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  • 1
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The aim of the present study was to correlate the changes in the peri-implant tissues occurring after functional loading of non-submerged titanium implants and assessed by radiographic, clinical and mobility measurements. 11 patients with distal extension situations received 18 implants of the ITI® Dental Implant System. After a healing period of 3months, the suprastructures were fabricated and seated 5months post-surgically. For the assessment of peri-implant bone changes, standardized vertical bitewing radiographs with reproducible exposure geometry were evaluated using computer assisted densitometric image analyses (CADIA) and bone height measurements. Since the radiographic evaluations were performed at mesial and distal sites only, the clinical parameters from these implant aspects were included in the analysis. Clinical periodontal parameters modified for the use around implants were obtained, damping characteristics were expressed as Periotest® readings and standardized radiographs were obtained at 1, 3, 6, 12 and 24 months after loading. In addition, radiographs were also taken at the start of functional loading. The data obtained from this small sample of implants demonstrated a wide range of different tissue alterations when using radiographic. clinical and mobility assessments. The parameter of probing attachment level (PAL) in combination with radiographic parameters obtained at 1, 3 and 6 months after loading were good predictors for the peri-implant tissue status at 2 years. This was shown by means of multiple stepwise regression analyses. Mobility measurements did not reveal valuable predictive information with the statistical models applied. Assessments of probing attachment levels using periodontal probes rendered information on peri-implant tissue alterations, which were closely correlated to the radiographically measurable peri-implant bone changes.
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  • 2
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The aim of the present study was to assess in vitro the heat generated within the implant body when preparing titanium implants of the ITI® Dental Implant System to estimate the potential risk of tissue damage of individual abutment preparation. The speed and the pressure were applied according to routine clinical procedures used in the patient's mouth. Much attention was paid to ensure optimal cooling at the point where the implant and secondary part were being cut. For each of 3 preparations the change from the original temperature was measured over a period of 40 s. Each type of preparation was repeated on 5 implants fitted with temperature probes. Three different preparatory procedures performed with rotating diamond burs and stainless steel finishing burs under cooling with spray from the dental unit may result in a maximal increase in temperature of 10°C, 7°C and 3°C measured coronally, both at the implant shoulder and at the coronal extent of the plasma-sprayed surface after 10 s. The use of additional spray and pressured air significantly reduced this maximal increase to 5°C 5°C and 4°C respectively at 10 s. At the 30-s and 40-s time points, all the measured temperatures were significantly lower. Preparation of implants or abutments does not lead to detrimental effects on peri-implant tissues provided that adequate cooling with spray is used. However, without cooling, extreme overheating could be provoked. reaching the critical temperature that would lead to irreversible 1 bone damage within only a few seconds.
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  • 3
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The principle of guided tissue regeneration has been successfully applied for the regeneration of bone in various jaw defects in human. The purpose of this study was to assess the bone volume regenerated using nonresorbable membrane barriers. Nineteen patients with jaw bone defects of various sizes and configurations were included in the study. Combined split-thickness/full-thickness mucosal flaps were elevated in the area of missing bone. The size of the defects was assessed by measuring the distance from a reference line between 2 adjacent teeth (cementoenamel junctions) to the alveolar crest (a) every 2 or 3 mm. In addition, the crestal width was measured. Consequently, the surface of the triangle formed by a and the width of the crest as well as the volume between all triangles were calculated geometrically. Following the placement of Gore-Tex® augmentation material as a barrier, the distance (b) to the top of the membrane from the reference line was assessed, and the maximum possible volume for bone regeneration based on (a-b) and the width of the crest was calculated. At the time of membrane removal (3–8 months later). the same measurements were performed and the percentages of regenerated bone in relation to the possible volume for regeneration determined. In 6 patients in whom the membranes had to be removed early due to an increased risk for infection between 3 and 5 months, bone regeneration varied between 0 and 60%. In 13 patients in whom membranes were left for 6–8 months, regenerated bone filled 90–100% of the possible volume. It was concluded that successful bone regeneration consistently occurred with an undisturbed healing period of at least 6 months.
