact of IL-1 Gene Polymorphisms on Early Implant Failure
- 2016
-
In: Clinical Implant Dentistry and Related Research. - : John Wiley & Sons. - 1523-0899 .- 1708-8208. ; 18:2, s. 234-240
-
Journal article (peer-reviewed)abstract
- Background The association between IL-1 gene polymorphisms and peri-implantitis has been well documented. However, data on the association with early implant failure are scarce. Purpose The objective of this case-control study was to explore the impact of IL-1A (-889), IL-1B (-511), and IL-1B (+3,954) gene polymorphisms on early implant failure in Caucasians Materials and Methods Between September 2004 and August 2007, 461 patients were treated with dental implants at the University Hospital in Ghent, Belgium. Fourteen subjects of this patient group who had experienced one or more early implant failures (within 6 months from implant installation) were recruited as cases. Fourteen controls, matched in terms of age, gender, and smoking habits, with only surviving implants, were selected from the same patient group. Allele and genotype analysis was performed on the basis of a blood sample by Sanger sequencing of polymerase chain reaction products containing the IL-1A (-889), IL-1B (-511), and IL-1B (+3,954) gene polymorphisms Results A significant impact of the IL-1A (-889) T allele (p=.039) and the IL-1B (+3,954) T allele (p=.003) on early implant failure was demonstrated (odds ratios=3.9 and 15.0, respectively). In addition, the genotypic distribution differed significantly between cases and controls for IL-1B (+3,954) (p=.015 ConclusionsThe IL-1B (+3,954) gene polymorphism seems to affect osseointegration. Additional case-control studies in larger patient groups are needed to confirm this observation.
|
|
| 2. |
- Browaeys, Hilde, et al.
(author)
-
A Retrospective Analysis of Early and Immediately Loaded Osseotite Implants in Cross-Arch Rehabilitations in Edentulous Maxillas and Mandibles Up to 7 Years
- 2013
-
In: Clinical Implant Dentistry and Related Research. - : John Wiley & Sons. - 1523-0899 .- 1708-8208. ; 15:3, s. 380-389
-
Journal article (peer-reviewed)abstract
- Background: Immediate loading of full-arch restorations yields good results in selected cases, but long-term follow-up and the outcome in compromised bone are scarcely evaluated. Purpose: To evaluate immediately loaded Osseotite implants (Biomet 3i, Palm Beach, FL, USA) installed in healed or grafted bone, with regard to implant survival and peri-implant bone loss up to 7 years in function. Materials and Methods: Information was retrospectively retrieved from 83 patients' records with 749 Osseotite implants supporting immediately loaded semipermanent full-arch acrylic restorations. Five hundred sixty-eight (75.8%) implants were placed in healed bone and 181 (24.2%) in augmented bone, regenerated with sinus lifting and/or onlay/inlay grafts with/without biomaterials and membranes. Implant survival and success based on radiological peri-implant bone loss were registered. Wilcoxon rank sum tests evaluated peri-implant bone loss in compromised versus healed bone or between jaws or time intervals with p < .05 as statistically significant. Results: Sixteen of 749 implants failed (2.1%), 11/343 in maxilla (3.2%) and 5/406 (1.2%) in mandible. After 7 years, the cumulative failure rate was 9%. Mean peri-implant bone loss increased to 1.2 mm (SD 1.0) during the first 2 years but remained unchanged thereafter. Around implants in grafted bone, on average, 0.3 mm more bone loss was found. Conclusion: The Osseotite implants offer a predictable long-term outcome in terms of implant survival and stable peri-implant bone under immediate loading even in grafted bone. However, the high incidence of technical repair because of fractures of the semipermanent provisionals requires attention because it may be negative from a cost-benefit perspective. Implants in grafted bone show a tendency to a more pronounced initial bone remodeling without clinical consequence in the long term.
|
|
| 3. |
- Cosyn, Jan, et al.
(author)
-
An analysis of the decision-making process for single implant treatment in general practice
- 2012
-
In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 39:2, s. 166-172
-
Journal article (peer-reviewed)abstract
- Purpose To study the frequency of and factors associated with the decision to perform single implant treatment after tooth extraction by general practitioners in a private, fee-for-service setting. Material and methods One hundred practitioners with a general dental practice in Ghent were randomly selected. Clinicians were asked to fill in a study form for every single extraction they performed during an 8-week period. The form related to the treatment decision and a number of patient- and clinician-related factors. Results Ninety-four general dentists (52 men, 42 women; mean age 49; range 24–68) agreed to participate and extracted 1180 single teeth. After exclusion of third molars and cases where the reason for tooth loss would generally prohibit replacement, 900 cases were identified. In 24% of these patients, there was no treatment decision and in 18% replacement was deemed unnecessary. When replacement was necessary (n = 526), removable partial denture (RPD), fixed partial denture (FPD), single implant treatment and resin-bonded bridge were chosen in 54%, 24%, 21% and 1% of the patients, respectively. Multinomial logistic regression was used to evaluate the decision-making process for single implant treatment against RPD and FPD. In relation to RPD, single implant treatment was more likely in highly educated patients with few missing teeth and no bone loss at adjacent teeth. In relation to FPD, single implant treatment was more likely in patients with intact adjacent teeth and when the tooth was extracted by a female dentist. Experience in implant prosthetics was positively associated with single implant treatment in all analyses. Conclusions Single implant treatment is not the most common procedure in daily practice to restore a single tooth gap. Patient's education, oral factors and clinician-related factors may affect the decision-making process, whereas medical factors may not.
