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Joseph Y K Kan

Bio: Joseph Y K Kan is an academic researcher from Loma Linda University. The author has contributed to research in topics: Implant & Osseointegration. The author has an hindex of 37, co-authored 81 publications receiving 6508 citations.


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Journal ArticleDOI
TL;DR: The types of complications that have been reported in conjunction with endosseous root form implants and associated implant prostheses indicate a trend toward a greater incidence of complications with implant prosthesis than single crowns, fixed partial dentures, all-ceramic Crowns, resin-bonded prostheses, and posts and cores.
Abstract: The purpose of this article is to identify the types of complications that have been reported in conjunction with endosseous root form implants and associated implant prostheses. A Medline and an extensive hand search were performed on English-language publications beginning in 1981. The searches focused on publications that contained clinical data regarding success/failure/complications. The complications were divided into the following 6 categories: surgical, implant loss, bone loss, peri-implant soft tissue, mechanical, and esthetic/phonetic. The raw data were combined from multiple studies and means calculated to identify trends noted in the incidences of complications. The most common implant complications (those with a greater than a 15% incidence) were loosening of the overdenture retentive mechanism (33%), implant loss in irradiated maxillae (25%), hemorrhage-related complications (24%), resin veneer fracture with fixed partial dentures (22%), implant loss with maxillary overdentures (21%), overdentures needing to be relined (19%), implant loss in type IV bone (16%), and overdenture clip/attachment fracture (16%). It was not possible to calculate an overall complications incidence for implant prostheses because there were not multiple clinical studies that simultaneously evaluated all or most of the categories of complications. Although the implant data had to be obtained from different studies, they do indicate a trend toward a greater incidence of complications with implant prostheses than single crowns, fixed partial dentures, all-ceramic crowns, resin-bonded prostheses, and posts and cores.

984 citations

Journal ArticleDOI
TL;DR: The mean facial dimension of peri-implant mucosa of 2-stage implants is slightly greater than the average dimension of the dentogingival complex.
Abstract: Background: Attempts have been made to evaluate the biologic dimension of osseointegrated implants; however, most are histologic studies in animals, and the effect of soft tissue support from adjacent teeth on the interproximal dimension of the peri-implant mucosa for anterior single implants has not been addressed. This study clinically evaluated the dimensions of the periimplant mucosa around 2-stage maxillary anterior single implants in humans after 1 year of function. The influence of the peri-implant biotype was also examined Methods: Forty-five patients (20 males and 25 females) with a mean age of 47.3 years were included in this study. A total of 45 maxillary anterior single implant crowns with a mean functional time of 32.5 months (range, 12 to 78) were evaluated. The dimensions of peri-implant mucosa were measured by bone sounding using a periodontal probe at the mesial (MI), mid-facial (F), and distal (DI) aspects of the implant restoration and the proximal aspects (MT, DT) of adjacent natural t...

600 citations

Journal ArticleDOI
TL;DR: Although the literature presents considerable information on implant complications, variations in study design and reporting procedures limited the available data and therefore precluded proper analysis of certain complications.
Abstract: Statement of problem. There is no comprehensive review of the literature that identifies the complications reported in clinical dental implant studies. Purpose. This article attempted to determine the types of complications that have been reported and to provide data regarding their frequency. Methods. All available clinical studies from 1981 to 1997, published in English or with English abstract, that presented success/failure data regarding implant treatment were evaluated to determine the types of reported complications and to quantify implant loss as it relates to type of prosthesis, arch, time, implant length, and bone quality. Results. Greater implant loss occurred with overdentures than with other types of prostheses. There was greater loss in the maxilla than mandible with fixed complete dentures and overdentures, whereas little arch difference was noted with fixed partial dentures. Implant loss increased with short implants and poor bone quality. The time of implant loss (preprosthetic vs postprosthetic) varied with type of prosthesis. Surgical complications included neurosensory disturbance, hematoma, mandibular fracture, hemorrhage, and tooth devitalization. Initial and long-term marginal bone changes were identified. Peri-implant soft tissue complications included dehiscence, fistulas, and gingival inflammation/proliferation. Mechanical complications were screw loosening/fracture, implant fractures, framework, resin base and veneering material fractures, opposing prosthesis fractures, and overdenture mechanical retention problems. Some studies also presented phonetic and esthetic complications. Conclusions. Although the literature presents considerable information on implant complications, variations in study design and reporting procedures limited the available data and therefore precluded proper analysis of certain complications. (J Prosthet Dent 1999;81:537-52.)

