Periodontal indices around natural and titanium abutments: a longitudinal multicenter study.
TL;DR: The resistance towards marginal bone loss around these implants confirms the previous studies on fully edentulous patients and the plaque and gingivitis index behaved similarly around abutments and teeth.
Abstract: This multicenter prospective study on the use of an implant system involved 9 centers and reports on the periodontal aspects after 3 years of observation. A total of 558 implants in 159 patients with 197 bridges all independent from natural teeth were originally included. Because of failures and patient withdrawals the number of implants was reduced to 460 and bridges to 174. The cumulative success rate for implants, starting from implant placement, is 94.3% after 2 years and 93.9% after 3 years indicating a leveling of implant loss. Failures concentrated in patients with a high plaque index. The loss of marginal bone was during the second and third years only 0.03 mm per year as an average while it was 0.4 mm during the first year. There were no reports of intense gingival inflammation in any of the patients and the plaque and gingivitis index behaved similarly around abutments and teeth. The probing pocket depth was significantly reduced over the observation time. The resistance towards marginal bone lo...
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TL;DR: The Brånemark Implant System is a safe and predictable method for restoring partially edentulous patients, as demonstrated by this 10-year follow-up investigation.
Abstract: A total of 127 partially edentulous patients, treated according to the Branemark protocol, was followed for 10 years after completion of prosthetic treatment. The patients ranged in age from 18 to 70 years, and 57% were female. Four hundred sixty-one implants were placed in 56 maxillae and 71 mandibles. In 125 patients, 163 fixed partial prostheses were attached to the implants; a majority of the prostheses (83%) were located in posterior regions. At the end of the 10-year period, 73% of the implants could be traced either as failed or in function, providing cumulative implant survival rates of 90.2% and 93.7% for the maxilla and mandible, respectively. Of the original fixed prostheses, 63% (cumulatively 86.5%) were still in use, whereas the level of continuous cumulative prosthesis function, including primary and remade restorations, was 94.3% at the end of the evaluation period. Marginal bone resorption at the implants was low (mean = 0.7 mm), and mucosal health was good. No severe complications apart from the above-mentioned implant and prosthetic failures were reported. The Branemark Implant System is a safe and predictable method for restoring partially edentulous patients, as demonstrated by this 10-year follow-up investigation.
570 citations
TL;DR: After 10 years in use without systematic supportive treatment, peri-implant lesions is a common clinical entity adjacent to titanium implants after 9-14 years of function.
Abstract: Objectives: The aim of this study was to analyse the proportions of peri-implant lesions at implants after 9–14 years of function. Material and Methods: Two hundred and ninety-four patients underwent implant therapy during the years 1988–1992 in Kristianstad County. These individuals were recalled to the speciality clinic 1 and 5 years after placement of the suprastructure. Between 2000 and 2002, 218 patients with 999 implants were examined clinically and radiographically. Results: Forty-eight per cent of the implants had probing depth X4 mm and bleeding on probing (peri-implant mucositis). In 20.4% of the implants, the bone level was located 3.1 mm apical to the implant shoulder. Progressive bone loss (X1.8 mm) during the observation period was found in 7.7% of the implants. Peri-implantitis defined as bone loss X1.8 mm compared with 1-year data (the apical border of the bony defect located at or apical to the third thread, i.e. a minimum of 3.1 mm apical to the implant shoulder), combined with bleeding on probing and or pus, were diagnosed among 16% of the patients and 6.6% of the implants. Conclusion: After 10 years in use without systematic supportive treatment, periimplant lesions is a common clinical entity adjacent to titanium implants.
565 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
TL;DR: Favourable clinical conditions were found at tooth and implant abutments after 4-5 years of function and bruxism as well as extensions were associated with more technical failures.
Abstract: The aim of this study was to compare the frequency of biological and technical complications with fixed partial dentures (FPDs) on implants, teeth and as mixed tooth-implant supported FPDs over 4 to 5 years of function. All implants belonged to the ITI Dental Implant System. Group I-I (implant FPD) included 33 patients with 40 FPDs, group T-T (tooth FPDs) 40 patients with 58 FPDs, group I-T (mixed tooth-implant FPDs) 15 with 18 FPD. Of the bridge abutments 144 were teeth and 105 were implants. The median number of units replaced by the FPDs was 3 (range 2-14). The mean age of the patients was 55.7 years (range 23-83). Complete failures resulted in the loss of one FPD in each group. Two implants were lost due to fracture secondarily to development of a bone defect. One tooth had a vertical fracture and 1 tooth was lost due to periodontitis. Biological complications (peri-implantitis, PPD > or = 5 mm and BOP+) occurred at 9.6% (10) of the implants. This number was, however, reduced to 5% if the threshold for definition of peri-implantitis was set at PPD > or = 6 mm and BOP+. Biological complications occurred in 11.8% (17) of the abutment teeth (NS compared to implants); 2.8% (4) had secondary caries, 4.9% (7) endodontic problems and 4.1% (6) had periodontitis (PPD > or = 5 mm, BOP+). Ten out of 32 patients with a general health problem indicated a biological complication, whereas 9 out of 53 patients with no general health problem had a biological complication (chi 2: NS). Statistically significantly more technical complications were found in FPDs on implants (chi 2, P < or = 0.05). The technical complications were associated with bruxism. Out of 10 bruxers 6 had a technical complication whereas 13 out of 75 non-bruxers had such a complication (chi 2 < or = 0.01). Extensions were associated with more technical complications (13 out of 35 with extensions versus 9 out of 81 without). In conclusion, favourable clinical conditions were found at tooth and implant abutments after 4-5 years of function. Loss of FPD over 4-5 years occurred at a similar rate with mixed, implant or tooth supported reconstructions. Significantly more porcelain fractures were found in FPDs on implants. Impaired general health status was not significantly associated with more biological failures but bruxism as well as extensions were associated with more technical failures.
