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Biomedical subjects

P A Köndell

Publications and source records attributed to P A Köndell.

At least 19 recordsLinked to original sources
PubMed2001

Brånemark System and ITI Dental Implant System for treatment of mandibular edentulism. A comparative randomized study: 3-year follow-up.

In a randomized prospective study, two implant systems were compared in forty consecutive patients treated for mandibular edentulism. The patients were randomly allotted for treatment by the Brånemark two-stage (submerged) system (BRS), or the ITI(R) one-stage (non-submerged) system. In all, 102 Brånemark selftapping implants and 106 ITI hollow screw implants were installed and all patients were treated with full bridges. Biological and prosthodontic parameters, complications, success rates, clinical efficacy, patient satisfaction and resource requirements were evaluated. No differences were found in plaque accumulation, bleeding or complications during the follow-up period. The BRS group showed deeper periimplant sulcus, less attached mucosa, larger bridge-mucosa distance and higher Periotest values. Prosthetic complications were not related to the configuration of the implant systems. After 3 years, the cumulative success rates were 97.9% and 96.8% for the Brånemark and ITI systems, respectively (difference not statistically significant). One implant in the BRS group had failed to osseointegrate at the time of abutment connection, and another was lost after 2 years due to progressive breakdown of bone. In the ITI group, three implants showed progressive bone loss after 1-3 years associated with periimplant infection. All 40 bridges were intact and remained stable throughout the study. There was general patient satisfaction, but about half the Brånemark patients reported difficulty in coping with the surgical procedures. Treatment time was similar for the two systems. It is concluded that both systems meet the current requirements for dental implant systems in the treatment of mandibular edentulism.

Adaptation, Psychological↗
PubMed1999

Implant treatment without bone grafting in severely resorbed edentulous maxillae.

PURPOSE: This article describes the surgical technique for implant treatment in severely resorbed edentulous maxillae without any alveolar reconstruction before or combined with implant placement. PATIENTS AND MATERIAL: Fifteen patients with severely resorbed edentulous maxillae were treated with osseointegrated implants and fixed dental prostheses. All patients were initially considered to be treated with bone grafting because of a lack of sufficient bone volume for conventional treatment. Preoperative radiographic examinations showed that the height of the alveolar crest was on average 7.4 mm at the 4-mm-width level (Classes V to VI). RESULTS: By fenestration of the maxillary sinus and uncovering the nasal floor, the maxillary bone could be visualized and used maximally for installation of implants. By angulation of the implants and permitting two to five uncovered fixture threads on the palatal aspect, implants of optimal length could be installed. Eighty-six implants were placed (four to six implants in every patient). One implant was lost during the observation time (range, 36 to 54 months; mean, 45 months). All patients had stable fixed prostheses at the end of the observation time. CONCLUSION: This cost-effective surgical technique may be considered as an alternative to more resource-demanding techniques such as bone grafting in patients with severely resorbed edentulous maxillae. However, further prospective comparative studies are necessary for full evaluation.

Adult↗
PubMed1999

Evaluation of single-tooth restorations on ITI dental implants. A prospective study of 29 patients.

From January 1992 to March 1997, a total of 30 ITI hollow cylinder implants were installed to replace lost single maxillary incisor teeth. Conical abutments with cemented all-ceramic crowns were used in 10 cases and the Octa-abutment with screw-retained metallo-ceramic crowns in 19 cases. One implant failed due to postoperative infection, and was extracted a month after installation. After a mean observation time of 3.4 years, the cumulative success rate is 96.7%. Only minor bone loss has occurred around the implants, and there have been no other complications to date. The implant system fulfills the requirements for good function and esthetics.

Adult↗
PubMed1998

Dental implant installation without antibiotic prophylaxis.

The objective of this study was to retrospectively compare the outcomes of dental implant treatment with and without antibiotic prophylaxis. Two groups of patients with edentulous or partially edentulous maxillas or mandibles (or both) were treated with dental implants. One group, consisting of 147 patients (790 implants), was given prophylaxis with oral phenoxymethylpenicillin; 1 g of antibiotic was administered 1 hour preoperatively, and 1 g was administered every 8 hours for 10 days postoperatively. The other group, consisting of 132 patients (664 implants) was not given any antibiotics preoperatively or postoperatively. There were no significant differences with respect to early and late postoperative infections or with respect to implant survival between the two groups. It appears that antibiotic prophylaxis for routine dental implant surgery offers no advantage for the patient.

Adolescent↗
PubMed1996

Histological characteristics of peri-implant mucosa around Brånemark and single-crystal sapphire implants.