|
|
| 4. |
- De Bruyn, Hugo, et al.
(author)
-
Long-term clinical, microbiological, and radiographic outcomes of Brånemark™ implants installed in augmented maxillary bone for fixed full-arch rehabilitation.
- 2013
-
In: Clinical Implant Dentistry and Related Research. - 1523-0899 .- 1708-8208. ; 15:1, s. 73-82
-
Journal article (peer-reviewed)abstract
- PURPOSE: The purpose of this study was to document the long-term outcome of Brånemark implants installed in augmented maxillary bone and to identify parameters that are associated with peri-implant bone level.MATERIAL AND METHODS: Patients of a periodontal practice who had been referred to a maxillofacial surgeon for iliac crest bone grafting in the atrophic maxilla were retrospectively recruited. Five months following grafting, they received 7-8 turned Brånemark implants. Following submerged healing of another 5 months, implants were uncovered and restorative procedures for fixed rehabilitation were initiated 2-3 months thereafter. The primary outcome variable was bone level defined as the distance from the implant-abutment interface to the first visible bone-to-implant contact. Secondary outcome variables included plaque index, bleeding index, probing depth, and levels of 40 species in subgingival plaque samples as identified by means of checkerboard DNA-DNA hybridization.RESULTS: Nine out of 16 patients (eight females, one male; mean age 59) with 71 implants agreed to come in for evaluation after on average 9 years (SD 4; range 3-13) of function. One implant was deemed mobile at the time of inspection. Clinical conditions were acceptable with 11% of the implants showing pockets ≥ 5 mm. Periodontopathogens were encountered frequently and in high numbers. Clinical parameters and bacterial levels were highly patient dependent. The mean bone level was 2.30 mm (SD 1.53; range 0.00-6.95), with 23% of the implants demonstrating advanced resorption (bone level > 3 mm). Regression analysis showed a significant association of the patient (p < .001) and plaque index (p = .007) with bone level.CONCLUSIONS: The long-term outcome of Brånemark implants installed in iliac crest-augmented maxillary bone is acceptable; however, advanced peri-implant bone loss is rather common and indicative of graft resorption. This phenomenon is patient dependent and seems also associated with oral hygiene.
|
|
| 5. |
- De Wilde, Elisabeth A. W. J., et al.
(author)
-
The soft tissue immunologic response to hydroxyapatite-coated transmucosal implant surfaces : a study in humans
- 2015
-
In: Clinical Implant Dentistry and Related Research. - : John Wiley & Sons. - 1523-0899 .- 1708-8208. ; 17:S1, s. e65-e74
-
Journal article (peer-reviewed)abstract
- ObjectiveTo evaluate the soft tissue response in humans immunologically and histologically after placement of mini-implants coated with or without nano-size hydroxyapatite coatings. Material and MethodsCommercially pure (cp) titanium mini-implants (n=13) or nano-hydroxyapatite-coated ones (n=12) were randomly placed into partially edentulous jaws. Crevicular fluid was sampled 1week after placement and subjected to quantitative polymerase chain reaction analysis to explore the inflammatory markers. After 8weeks, implants and surrounding soft and hard tissue were trephined, and undecalcified ground sections were prepared. Inflammatory cell accumulation within a defined region of interest in the soft tissue was quantified histomorphometrically. ResultsNo statistically significant differences in immunological response to the different implant surfaces were found for IL-6 (p=.438), TGF-2 (p=.467), MMP-8 (p=.758), CCL-3 (p=.758), IL-8 (p=.771), and IL-1 (0.771). Histomorphometric evaluation presented no statistically significant difference between the two mini-implant surfaces with regards to number of inflammatory cells (p=.669). ConclusionNano-hydroxyapatite-coated surfaces in the transmucosal region yielded similar inflammatory response and is suggested to be as biocompatible as commercially pure titanium surfaces.
|
|
| 6. |
- Dierens, Melissa, et al.
