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  • 1
    Electronic Resource
    Electronic Resource
    Copenhagen : Munksgaard International Publishers
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A new technique for surgical correction of malpositioned implants is described. A 64-year-old female got her first fixed prosthesis anchored to 6 Brånemark implants in her upper jaw, in April 1993. The implants were poorly positioned and despite great efforts to make the construction aesthetically acceptable, the patient did not approve. In order to obtain better aesthetics, it was decided to move some of the osseointegrated implants to other positions. With a trephine drill, fixtures were removed including the surrounding bone, and 2 of them were placed in new sites made with the same drill. After a healing period of 6 months, abutments were connected and a new fixed prosthesis was made. After 1 year of loading, all implants were still stable. A marginal bone resorption to the 3rd thread was found around one of the implants.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Wound healing at the implant-soft tissue interface occurs in the presence of saliva and blood. The aim of this in vitro study was to investigate potential influence of saliva and serum on initial attachment of human gingival fibroblast-like cells to titanium (Ti) surfaces. 10×10mm large specimens were prepared from pure Ti, incubated for 1 h in either whole human saliva, fetal calf serum, their mixtures in proportions 75:25, 50:50 and 25:75, or buffer as control. Subsequently suspensions of human gingival fibroblast-like cells were applied in 4 separate assays to Ti surfaces for 40 min and cell attachment was evaluated by means of image analysis under reflected light microscopy. Significantly lower numbers of attached cells (p〈0.001) were found on all surfaces pretreated with saliva alone or in combination with serum. Pretreatment with serum alone showed no consistent enhancing effect on cell adhesion. These results suggest that exposure of implant necks to saliva during implant insertion or peri-implantitis treatment might inhibit adhesion of gingival fibroblasts and thus indirectly support isolation of the implant by epithelial proliferation.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Non-submerged ITI Bonefit implants ITI Dental Implant System) were inserted in edentulous lower jaws of 46 patients. The patients were provided with either a fixed prosthesis or an overdenture, and has been followed during a 2-year-period. At the 1-year examination, the suprastructures were removed permitting test of the individual implant stability. Radiographic examinations were performed in connection with the loading of the implants and at the 1-year examination. In total 216 implants were inserted. 4 implants were lost before loading and 4 during the 2nd year of function, which gives a survival rate after 1 year of 98% and after 2 years of 96%. The mean marginal bone loss during the first year of function was 0.1mm. However, the marginal bone changes had a high degree of variation and four implants showed a severe bone loss. The intention is to follow this patient group with annual examinations during 5 years.
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  • 4
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In this prospective study 47 edentulous patients were treated with mandibular fixed prostheses supported by osseointegrated Brånemark implants and followed for 12 to 15 years. Three 1%) of the 273 inserted implants were lost, two before and one six years after placement of the fixed prosthesis. The cumulative success rate CSR) of the implants was 98.9% both after 10 and 15 years. None of the fixed prostheses was lost and at the last follow-up, all patients had stable fixed prostheses in function (CSR 100%). The marginal bone loss around the implants was small, on average 0.5mm during the first post surgical year and thereafter about 0.05mm annually. More bone was lost around the anterior implants than around the most posterior ones. Smoking and poor oral hygiene had significant influence on bone loss, while occlusal loading factors such as maximal bite force, tooth clenching and length of cantilevers were of minor importance. It is concluded that the long-term results of the mandibular implant treatment were extremely successful, regarding both the fixed prostheses and implant stability. Bone resorption around the implants, albeit limited, was influenced by several factors, smoking and oral hygiene appeared to be most important.
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  • 5
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The purpose of the present study was to compare bone height determinations of implant sites by different radiographic techniques. Available bone height was measured in regions posterior to the mental foramen on panoramic radiographs, and on tomographs where the faciolingual dimensions was at least 5mm. The one heights were recorded at 401 edentulous and denate sites in 100 patients. The overall mean bone height ±SD) was 11.25±3.29mm on panoramic radiographs and 8.81±3.38mm on tomographs. The correlation between the two radiographic techniques ranged from 0.36 to 0.91 if the material was stratified according to factors such as height of available bone, age, gender and the presence of teeth. Gender was significantly correlated to panoramic and tomographic measurements in all regions. However, the precision of predicted tomographic measurements by using a linear regression model was not significantly increased by including gender as an explanatory variable. For evaluation of available bone height in mandibular regions posterior to the mental foramen, tomography is recommended for all prospective implant sites.