Soft tissues surrounding Brånemark titanium implants and single crystal sapphire implants were studied by conventional light- and transmission electron microscopy and by immunohistochemical markers for cytokeratin, protein S-100, Factor VIII and KP1. Histological sections of biopsies obtained from clinically healthy peri-implant mucosa were separated into a keratinized outer implant epithelium and an inner, non-keratinized epithelium, both immunoreactive towards cytokeratin. The inner implant epithelium terminated in a junctional epithelium, apically not a few cell layers thick. The cells adjacent to the implant showed a condensed cytoplasm, resembling hemidesmosomes. In the underlying connective tissue, rich in fibroblasts and factor VIII immunoreactive blood vessels, the bundles of collagen ran in different directions. S-100 immunoreactive nerve structures were more frequently found beneath the outer than the inner implant epithelium. Inflammatory cell infiltrates, some KP1 positive, were observed in the apical parts of the inner implant epithelium. S-100 positive Langerhans' cells were present mainly within the the outer implant epithelium. For the two implant systems, the techniques disclosed no qualitative structural differences in the adjacent soft tissues.

Aluminum Oxide↗
PubMed1996

Reconstruction of the resorbed edentulous maxilla using autogenous rib grafts and osseointegrated implants.

14 patients with severely resorbed edentulous maxillae underwent reconstruction by the use of autogenous rib graft on-lays and osseointegrated Brånemark System implants in a one-stage procedure. 75 implants were installed. 16 (21.3%) failed to osseointegrate at the abutment connection. After a mean observation period of 5.2 years, 55 (73.3%) of the original implants were osseointegrated. 10 supplementary implants were inserted in 3 patients. At the end of the observation periods, 2 patients had overdentures and 12 had fixed prostheses. The mean marginal bone loss was 2.13 mm (SD 0.47 mm) the 1st year after grafting, and 2.92 mm (SD 1.27 mm) at the end of the follow-up periods. Long-term follow-up did not show any persistent donor site discomfort. The results indicate that this technique is a conceivable alternative for patients with severe maxillary resorption.

Aged↗
PubMed1996

Immunological responses to maxillary on-lay allogeneic bone grafts.

4 patients with severely resorbed maxillae underwent rehabilitation with on-lays of allogeneic femoral head bone grafts, titanium implants (Brånemark System) and fixed prostheses. Donors and recipients were matched according to blood groups (ABO/Rh). Potential immunological responses were monitored by determining autoantibodies in peripheral blood, and inflammatory reactions in the recipient site. Biopsies from the bone graft 6 months after grafting showed vital bone. After a mean observation period of 19.5 months, 22 of 23 implants were osseointegrated. None of the investigated autoantibodies were detected in peripheral blood, and there was no local inflammatory response. Allogeneic bone grafts in combination with titanium implants can be used in reconstruction of edentulous severely resorbed maxillae without immunological reactions directed against the graft.

Aged↗
PubMed1992

Clindamycin versus phenoxymethylpenicillin in the treatment of acute orofacial infections.

The efficacy of clindamycin and phenoxymethylpenicillin in the treatment of orofacial infections was compared in a randomised study in 60 patients: 30 patients received clindamycin 150 mg every 6 h for seven days, and 30 received phenoxymethylpenicillin 1 g every 12 h for seven days. Where indicated incision and drainage were carried out. All patients but one in each group responded satisfactorily to treatment. Although the clindamycin group had a shorter duration of pain, swelling and fever and more favourable laboratory findings, the differences between the groups were not statistically significant. Of the 60 microbiological specimens 23 yielded only anaerobic bacteria, 34 both anaerobic and aerobic bacteria, two aerobic bacteria only and one no growth. In the penicillin group one case of severe diarrhoea occurred, and six patients in the clindamycin group had moderate to severe gastrointestinal discomfort, including one case of Clostridium difficile associated diarrhoea. This difference was however not statistically significant. The results support the continued use of penicillin for treatment of orofacial infections, with clindamycin serving as an effective alternative.

Adult↗
PubMed1991

Gingival fluid and tissues around successful titanium and ceramic implants. A comparative clinical, laboratory, and morphologic study.

The gingival tissue reactions around 19 titanium implants (Brånemark System) and 6 ceramic implants (Frialit) were studied by using established variables for monitoring periodontal status. Natural teeth in the same or the opposite jaw served as controls. Both clinical and laboratory examinations showed healthy gingival status. No differences in soft-tissue reactions between the two types of implant or between the implants and the natural teeth were registered.

Adult↗
PubMed1990

ACP and Surgicel in bone hemostasis. A comparative experimental and histologic study.

The search for a biodegradable material which may prevent or stop bleeding in bone tissue and ensure healing is of continuous interest. ACP, an absorbable collagen paste, is a new hemostatic agent. The present study was devised to compare ACP with another commonly used hemostatic agent, Surgicel, in order to determine the tissue response during bone healing. The materials were implanted in the mandibular bone of New Zealand white rabbits. The observation times were 1, 2, 4 and 8 weeks. The result showed that the healing was uneventful for both the hemostatic agents even though healing was slightly retarded compared to natural healing. Both the hemostatic agents were completely resorbed within 4-8 weeks and also the bone healing was completed after this observation period.

Animals↗
PubMed1989

Lateral periodontal cysts. Clinical, radiographical and histopathological findings.

