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Biomedical subjects

P Astrand

Publications and source records attributed to P Astrand.

At least 19 recordsLinked to original sources
PubMed2001

Nonsubmerged implants in the treatment of the edentulous lower jaw: a 5-year prospective longitudinal study of ITI hollow screws.

BACKGROUND: Although most implant systems have been designed for a two-stage surgical technique, a one-stage surgical technique has always been advocated for the ITI Dental Implant System (Straumann AG, Waldenburg, Switzerland). A new generation of ITI implants was presented in 1988 and included a hollow cylinder, a hollow screw, and a solid screw. PURPOSE: The goal of this study was to evaluate the one-stage surgical technique in connection with the ITI hollow screw in a longitudinal study over 5 years. MATERIALS AND METHODS: Forty-six patients with edentulous lower jaws were supplied with ITI hollow-screw implants. Patients who requested an overdenture (n = 18) had four implants inserted; those who requested a fixed bridge (n = 28) had five to six implants. The patients have been followed annually for 5 years. There was a dropout of three patients (6.5%); one patient did not want to cooperate, one moved from the area, and one was deceased. The clinical examinations included bridge removal for evaluation of the individual implant stability in connection with the 1-, 3-, and 5-year examinations. Radiographic examinations were performed with intraoral radiographs and the long-cone technique. RESULTS: The survival rate after 5 years was 95.7%. The success rate (in which implants undergoing treatment of peri-implantitis were not counted as successes) was 91.4%. The mean marginal bone loss between the baseline and the 1-year examination was 0.1 mm and between the 1- and 5-year examinations was 0.1 mm. These changes in marginal bone level were not significant. CONCLUSIONS: The success rate of ITI hollow-screw implants in the edentulous mandible was 91.4% after a 5-year observation period. There was no significant change in mean bone level between the loading of the implants and the 5-year examination. Peri-implantitis was diagnosed in three patients with poor oral hygiene, and it affected six implants. Five of these failed in spite of treatment.

Adult↗
PubMed2000

Pain and orthopaedic and neurologic signs after lumbar discectomy: a 2-year followup.

In a prospective study of 161 consecutive patients with lumbar discectomy, pain, lumbar mobility, and neurologic and root tension signs were followed up for at least 2 years. Sciatica and root tension signs decreased promptly after surgery and remained largely unchanged during followup, which was not the case for neurologic signs. Similarly, pain relief was not associated with neurologic signs but was associated with lumbar mobility and root tension signs. Patients without neurologic symptoms before surgery did not report more sciatica after 2 years than did those with positive neurologic signs before surgery. Positive crossed Lasegue sign and restricted lumbar mobility before surgery predicted better chances for postoperative pain relief. Patients with a ruptured anulus fibrosus at surgery had less sciatica and back pain after surgery than did patients with an intact anulus fibrosus.

Adult↗
PubMed2000

Nonsubmerged implants in the treatment of the edentulous upper jaw: a prospective clinical and radiographic study of ITI implants--results after 1 year.

BACKGROUND: A new generation of ITI implants, including a hollow cylinder, a hollow screw, and a solid screw, was described in 1988. Currently, the solid screw is the main alternative. PURPOSE: The aim of this study was to gain further clinical documentation of ITI solid-screw implants used in the edentulous upper jaw. This is a report 1 year after loading. MATERIALS AND METHODS: Twenty-eight patients with edentulous upper jaws (mean age, 57 yr) were supplied with four to eight ITI solid-screw implants in the upper jaw. In total, 167 implants (3.3 and 4.1 mm in diameter) were inserted. The implants were loaded about 7 months postoperatively. All patients were supplied with fixed screw-retained bridges. RESULTS: Twelve implants failed: 10 prior to loading and 2 after. Overall implant survival rate was 92.8%. Three of the five patients with implant loss were smokers. Signs of peri-implantitis were found in seven patients, affecting 12 implants. Mean marginal bone level at the loading of the implants (7 months after insertion) was situated 4.7 mm from the reference point of the implant. There was no significant change between loading and the 1-year examination. However, at several implants, the bone level at baseline was situated far apical of the reference point, indicating a bone loss before loading. CONCLUSIONS: The ITI screw implants, used in the edentulous upper jaw, had a survival rate of 92.8%. Mean bone loss between loading and the 1-year examination was 0.1 mm. Some implants had a bone level indicating a significant bone loss before loading. Peri-implantitis was found at about 7.2% of the implants inserted and at 25% of the failing implants.