598 citations

Journal ArticleDOI
TL;DR: The lowest incidence of clinical complications was associated with all-ceramic crowns and posts and cores, and resin-bonded prostheses and conventional fixed partial dentures were found to have comparable clinical complications incidences.
Abstract: The purpose of this article is to identify the incidence of complications and the most common complications associated with single crowns, fixed partial dentures, all-ceramic crowns, resin-bonded prostheses, and posts and cores. A Medline and an extensive hand search were performed on English-language publications covering the last 50 years. The searches focused on publications that contained clinical data regarding success/failure/complications. Within each type of prosthesis, raw data were combined from multiple studies and mean values calculated to determine what trends were noted in the studies. The lowest incidence of clinical complications was associated with all-ceramic crowns (8%). Posts and cores (10%) and conventional single crowns (11%) had comparable clinical complications incidences. Resin-bonded prostheses (26%) and conventional fixed partial dentures (27%) were found to have comparable clinical complications incidences. The 3 most common complications encountered with all-ceramic crowns were crown fracture (7%), loss of retention (2%), and need for endodontic treatment (1%). The 3 most common complications associated with posts and cores were post loosening (5%), root fracture (3%), and caries (2%). With single crowns, the 3 most common complications were need for endodontic treatment (3%), porcelain veneer fracture (3%), and loss of retention (2%). When fixed partial denture studies were reviewed, the 3 most commonly reported complications were caries (18% of abutments), need for endodontic treatment (11% of abutments), and loss of retention (7% of prostheses). The 3 most common complications associated with resin-bonded prostheses were prosthesis debonding (21%), tooth discoloration (18%), and caries (7%). (J Prosthet Dent 2003;90:31-41.) A complication has been defined 1 as “a secondary disease or condition developing in the course of a primary disease or condition.” Although complications may be an indication that clinical failure has occurred, this is not typically the case. It is also possible that complications may reflect substandard care. But once again, this is usually not true. Most of the time, complications are conditions that occur during or after appropriately performed fixed prosthodontic treatment procedures. Knowledge regarding the clinical complications that can occur in fixed prosthodontics enhances the clinician’s ability to complete a thorough diagnosis, develop the most appropriate treatment plan, communicate realistic expectations to patients, and plan the time intervalsneededforpost-treatmentcare.Althoughaplethora of articles present clinical complications data, none provide a comprehensive comparison of the complications associated with the most commonly used restorations/

501 citations

Journal Article
TL;DR: The results of this study suggest that favorable implant success rates, peri-implant tissue responses, and esthetic outcomes can be achieved with immediately placed and provisionalized maxillary anterior single implants.
Abstract: Purpose This 1-year prospective study evaluated the implant success rate, peri-implant tissue response, and esthetic outcome of immediately placed and provisionalized maxillary anterior single implants. Materials and methods Thirty-five patients (8 men, 27 women) with a mean age of 36.5 years (range 18 to 65) were included in this study. Thirty-five threaded, hydroxyapatite-coated implants were placed and provisionalized immediately after each failing tooth had been removed. The definitive restoration was placed 6 months later. The patients were evaluated clinically and radiographically at implant placement and at 3, 6, and 12 months after implant placement. Results At 12 months, all implants remained osseointegrated. The mean marginal bone change from the time of implant placement to 12 months was -0.26 +/- 0.40 mm mesially and -0.22 +/- 0.28 mm distally. No significant differences in the Plaque Index scores were noted at different time intervals. The mean midfacial gingival level and mesial and distal papilla level changes from pretreatment to 12 months were -0.55 +/- 0.53 mm, -0.53 +/- 0.39 mm, and -0.39 +/- 0.40 mm, respectively. All patients were very satisfied with the esthetic outcome and none had noticed any changes at the gingival level. Discussion Although marginal bone and gingival level changes were statistically significant from pretreatment to 12 months of follow-up, they were well within clinical expectations. Conclusion The results of this study suggest that favorable implant success rates, peri-implant tissue responses, and esthetic outcomes can be achieved with immediately placed and provisionalized maxillary anterior single implants.

481 citations


Cited by
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Journal ArticleDOI
TL;DR: The types of complications that have been reported in conjunction with endosseous root form implants and associated implant prostheses indicate a trend toward a greater incidence of complications with implant prosthesis than single crowns, fixed partial dentures, all-ceramic Crowns, resin-bonded prostheses, and posts and cores.
Abstract: The purpose of this article is to identify the types of complications that have been reported in conjunction with endosseous root form implants and associated implant prostheses. A Medline and an extensive hand search were performed on English-language publications beginning in 1981. The searches focused on publications that contained clinical data regarding success/failure/complications. The complications were divided into the following 6 categories: surgical, implant loss, bone loss, peri-implant soft tissue, mechanical, and esthetic/phonetic. The raw data were combined from multiple studies and means calculated to identify trends noted in the incidences of complications. The most common implant complications (those with a greater than a 15% incidence) were loosening of the overdenture retentive mechanism (33%), implant loss in irradiated maxillae (25%), hemorrhage-related complications (24%), resin veneer fracture with fixed partial dentures (22%), implant loss with maxillary overdentures (21%), overdentures needing to be relined (19%), implant loss in type IV bone (16%), and overdenture clip/attachment fracture (16%). It was not possible to calculate an overall complications incidence for implant prostheses because there were not multiple clinical studies that simultaneously evaluated all or most of the categories of complications. Although the implant data had to be obtained from different studies, they do indicate a trend toward a greater incidence of complications with implant prostheses than single crowns, fixed partial dentures, all-ceramic crowns, resin-bonded prostheses, and posts and cores.

