摘要:

The aim of this study was to longitudinally evaluate alterations in the position of the peri‐implant soft tissue margin, occurring during a 2‐year period after insertion of fixed prostheses. 41 patients, subjected to treatment with partial or full‐arch implant supported fixed prostheses based on a total of 163 standard Brånemark oral implants, were included in the study. A baseline examination was performed at time of insertion of the prosthetic construction and involved assessments of plaque, mucositis, probing depth, bleeding on probing, marginal soft tissue level, width of masticatory mucosa and marginal soft tissue mobility. All patients were re‐examined after 6 months, and after 1 and 2 years, respectively. A regression analysis was performed to evaluate if alterations, occurring in the position of the periimplant soft tissue margin during the 2 years, could be predicted by various variables recorded at time of the installation of the fixed prosthesis. The descriptive analysis showed a slight decrease in mean probing depth (0.2mm) and width of masticatory mucosa (0.3mm) during the follow‐up period. Apical displacement of the soft tissue margin mainly took place during the first 6 months of observation. Lingual sites in the mandible showed the most pronounced soft tissue recession, decrease of probing depth, and decrease of width of masticatory mucosa. The statistical analysis revealed that lack of masticatory mucosa and mobility of the periimplant soft tissue at time of bridge installation were poor predictors of soft tissue recession occurring during the 2 years of follow‐up, but indicated a greater amount of recession in women than men, in the mandible than in the maxilla, at lingual than at facial sites and with increased initial probing depth. It was suggested that the recession of the periimplant soft tissue margin mainly may be the result of a re‐modelling of the soft tissue in order to establish “appropriate biological dimensions” of the periimplant soft tissue barrier, i.e. the required dimension of epithelial‐connective tissue attachment in relation to the facio‐lingual thickness of the su

ISSN:0905-7161    

DOI:10.1034/j.1600-0501.1996.070401.x

出版商:Munksgaard International Publishers    

年代:1996

数据来源: WILEY

摘要:

Wound healing at the implant‐soft tissue interface occurs in the presence of saliva and blood. The aim of thisin vitrostudy 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 proli

ISSN:0905-7161    

DOI:10.1034/j.1600-0501.1996.070402.x

出版商:Munksgaard International Publishers    

年代:1996

数据来源: WILEY

摘要:

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 impl

ISSN:0905-7161    

DOI:10.1034/j.1600-0501.1996.070403.x

出版商:Munksgaard International Publishers    

年代:1996

数据来源: WILEY

摘要:

The objective of the present study was to evaluate the effect of systemic antibiotics and local debridement in the treatment of experimentally induced periimplantitis lesions. 5 Labrador dogs, about 1‐year old, were included in the study. In order to establish bilateral recipient sites for implants the mandibular right and left 1st molars, 4th and 3rd premolars were removed. 6 titanium fixtures (Brånemark System® Nobelpharma AB, Göteborg, Sweden) were installed and standard abutments were connected 3 months after fixture installation. Cotton floss ligatures were placed in a submarginal position around the neck of the abutments and the animals were placed on a diet which allowed plaque accumulation. After 68 weeks, when the tissue destruction amounted to about 20% of the fixture length, the ligatures were removed. 1 month after ligature removal, an antibiotic regimen (amoxicillin and metronidazole) was initiated and maintained for 3 weeks. In the left side of the mandible, buccal and lingual mucoperiosteal flaps were elevated, the granulation tissue within the bone craters adjacent to the implants was curetted, and the abutments were removed. The exposed outer surface, the internal part of the fixtures, as well as the abutments were treated with a detergent, delmopinol. The cleaned abutments were autoclaved, and connected to the cleaned fixtures. The mucoperiosteal flaps were replaced to their original position, adapted to the abutments and sutured. A careful plaque control program was initiated for the left jaw quadrants. In the right side of the mandible no local treatment was given to the fixtures and the abutments following ligature removal. Furthermore, no plaque control was provided to the implant segments in the right jaws. After 4 months of healing block biopsies including one implant with adjacent hard and soft tissue were harvested and prepared for light microscopy. It was observed that systemic antimicrobial therapy, combined with implant cleaning, curettage of the bone defect and regular plaque control resulted in (i) resolution of the peri‐implantitis lesion, (ii) a significant recession of the marginal peri‐implant mucosa: and (iii) a minor additional apical shift of the base of the bone defect. In the untreated sites the plaque associated infiltrate remained and was in several sites examined in contact with the adjacent bon