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  • 6
    Electronic Resource
    Electronic Resource
    Copenhagen : Munksgaard International Publishers
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The objective of the present experiment was to study the soft and hard tissure healing following treatment of experimentally induced peri-implantitis. 5 labrador dogs about 1-year old were used. The mandibular right and left 1st molars, 4th and 3rd premolars were removed, titanium fixtures (Brånemark System®) were installed, and standard abutements were connected in a 2nd stage procedure. After 3 months experimental peri-implantitis was induced by the placement of cotton floss ligatures in a submarginal position. 6 weeks later the ligatures were removed. 1 month after ligature removal, an antibiotic regimen was initiated. During a 3-week period, each dog was given tablets of amoxicillin and metronidazole. In the left side of the mandible, buccal and lingual mucoperiosteal flaps were elevated and granilation tissure within the bone craters curetted. The abutments were removed. The exposed outer surface and the internal part of the fixtures were carefully cleaned with a detergent (delmopinol HC1). An e-PTFE membrane was placed over each fixture and adjusted to cover the bone crater. New cover screws were fitted through the membranes to the cleaned fixtures. The implants were submerged and the flaps sutured. In the right side of the mandible no local treatment was performed. The dogs were sacrificed after 4 months and biopsies prepared for histological examination. The findings indicated that treatment of a peri-implantitis lesion, including comprehensive systemic antimicrobial therapy and cleaning of submerged implants resulted in (i) the elimination of the inflammatory process in the peri-implantitis tissues and (ii) the establishment of a dense connective tissue capsule in direct contact with the previously exposed surface of the implant system. It was also observed that (iii) new bone was frequently laid down on the pristine cover screws.
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  • 7
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Force transmission onto implants supporting overdentures was measured in viva by means of piezoelectric transducers that allow for simultaneous force registrations in 3 dimensions. The transducers are directly mounted onto the implants, beneath the anchorage device. The force registrations were analyzed with regard to the anchorage device and retention mechanism of overdenture support. The 3 types of denture anchorage were a U-shaped bar, a round clip-bar and single telescopes. Forces were measured in the following test situations: maximum force when biting in centric occlusion, maximum bite force during biting on a bite plate, grinding and chewing bread. Multiple regression showed that the vertical component of maximum forces was dependent on the anchorage device and test situation. The transverse components reached 10 to 50% of the vertical force magnitude. With the bite plate in situ maximum forces measured in vertical direction were significantly higher on the ipsilateral implant with telescopes than with bars (p〈0.01 and p〈0.001). Chewing and grinding resulted in lower vertical forces compared to maximum biting. In transverse dimensions, mainly in the anterior-posterior direction, registered forces reached magnitudes that resembled the vertical component (50 to 100%). Force magnitudes of chewing and grinding were similar for all three anchorage devices. However, differences were observed between bars and telescopes with regard to the direction of transverse force components. The results of this study do not suggest the preference of one specific anchorage system or retention mechanism for overdenture support. However, rigid bars contribute to load sharing and stress distribution onto the implants.
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  • 8
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: This paper presents the Orthosystem (Institute Straumann, Waldenburg, Switzerland), a new endosseous orthodontic implant anchor system for palatal anchorage. The Orthosystem may replace compliance dependent extraoral anchoring aids for orthodontics and makes a bonding of well aligned mandibular dentition and it's use with class II elastics unnecessary. The fixture is designed for a one-stage application. It consists of an implant of pure titanium with a surface-treated: screw-shaped endosseous part of 3.3mm diameter and lengths of 4 and 6mm. Above the polished transmucosal neck follows an abutment where transpalatal arches made of rigid orthodontic wires (0.032×0.032inch) are fixed by means of a clamp-cap. 6 patients with an angle class II malocclusion were implanted with the 6mm fixture in the proximal midsagittal region of the palate during a pilot study. The treatment goal was extraction of the first maxillary pre-molars with subsequent retraction of the frontal dentition under maximal anchorage of the lateral teeth. For the implantation a simple surgical procedure of 10 min length was required while no further invasive actions are needed until explantation. This way the strain on the patients was reduced to a minimum. They are now at varying stages of active treatment and the most advanced case is demonstrated here. The clinical and radiological findings after 12 months of treatment comprising 3 months of healing revealed no implant mobility or dislocation, favourable peri-implant soft tissue conditions, and no marked mesial movement of the implant supported teeth. The frontal dentition was retracted by 8mm with space closure occurring in a relatively short treatment period.
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  • 9
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The aim of the present experiment was to study the marginal peri-implant tissues at intentionally non-submerged (1-stage implants) and initially submerged and subsequently exposed implants (2-stage implants). 5 beagle dogs, about 1-year-old, were used. 3 months after the extraction of the mandibular premolars, fixtures of the Astra Tech Implants Dental System®, the Brånemark System® and the Bonefit®-ITI System were installed. In each mandibular quadrant, 1 fixture of each implant system was installed in a randomised order. The installation procedure followed the recommendations given in the manuals for each system. Thus, following installation, the bone crest coincided with the fixture margin of the Astra Tech Implants Dental System® and the Brånemark System®, whereas the border between the plasma sprayed and the machined surface of the Bonefit®-ITI implant system was positioned at the level of the bone crest. Following a healing period of 3 months, abutment connection was carried out in the 2-stage systems (the Astra Tech Implants Dental System® and the Brånemark system®). A 6-month period of plaque control was initiated. The animals were sacrificed and biopsies representing each implant region dissected. The tissue samples were prepared for light microscopy and exposed to histometric and morphometric measurements. The mucosal barrier which formed to the titanium surface following 1-stage and 2-stage implant installations comprised an epithelial and a connective tissue component, which for the 3 systems studied, had similar dimensions and composition. The amount of lamellar bone contained in the peri-implant region close to the fixture part of the 3-implant systems was almost identical. It is suggested that correctly performed implant installation may ensure proper conditions for both soft and hard tissue healing, and that the geometry of the titanium implant seems to be of limited importance.
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  • 10
    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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