21 lesions, clinically and radiographically diagnosed as lateral periodontal cysts (LPC), were retrospectively studied. The majority of the lesions were symptomless and were located in the premolar-canine-incisor region and predominantly in the mandible. 15 cases had the typical lining consistent with the diagnosis LPC. Three lesions were odontogenic keratocysts and 3 were inflammatory cysts. It was concluded that cysts in a lateral periodontal position are usually LPC but the diagnoses of keratocyst and inflammatory cyst must be considered.

Diagnosis, Differential↗
PubMed1988

Absele in bone hemostasis--a clinical and experimental investigation.

Control of bleeding from bone tissue may sometimes be difficult to maintain. Existing methods of haemorrhage control with standard bone wax can interfere with subsequent healing. This paper presents clinical and experimental results of the use of a new absorbable bone sealant, Absele a paste made from stabilised fibrin and soluble collagen.

Adolescent↗
PubMed1988

The tissue-integrated prosthesis in the treatment of edentulous patients. A follow-up study.

This paper reports the results of clinical series of osseointegrated implants (BiotesTM) at the Karolinska Institute, Stockholm. From 1980 to 1985, 350 implants were installed in 68 upper jaws and 440 implants in 83 lower jaws. After observation periods of 1 to 6 years, 307 (88%) maxillary implants and 434 (99%) mandibular implants were fully functional. Of 128 bridges and 23 overdentures 124 (97%) and 21 (91%) respectively were in function at the end of the observation time. The most frequent tissue complications were fistulae (8 cases) and mucosal hyperplasia adjacent to abutments (11 cases). The most frequent prosthetic complications were phonetic problems in the maxilla only (10 cases), acrylic fractures in bridges (3 cases) and fractures or distortion of the metallic framework (2 cases). The results indicated that treatment with osseointegrated implants (BiotesTM) is a safe method with predictable long-term prognosis for rehabilitation of the edentulous patient.

Adolescent↗
PubMed1988

Odontogenic keratocysts. A follow-up study of 29 cases.

This study reports the incidence and recurrence rate of odontogenic keratocysts in a series of 531 jaw cysts treated at the Department of Oral Surgery, Karolinska Institute, Stockholm, from 1977 to 1984. Each case of a histologically verified odontogenic keratocyst was analysed and registered with respect to patient's age and sex, type of cyst, location and rate of recurrence. Twenty-nine odontogenic keratocysts were found (5.4% of all cysts). The most frequent locations were in the mandibular angle, ramus and third molar regions. During the observation period (1-8 years) 7 keratocysts (24%) recurred. These findings support previous observations.

Adolescent↗
PubMed1986

Experimental mandibular Staphylococcus aureus osteomyelitis; antibody response and treatment with dicloxacillin.

Staphylococcus aureus mandibular osteomyelitis was produced in 20 rabbits by injection of a sclerosing agent and 1 X 10(9) colony-forming units of Staphylococcus aureus V8 into the medullary cavity of the mandible. After 2 weeks all rabbits developed infections. 10 of the rabbits were then treated with dicloxacillin (22.5 mg/kg body weight) every 12 h for 7 days and 10 were left untreated. The animals were sacrificed after 8 weeks and histopathological examination was performed. An enzyme-linked immunosorbent assay (ELISA) was used to measure IgG response against staphylococcal teichoic acid and alpha-toxin during the observation period. In the treated group, there was a decrease in clinical symptoms after the treatment period, while in the untreated group, progression of the infection was a common finding. At the end of the treatment period, Staphylococcus aureus V8 could not be recovered from aspirates obtained from animals in the treatment group, while in the non-treatment group, Staphylococcus aureus V8 could be recovered from abscesses in 6 rabbits. Both in the treated group and in the untreated group, the rabbits showed increasing IgG titers against teichoic acid and alpha-toxin during the first 2-3 weeks. No significant differences in antibody response patterns were noted between the treated and untreated groups and no clear correlation between the immunological response and the severity of the disease was observed.

Animals↗
PubMed1985

Endosseus titanium implants in extraction sockets. An experimental study in monkeys.

In a series of monkeys, titanium implants (Xenodent) were installed in the sockets of mandibular incisors. The animals were sacrificed 7 and 12 weeks after the implantations. The healing was studied by histological and microradiographical techniques. A gradual osseointegration free from adverse interference could be noticed.

Alveolar Process↗
PubMed1984

Influence on oropharyngeal and nasal carriage of Staphylococcus aureus by dicloxacillin therapy in patients undergoing oral surgery.

71 healthy oral, throat and nasal carriers of Staphylococcus aureus undergoing surgical removal of impacted mandibular third molars were assigned to the following regimens. 40 patients received dicloxacillin 500 mg orally 60 min before the operation and then 500 mg dicloxacillin 3 times daily for 7 days and 31 patients no antibiotic. Oropharyngeal and nasal cultures were obtained from each patient before, during and after the operation. Dicloxacillin reduced the carrier rates significantly. No increase in in vitro antibiotic resistance was observed in the staphylococcal isolates obtained after therapy. Dicloxacillin was well tolerated and toxicity was not encountered in any patient.

Adolescent↗