(author)
-
Alterations in soft tissue levels and aesthetics over a 16–22 year period following single implant treatment in periodontally-healthy patients : a retrospective case series
- 2013
-
In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 40:3, s. 311-318
-
Journal article (peer-reviewed)abstract
- Purpose Long term studies on single implants are scarce and merely focus on clinical response parameters, complications and bone remodelling. The objective of this retrospective case series was to assess alterations in soft tissue levels and aesthetics over a 16–22 year period in periodontally-healthy patients. Material and methods Patients who had received a single turned implant in the anterior maxilla/mandible at the Dental Specialist Clinic in Malmö between 1987 and 1993 were invited for a re-examination on the basis of a number of inclusion criteria. Both neighbouring teeth had to be present at re-examination and baseline clinical photographs (within the first year of function) had to be available for soft tissue evaluation. These photographs were superimposed onto final clinical photographs to assess longitudinal soft tissue alterations. Results Twenty-one patients (nine females; mean age 23, range 16–41) treated with 24 single implants met the criteria for soft tissue evaluation. Peri-implant soft tissue levels (papillae, midfacial level) remained stable over a 16–22 year observation period (p ≥ 0.372). However, neighbouring teeth demonstrated midfacial recession and eruption pointing to a major distortion with the implant crown (> 1 mm) in 5/24 (21%) and 10/24 (42%) of the cases, respectively. Baseline aesthetics was considered poor (mean Pink Esthetic Score 7.42, mean White Esthetic Score 5.43), yet a significant time effect could not be demonstrated (p ≥ 0.552). Implant and tooth bone loss was low (mean 0.6 mm and 0.4 mm, respectively) over a 16–22 year period. Conclusions This limited case series demonstrated stable peri-implant soft tissue levels and aesthetics in the long term following single implant treatment in periodontally-healthy patients. However, midfacial recession and eruption may be expected at neighbouring teeth.
|
|
| 7. |
- Koole, S, et al.
(author)
-
Using Online Periodontal Case-Based Discussions to Synchronize Theoretical and Clinical Undergraduate Dental Education
- 2012
-
In: European journal of dental education. - : Wiley-Blackwell. - 1396-5883 .- 1600-0579. ; 16:1, s. 52-58
-
Journal article (peer-reviewed)abstract
- Background: Clinical experience is important in undergraduate dental education, but (suitable) patients to learn from are often lacking. Online case-based discussions were introduced to overcome patient dependency and to synchronize theoretical with clinical education. Materials and methods: Undergraduate dental students in groups of 5-7 discussed online clinical case reports presenting either minor (2nd year) or complex periodontal pathology (3rd year). Each case consisted of a brief patient history, extra-and intraoral clinical pictures, periodontal chart, peri-apical and/ or orthopantomographic radiographs. Students had to discuss diagnosis and treatment planning. Questionnaires assessed students' and supervisors' general appreciation (score on 20), time investment and opinions about organisation, relation case/course content, future planning, learning effect and online environment (5-point Likert scale). A crossover design with three tests (pre-test, test in between and post-test) was used to investigate whether the frequency of case introduction (one case per week vs. one case element per week) had an effect on learning. Data was analysed with descriptive statistics (questionnaires) and repeated measures ANOVA (crossover design). Results: Students (n = 119) and supervisors (n = 9) highly appreciated the exercise. Students reported spending on average 74 min per week to read a case, prepare and post messages. Supervisors' total time investment was 342 min per semester to create a case, provide online feedback and to prepare a live-discussion. No significant differences in test-scores were found between the two modalities of case introduction. Conclusion: Online case-based discussions, in conjunction with a theoretical course, are valuable additions to the dental curriculum, especially to reinforce the transition from theory to clinical practice.
|
|
| 8. |
- Miremadi, S R, et al.
(author)
-
A pilot assessment tool of the need for oral health care and cost prediction in institutionalized elderly people
- 2017
-
In: International Journal of Dental Hygiene. - : Blackwell Munksgaard. - 1601-5029 .- 1601-5037. ; 15:4, s. 306-312
-
Journal article (peer-reviewed)abstract
- OBJECTIVE: To assess the dental treatment backlog and associated costs among institutionalized elderly people using a novel composite index, called the oral health index. BACKGROUND: Despite numerous reports about oral health of old individuals, there is still lack of a systematic and practical method to estimate their treatment need covering all relevant aspects of oral health. In addition, little has been published on associated treatment costs and prediction of such costs. MATERIALS AND METHODS: An observational study was performed on 143 dentate institutionalized elderly people, whereby several clinical parameters were registered. The collected data were included in the oral health index representing the need for oral health care. This covered the number of caries lesions, number of residual roots, periodontal health condition, plaque score and denture condition with a final score of 0-9. To investigate the validity of the index, the treatment costs were estimated using the measured clinical parameters and later compared with the actual expenditure of the patients for the following 2 years. RESULTS: The average score of the index was 4.6 (SD 1.4) with 65.1% of the individuals having a score between 3 and 6 and 27.3% having a score of 6 and more, exhibiting medium and high need for oral health care, respectively. Only 30% of the patients underwent all the indicated treatments. The major reason of non-completion of the treatment was patient's refusal. From the fully treated group, 61.5% of the subjects actually spent within the predicted range while 38.5% of them spent more than estimated. The underestimation was related to yearly calculus removals leading to repeated calculation of the same costs and newly emerging dental problems (33% developed new caries and 20% was confronted with tooth fracture within the 2-year period). CONCLUSION: The novel index can be helpful to determine oral treatment needs and associated costs. Further research is needed to extend the clinical applicability of the index.
|
|
| 9. |
- Miremadi, S. R., et al.