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  • 4
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract. The aim of the present study was to evaluate the effects of a 1 -month period of chlorhexidine (CHX) rinses on the periodontal conditions of teeth adjacent to extraction sockets. 40 patients signed consent forms for this double blind trial and were randomly assigned to either the test group rinsing 2 × daily with 15 ml of a 0.12% CHX solution (Peridex®) starting 2 days after tooth extraction or the control group rinsing with a placebo solution for 30 days. Clinical periodontal parameters were obtained from test sites located adjacent to as well as matched controls distant to the extraction sites. The measurements were performed at baseline before the extraction and 1, 2, 3 and 6 months thereafter. During the observation period, the patients were exposed to initial periodontal therapy. The test sites of the group rinsing with CHX demonstrated significantly reduced (p 〈 0.05) plaque indices, gingival indices and lower %s of sites bleeding on probing one month following the extraction. The test sites of the control group rinsing with the placebo demonstrated a tendency for loss of clinical attachment between 1 and 2 months after the tooth extraction. The mean pocket probing depth (PPD) at test sites of the CHX rinsing group was smaller than in the placebo rinsing group at the one month examination. Also, the mean PPD of the test sites in the CHX group was significantly smaller than at the control sites at 1 month. This difference was not observed in the control group rinsing with placebo. Due to the effect of initial periodontal therapy, the differences in the clinical parameters were no longer statistically significant at six months. It is concluded that the administration of 0.12% CHX rinses following tooth extraction results in a significant improvement of the periodontal conditions adjacent to extraction sockets and hence, should be recommended routinely.
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  • 5
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract. The aim of the present study was to assess the influence of a 1-month period of chlorhexidine digluconate (CHX) rinses on the remodelling activity of periodontal tissues adjacent to an extraction wound. From 12 patients assigned to the test group rinsing 2 × daily with 15 ml of 0.12% CHX solution (Peridex®) starting 2 days after tooth extraction and from 11 patients assigned to the control group rinsing with a placebo solution, standardized radiographs were available taken immediately after tooth extraction and 1, 2, 3 and 6 months thereafter. Computer assisted densitometric image analysis (CADIA) was applied in order to quantify changes in density during the healing phase after tooth extraction. Regions of interest (ROI) were chosen for CADIA covering supracrestal periodontal soft tissue adjacent to the extraction wound. ROIs were also defined on crestal alveolar bone adjacent to the extraction wound. In the active group, 15/20 sites demonstrated an increase in alveolar bone density between months 1 and 6 (mean CADIA value 6.7 ± 10.0), whereas in the control group 11/21 sites demonstrated a loss in density (mean CADIA values -1.4 ± 10.5). Similar observations were made when the ROIs covering supracrestal periodontal tissues were analyzed (mean CADIA values 7.8 ± 8.4 for the experimental group and –0.3 ± 10.5 for the control group). These differences were statistically significant (p 〈 0.04). The digitized series of standardized radiographs were also evaluated for changes in bone height. The distances from the alveolar bone crest to reference points were measured in mm within the baseline: the 1, 2, 3 and 6 month radiographs. Whereas the control group rinsing with a placebo solution lost almost 1 mm of bone height over 6 months after tooth extraction, it was obvious that in the patients rinsing with the CHX solution, the crestal alveolar bone level was maintained. It was concluded that the administration of 0.12% chlorhexidine rinses for 1 month following tooth extraction resulted in a beneficial healing effect on the periodontal conditions of teeth adjacent to the extraction site.
