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Biomedical subjects

Hans Nilson

Publications and source records attributed to Hans Nilson.

3 recordsLinked to original sources

Oxidized titanium implants in reconstructive jaw surgery.

BACKGROUND: Rehabilitation with implant-supported bridges in patients with insufficient bone volumes may require bone reconstructive procedures in conjunction with or prior to implant placement. Clinical follow-up studies using turned titanium and bone grafts have demonstrated higher failure rates than when used in nongrafted patients. Improved bone integration has been demonstrated for oxidized titanium implants; however, their clinical performance in bone reconstruction situations is not known. PURPOSE: This study was performed to analyze the survival and stability of oxidized titanium implants placed in patients subjected to reconstructive jaw surgery at one clinic. MATERIALS AND METHODS: Two hundred oxidized titanium implants (Mk III, TiUnite, Nobel Biocare AB, Göteborg, Sweden) were placed in 47 patients in conjunction with or secondary to six different reconstructive procedures owing to insufficient bone volume. In all six groups, implant stability was assessed by resonance frequency analysis and manually checked for rotation stability at implant insertion, at the time of abutment connection, and after a minimum of 12 months of loading of the prosthetic construction. Periapical radiographs were taken after a minimum of 12 months of loading (mean 21 months) for evaluation of the marginal bone levels. The mean clinical follow-up period was 30 months. RESULTS: Of the 200 implants, 199 were considered osseointegrated at the time of abutment surgery. At the 12-month postloading follow-up, another two implants were considered not stable. Three implants (1.5%) were ranked as unsuccessful. CONCLUSION: Clinical experience with 200 consecutive oxidized implants in various reconstruction situations shows a successful outcome, with only three failures (1.5%) during a mean follow-up period of 30 months.

Adolescent↗

Provisional implants: a clinical prospective study in 45 patients, from implant placement to delivery of the final bridge.

BACKGROUND: Protocols for submerged healing of dental implants often require the patient to have no teeth until suture removal and to wear a removable prosthesis during the remaining healing period. This may be inconvenient for the patient, and healing may be influenced negatively by the removable prosthesis. PURPOSE: The aim of the present prospective clinical study was to evaluate the use of provisional implants (PIs) to provide patients with a provisional fixed bridge during the healing of permanent implants. MATERIALS AND METHODS: Twenty female and 25 male patients were consecutively included in the study. The 45 patients were treated for either partial (16 patients) or total (29 patients) edentulism in the maxilla. The permanent implants were placed first; as many PIs as possible were then installed between the permanent implants. After suturing, impressions from which to manufacture provisional bridges (to be cemented to the PIs) were taken. The patients were monitored with clinical and radiographic follow-up from implant placement to delivery of the final prosthesis. RESULTS: Five (2.2%) of the 230 permanent Brånemark System implants (Nobel Biocare AB, Gothenburg, Sweden) did not integrate. None of the failures could be related to the presence of PIs between the permanent implants. Seven PIs failed during the observation period. In addition, 17 (9%) of the 192 PIs showed mobility at the second-stage surgery although they had supported the provisional bridges without clinical symptoms. Forty-four of 45 patients showed stabile PI bridges at the time of second-stage surgery. CONCLUSION: Based on our experiences we concluded that provisional implants can be successfully used to provide patients with a fixed provisional bridge during the healing of permanent implants.

Adult↗

An intraindividual clinical comparison of two metal-ceramic systems: a 5-year prospective study.

PURPOSE: Earlier studies on low-fusing ceramics have shown the occurrence of changes over time regarding surface and color. The present prospective study is an ongoing follow-up of an intraindividual comparison between two metal-ceramic systems, the Procera system (titanium copings veneered with a low-fusing ceramic) and noble-alloy copings veneered with a medium-fusing ceramic. MATERIALS AND METHODS: Twenty-one crown pairs were fabricated for 18 patients. After 5 years, 18 crown pairs in 15 patients were available for comparison. The crowns were examined shortly after cementation (baseline), and after 1, 2, and 5 years. The crowns were rated according to the CDA system. Bleeding index and margin index were also evaluated. RESULTS: Obvious changes regarding surface and color were noted for the titanium-ceramic crowns. The difference between the two types of crowns was statistically significant at 5 years (P = .004). The differences between the two systems regarding anatomic form, margin integrity, bleeding index, and margin index were small. CONCLUSION: Within the limitations of this study, it is concluded that low-fusing ceramic-veneered titanium copings are inferior to medium-fusing ceramic-veneered conventional copings regarding surface and color of the ceramic. Therefore, conventional ceramic-veneered crowns seem to be preferable, at least in the anterior area, where the esthetic requirements are greater than in premolar and molar regions. Whether possible changes in the properties of low-fusing ceramics will reduce the differences between the two types of metal-ceramic crowns remains to be proven.

Adult↗