(author)
-
Effects of root surface debridement using Er:YAG Laser versus ultrasonic scaling : a SEM study
- 2014
-
In: International Journal of Dental Hygiene. - : John Wiley & Sons. - 1601-5029 .- 1601-5037. ; 12:4, s. 273-284
-
Journal article (peer-reviewed)abstract
- Objective: Despite promising results of Er:YAG laser in periodontal debridement, to date there is no consensus about the ideal settings for clinical use. This experimental clinical trial aimed to determine the effects of debridement using Er:YAG laser and to compare with ultrasonic treatment. Materials and methods: Sixty-four teeth were divided into two in vivo and in vitro subgroups. Each tooth received ultrasonic treatment on one side and Er:YAG laser debridement at either 60, 100, 160 or 250mJpulse(-1) and at 10Hz on the other side on a random basis. All samples were morphologically analyzed afterwards under scanning electron microscope for surface changes and dentinal tubules exposure. Treatment duration (d) was also recorded. Results: Laser debridement produced an irregular, rough and flaky surface free of carbonization or meltdown while ultrasound produced a relatively smoother surface. The number of exposed dentinal tubules (n) followed an energy-dependent trend. The number of exposed tubules among the in vivo laser groups was n60mJ=n100mJd100mJ>dUltrasound=d160mJ>d250mJ (P0.046), while for the in vitro groups it was d60mJ>d100mJ=dUltrasound=d160mJ>d250mJ (P0.046). Conclusions: Due to excessive treatment duration and surface damage, Er:YAG laser debridement at 60 and 250mJpulse(-1), respectively, is not appropriate for clinical use. Although laser debridement at 100 and 160mJpulse(-1) seems more suitable for clinical application, compared to ultrasound the former is more time-consuming and the latter is more aggressive. Using a feedback device or lower pulse energies are recommended when using laser in closed field.
|
|
| 10. |
- Van de Velde, Tommie, et al.
(author)
-
Effect of implant design on preservation of marginal bone in the mandible.
- 2010
-
In: Clinical implant dentistry and related research. - : Wiley. - 1708-8208 .- 1523-0899. ; 12:2, s. 134-41
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Implant design and surface may have an influence on the marginal bone response during immediate functional loading. AIM: The purpose of this study was to radiographically study the effect of implant design on marginal bone preservation at immediately loaded implants used for prosthetic rehabilitation of the completely edentulous mandible. MATERIALS AND METHODS: A total of 39 patients, previously treated with five implants for support of a full-arch fixed bridge in the mandible, were included in the study. Either machined Brånemark implants (Ma) (Nobel Biocare AB, Gothenburg, Sweden) or surface modified Astra Tech implants with (Mi) or without a microthreaded neck (Ti) (TiOblast, AstraTech AB, Mölndal, Sweden) were used. All fixtures were loaded with a provisional glass fiber or metal-reinforced screw-retained restoration within 24 hours. The provisional restorations were replaced by a 12-unit screw-retained metal-ceramic or metal-resin cantilever bridge after 3 months. Bone loss from baseline to 1 year of loading was measured by means of intraoral radiographs. Only patients with baseline and 1-year radiographs of all implants were selected for comparison. Statistical analysis was carried out on both patient and implant levels. RESULTS: The survival rates after 1 year in function were 98.6, 100, and 100% for the Ma, Ti, and Mi implants, respectively. The overall mean bone loss after 1 year was 1.03 mm (SD 0.87; range -0.77 to 2.5). The mean bone loss was calculated to 1.52 (SD 0.66) for the Ma group, 0.79 (SD 0.79) for the Ti group, and 0.70 (SD 1.01) for the Mi group. There was a significant difference between Ma and Ti (p = .023) and between Ma and Mi (p = .046) groups but not within Ti and Mi implants (p = .70). These conclusions were also valid when the statistical analysis was performed on implant level. CONCLUSIONS: There is no impact of design and surface on implant survival in the completely edentulous mandible. Bone preservation in immediately loaded implants in the mandible is influenced by implant design and significantly better on surface-modified AstraTech implants compared with machined Brånemark implants. In the mandible, a microthread design of the implant collar does not seem to improve bone preservation.
|
|