984 citations

Journal ArticleDOI
TL;DR: Implant loss was most frequently described (reported in about 100% of studies), while biological complications were considered in only 40-60% and technical complications in only 60-80% of the studies, indicating that data on the incidence of biological andTechnical complications may be underestimated and should be interpreted with caution.
Abstract: Objective: To systematically review the incidence of biological and technical complications in implant therapy reported in prospective longitudinal studies of at least 5 years. Methods: A MEDLINE search was conducted for prospective longitudinal studies with follow-up periods of at least 5 years. Screening and data abstraction were performed independently by multiple reviewers. The types of complications assessed were as follows: implant loss, sensory disturbance, soft tissue complications, peri-implantitis, bone loss ≥2.5 mm, implant fracture and technical complications related to implant components and suprastructures. Results: The search provided 1310 titles and abstracts, out of which 159 were selected for full-text analysis. Finally, 51 studies were included. Meta analysis of these studies indicated that implant loss prior to functional loading is to be expected to occur in about 2.5% of all implants placed in implant therapy including more than one implant and when routine procedures are used. Implant loss during function occurs in about 2–3% of implants supporting fixed reconstructions, while in overdenture therapy >5% of the implants can be expected to be lost during a 5-year period. Few studies (41% of those included) reported data on the incidence of persisting sensory disturbance >1 year following implant surgery. Most of the studies that provided such data reported on the absence or a low incidence (1–2%) of this complication beyond this interval. A higher incidence of soft tissue complications was reported for patients treated with implants supporting overdentures. There is limited information regarding the occurrence of peri-implantitis and implants exhibiting bone loss ≥2.5 mm. Implant fracture is a rare complication and occurs in <1% of all implants during a 5-year period. The incidence of technical complications related to implant components and suprastructures was higher in overdentures than in fixed reconstructions. Conclusion: Implant loss was most frequently described (reported in about 100% of studies), while biological complications were considered in only 40–60% and technical complications in only 60–80% of the studies. This observation indicates that data on the incidence of biological and technical complications may be underestimated and should be interpreted with caution.

980 citations

Journal ArticleDOI
TL;DR: The goal of this review is to consider the role of nanoscale topographic modification of titanium substrates for the purpose of improving osseointegration and dental implant therapy.

878 citations

Journal ArticleDOI
TL;DR: This article reviews the current literature covering all-ceramic materials and systems, with respect to survival, material properties, marginal and internal fit, cementation and bonding, and color and esthetics, and provides clinical recommendations for their use.
Abstract: Statement of problem Developments in ceramic core materials such as lithium disilicate, aluminum oxide, and zirconium oxide have allowed more widespread application of all-ceramic restorations over the past 10 years. With a plethora of ceramic materials and systems currently available for use, an overview of the scientific literature on the efficacy of this treatment therapy is indicated. Purpose This article reviews the current literature covering all-ceramic materials and systems, with respect to survival, material properties, marginal and internal fit, cementation and bonding, and color and esthetics, and provides clinical recommendations for their use. Material and methods A comprehensive review of the literature was completed seeking evidence for the treatment of teeth with all-ceramic restorations. A search of English language peer-reviewed literature was undertaken using MEDLINE and PubMed with a focus on evidence-based research articles published between 1996 and 2006. A hand search of relevant dental journals was also completed. Randomized controlled trials, nonrandomized controlled studies, longitudinal experimental clinical studies, longitudinal prospective studies, and longitudinal retrospective studies were reviewed. The last search was conducted on June 12, 2007. Data supporting the clinical application of all-ceramic materials and systems was sought. Results The literature demonstrates that multiple all-ceramic materials and systems are currently available for clinical use, and there is not a single universal material or system for all clinical situations. The successful application is dependent upon the clinician to match the materials, manufacturing techniques, and cementation or bonding procedures, with the individual clinical situation. Conclusions Within the scope of this systematic review, there is no evidence to support the universal application of a single ceramic material and system for all clinical situations. Additional longitudinal clinical studies are required to advance the development of ceramic materials and systems.

836 citations