375 citations
TL;DR: The 5-year survival of screw-retained and full-arch FDPs was reported to be 96.9% (95% confidence interval (CI): 94.8-97.7%) and 89.3% respectively as discussed by the authors.
Abstract: OBJECTIVES: To assess the 5-year survival rates and incidences of complications of cemented and screw-retained implant reconstructions. METHODS: An electronic Medline search complemented by manual searching was conducted to identify randomized controlled clinical trials (RCTs), and prospective and retrospective studies giving information on cemented and screw-retained single-unit and multiple-unit implant reconstructions with a mean follow-up time of at least 1 year. Assessment of the identified studies and data abstraction were performed independently by three reviewers. Failure rates were analyzed using Poisson regression models to obtain summary estimates and 95% confidence intervals of failure rates and 5-year survival proportions. RESULTS: Fifty-nine clinical studies were selected from an initial yield of 4511 titles and the data were extracted. For cemented single crowns the estimated 5-year reconstruction survival was 96.5% (95% confidence interval (CI): 94.8-97.7%), for screw-retained single crowns it was 89.3% (95% CI: 64.9-97.1%) (P = 0.091 for difference). The 5-year survival for cemented partial fixed dental prostheses (FDPs) was 96.9% (95% CI: 90.8-99%), similar to the one for screw-retained partial FDPs with 98% (95% CI: 96.2-99%) (P = 0.47). For cemented full-arch FDPs the 5-year survival was 100% (95% CI: 88.9-100%), which was somewhat higher than that for screw-retained FDPs with 95.8% (95% CI: 91.9-97.9%) (P = 0.54). The estimated 5-year cumulative incidence of technical complications at cemented single crowns was 11.9% and 24.4% at screw-retained crowns. At the partial and full-arch FDPs, in contrast, a trend to less complication at the screw-retained was found than at the cemented ones (partial FDPs cemented 24.5%, screw-retained 22.1%; full-arch FDPs cemented 62.9%, screw-retained 54.1%). Biological complications like marginal bone loss >2 mm occurred more frequently at cemented crowns (5-year incidence: 2.8%) than at screw-retained ones (5-year incidence: 0%). CONCLUSION: Both types of reconstructions influenced the clinical outcomes in different ways, none of the fixation methods was clearly advantageous over the other. Cemented reconstructions exhibited more serious biological complications (implant loss, bone loss >2 mm), screw-retained reconstructions exhibited more technical problems. Screw-retained reconstructions are more easily retrievable than cemented reconstructions and, therefore, technical and eventually biological complications can be treated more easily. For this reason and for their apparently higher biological compatibility, these reconstructions seem to be preferable.
359 citations
References
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TL;DR: In this paper, the correlation between oral hygiene and periodontal condition was investigated in the context of pregnant women with Periodontal Disease in Pregnancy II (PDI II).
Abstract: (1964). Periodontal Disease in Pregnancy II. Correlation Between Oral Hygiene and Periodontal Condition. Acta Odontologica Scandinavica: Vol. 22, No. 1, pp. 121-135.
7,017 citations
Journal Article•
TL;DR: The long-term outcome of prostheses and fixtures (implants) in 759 totally edentulous jaws of 700 patients concur with multicenter and earlier results for the osseointegration method.
Abstract: This study reviews the long-term outcome of prostheses and fixtures (implants) in 759 totally edentulous jaws of 700 patients. A total of 4,636 standard fixtures were placed and followed according to the osseointegration method for a maximum of 24 years by the original team at the University of Goteborg. Standardized annual clinical and radiographic examinations were conducted as far as possible. A lifetable approach was applied for statistical analysis. Sufficient numbers of fixtures and prostheses for a detailed statistical analysis were present for observation times up to 15 years. More than 95% of maxillae had continuous prosthesis stability at 5 and 10 years, and at least 92% at 15 years. The figure for mandibles was 99% at all time intervals. Calculated from the time of fixture placement, the estimated survival rates for individual fixtures in the maxilla were 84%, 89%, and 92% at 5 years; 81% and 82% at 10 years; and 78% at 15 years. In the mandible they were 91%, 98%, and 99% at 5 years; 89% and 98% at 10 years; and 86% at 15 years. (The different percentages at 5 and 10 years refer to results for different routine groups of fixtures with 5 to 10, 10 to 15, and 1 to 5 years of observation time, respectively.) The results of this study concur with multicenter and earlier results for the osseointegration method.
1,927 citations
Book•
01 Jan 1985
1,666 citations
Journal Article•
TL;DR: Preliminary results suggest that a success rate equal to or better than that obtained with edentulous patients may be expected.
Abstract: Nine clinical centers using the Branemark System participated in a prospective study of 159 partially edentulous patients between 18 and 70 years of age. Clinical parameters evaluated were plaque index, gingivitis, pocket depth, bleeding index, tooth mobility, and stomatognathic function. Initially, 558 fixtures were placed and 521 remained in the study following prosthesis placement (199 prostheses in 154 patients). Fixtures were lost or unaccounted for because of nonintegration prior to prosthesis fabrication (19), patient withdrawal (11), prosthodontic reasons (6), and failure during prosthetic procedures (1). Failure was primarily attributable to unfavorable bone quality, sex (more in males), and smaller fixture size. Complications and failure related to other patient characteristics are presented. After 1 year of a 5-year study, preliminary results suggest that a success rate equal to or better than that obtained with edentulous patients may be expected.
576 citations