ISSN:0905-7161    

DOI:10.1034/j.1600-0501.1996.070404.x

出版商:Munksgaard International Publishers    

年代:1996

数据来源: WILEY

摘要:

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 impor

ISSN:0905-7161    

DOI:10.1034/j.1600-0501.1996.070405.x

出版商:Munksgaard International Publishers    

年代:1996

数据来源: WILEY

摘要:

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 durin

ISSN:0905-7161    

DOI:10.1034/j.1600-0501.1996.070406.x

出版商:Munksgaard International Publishers    

年代:1996

数据来源: WILEY

摘要:

In this retrospective clinical evaluation, the performance of loaded titanium implants with a bilayer bioactive surface coating of the relatively reactive hydroxylapatite (HA. outer layer) and the more stable fluorapatite (FA, inner layer) was evaluated. 98 consecutive patients were included in the study for a total of 354 implants, loaded by overdentures, fixed partial dentures and single tooth replacements. Statistical analyses revealed a cumulative probability of implant survival on a per patient basis of 94.5%(s.e. 2.7%) one year after implant installation. On implants that were lost parts of the bilayer FA/HA coating had vanished as a result of primary or secondary infection and subsequently epithelial down growth. Most complications were associated with implants placed in the maxilla. Periotest values (PTV) were generally high, indicating adequate osseointegration. The PTV's were statistical significantly less favorable in implants placed in the maxilla. The most favorable PTV’s and gingival index scores were found around implants servicing overdentures. Marginal bone loss averaged ‐ 2mm during the observation period. The amount of marginal bone loss corresponded with the distance from the neck of the implant to the first thread of the implant's cervical screw‐section. It is concluded that, during the relatively short observation period, the FA/HA coated implants function adequately. However, in the absence of a direct implant‐to‐bone contact preceding implant loss, part of the FA/HA coating on the titanium implants generally

ISSN:0905-7161    

DOI:10.1034/j.1600-0501.1996.070407.x

出版商:Munksgaard International Publishers    

年代:1996

数据来源: WILEY

摘要:

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 sit

ISSN:0905-7161    

DOI:10.1034/j.1600-0501.1996.070408.x

出版商:Munksgaard International Publishers    

年代:1996

数据来源: WILEY

摘要:

8 titanium implants (Nobel Biocare, Göteborg, Sweden) were inserted into edentulous lower premolar areas of 4 dogs so that 6 threads of the implant protruded from the bone crest. Newly‐developed perforated dome‐shaped titanium space maintainers were fixed to the implant with cover screws. Autogenous bone fragments were placed under the space maintainers. On one side of the arch, the space maintainer was covered with a non resorbable cell occluding barrier. The implant/space maintainers were submerged under coronally postitioned flaps. Following a 3‐month healing period, there was a mean gain of new bone amounting to 2.5mm for all specimems. A greater height of bone was found for those sites in which an e‐PTFE membrane was used; 3.1mm vs. 1.9mm (p<0.05). This study demonstrated the potential of coronal bone growth of the alveolar bone in a protected space around screw implants with exposed treads when placed in

ISSN:0905-7161    

DOI:10.1034/j.1600-0501.1996.070409.x

出版商:Munksgaard International Publishers    

年代:1996

数据来源: WILEY

摘要:

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 pristi

ISSN:0905-7161    

DOI:10.1034/j.1600-0501.1996.070410.x

出版商:Munksgaard International Publishers    

年代:1996

数据来源: WILEY