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  • 6
    ISSN: 1600-0765
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The aim of this study was to develop and test in vitro an opto-electronic positioning device for serial direct digital images of oral structures, i.e. to associate direct digital imaging with the principles of computer-aided surgery. This system registered positions of infrared light emitting diodes (LED) on carriers, establishing local coordinate systems. With LED markers attached on the sensor holder, the X-ray tube and a fix reference, the opto-electronic camera (Optotrak®) registered the geometric source/detector relation. A specially designed tracking and guidance software was developed which enabled the operator to reposition the X-ray source. A graphical user interface guided the operator in aligning 2 circles to the reference axis, one indicating the origin of the beam, the other its tip. In addition, depth control was provided. An in vitro calibration was performed. A sensor holder/bite block carried the Sens-A-Ray® sensor with a hair-cross. In front of the object a second hair-cross was fixed. A steel ball fixed to the center of the X-ray cone allowed to verify the alignment. The mean angulation error in the vertical plane was 0.06° and 0.04° in the horizontal one. Translation mean errors were small and ranged between −0.02 mm and 0.37 mm. The translation in the Z axis is negligible. This resulted in pairs of images suitable for digital subtraction. Although still in an experimental state, the results showed that opto-electronic navigation was useful to standardize projection geometry without any mechanical link and to achieve digital subtraction images based on direct digital imaging.
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  • 7
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In aesthetically demanding locations of the dentition, the replacement of a single tooth by means of an oral implant is often difficult because of technical limitations of the abutment systems used. The Transversal Fixation System® in combination with the Octa® abutment of the ITI Dental Implant System® presents a novel development to overcome these limitations. The report describes the engineering and design of this technical development.
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  • 8
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Fixed reconstructions on implant abutments may be a welcome modality in the treatmcnt of partially edentulous patients following the principle of a prophylactically oriented comprehensive care. The option to create artificial tissue integrated abutments widens the range of indications for fixed reconstructions. Risky long-span bridges as well as the preparation of intact teeth for bridge abutments may frequently be avoided. Never should the contours of the prosthesis interfere with the patient's performance of optimal plaque control. Furthermore, supportive periodontal therapy with regular maintenance visits may be provided to optimize a long-term prognosis of the dention as well as the tissue-integrated artificial abutments.
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  • 9
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The aim of the present study was to compare the peri-implant mucosal conditions 1 year after immediate transmucosal implant placement without or in combination with guided tissue regeneration with the situation after regular placement of transmucosal 1-stage procedure implants in partially edentulous patients. The test group consisted of 15 patients who required the immediate replacement of 20 teeth with oral implants in combination with guided tissue regeneration. The control group 1 consisted of 6 patients who received 8 immediate implants, without concomitant bone regeneration procedure due to the small size of the extracted roots in comparison to the diameter of the implants. The 20 patients of the control group 2 were randomly chosen from over 150 partially edentulous patients who received implants of the ITI® Dental Implant System according to the standard procedure. Similar favorable clinical parameters were found around the implants of all the 3 groups with low plaque and mucosal indices, similar amounts of recession, pocket probing depths and clinical attachment levels. The immediate implants demonstrated lower frequencies of sites bleeding on probing. The study has established that immediate oral implants are a feasible treatment modality with high predictability.
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  • 10
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The aim of this study was to determine the threshold of tactile perception of endosseous dental implants and to assess the relative difference of that threshold between implants and teeth. Twenty-two subjects with implants of the ITI® Dental Implant System were included in the study. All implants served as abutments for single tooth crowns and had been in function for a minimum of 1 year. A strain gauge glued to the shaft of an amalgam plugger served as a force sensor. It transformed the elastic deformation exerted onto the shaft into an electronic signal for recording. By use of the amalgam plugger, a continuously increasing force was exercised on the implants or teeth until the first sensation of touch was indicated by the patient. Statistical analysis revealed threshold values for the implants ranging from 13.2 to 189.4g (1g=0.0lN)(mean 100.6; SD 47.7), while a range of 1.2 to 26.2g (mean 11.5; SD 11.5) was found for control teeth. Thus, the mean threshold values for implants were 8.75 times higher than for teeth. This difference was highly statistically significant. A general linear models procedure was applied to determine the influence of patient age, jaw, implant position and the threshold values of teeth on the measurements obtained for implants. Only gender and the threshold values for contralateral teeth had a significant influence. These 2 parameters together explained 27% of the variability in threshold measurements. It is concluded that a more than 8-fold higher threshold value for tactile perception exists for implants compared with teeth.
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