Adult↗
PubMed1999

Diagnosis and prognosis in lumbar disc herniation.

In a prospective 2-year followup study of 160 consecutive patients undergoing primary surgery for suspected lumbar disc herniation, the authors studied the diagnostic and prognostic factors by using stepwise logistic regression analysis. When the different factors were entered in the same order as presented clinically, history and pain analysis contained most of the predictive information available. When all factors were entered simultaneously in the computations, the following factors (in order of relative importance) predicted relief of sciatica after 2 years: rupture of the anulus (as opposed to bulging disc or negative exploration), no preoperative comorbidity, and male gender. The following factors predicted return to work at 2 years: no preoperative comorbidity, duration of sciatica less than 7 months, education or vocational training in addition to compulsory school, age younger than 41 years, male gender, and no previous nonspinal surgery. Return to work does not seem to be a valid result parameter in lumbar disc surgery. The most important physical signs were root tension tests and lumbar range of motion, whereas neurologic signs were of secondary importance. Many people have asymptomatic herniations, and today supersensitive diagnostic imaging is widely available. Thus, the importance of clinical evaluation has increased, and most of the relevant information can be obtained by listening to the patient. A simple anamnesis apparently is a good alternative to psychologic tests in surgical triage.

Absenteeism↗
PubMed1999

Astra Tech and Brånemark System implants: a prospective 5-year comparative study. Results after one year.

BACKGROUND: Endosseous dental implants are used frequently, and many implant systems are available. The scientific documentation of the implant system presents a great variation, and it is often difficult to compare studies of different systems. PURPOSE: The aim of this study was to compare two Swedish implant systems (Astra Tech and Brånemark System implants), in a prospective randomized study. MATERIALS AND METHODS: Sixty-six patients were equally distributed between the two implant systems; 184 Astra Tech and 187 Brånemark System implants were used. The patients have been followed annually with clinical and radiographic examinations. The results after 1 year are reported. RESULTS: The abutment procedure was found to be easier and less time-consuming with Astra Tech than with Brånemark implants. The operation times in minutes (mean +/- SEM) were for the respective implant 35 +/- 4.0 and 51 +/- 4.8 in the maxilla and 32 +/- 3.8 and 43 +/- 2.4 in the mandible. The differences in both cases were significant: p < .02 and p < .05, respectively. The failure rate for Astra Tech implants was 0.5% and for Brånemark implants 4.3%. The difference was significant (p < .05); however, taking into account that five of the eight implant losses in the Brånemark implant group occurred in one patient, an intraindividual correlation cannot be excluded. Therefore, this result should be interpreted with caution. The marginal bone level changes were examined already from the fixture installation. The major bone loss was found between fixture installation and baseline. This bone loss was several times greater than the bone loss between the baseline and the 1-year follow-up. The total bone loss during the observation period did not differ significantly between the systems, but they had different resorption patterns. The bone loss in the upper jaw between baseline and 1-year follow-up was 0.22 +/- 0.14 and 0.03 +/- 0.09 mm for the Astra Tech and Brånemark implants, respectively. In the lower jaw, the loss was -0.31 for both systems. The frequency of plaque accumulation and bleeding on probing did not differ between the implant systems. CONCLUSIONS: Abutment connection with Astra Tech implants was simpler than the corresponding surgery with Brånemark System implants and the survival rate of Astra Tech implants was higher than that of Brånemark system implants.

Adult↗
PubMed1996

Titanium implants and onlay bone graft to the atrophic edentulous maxilla: a 3-year longitudinal study.

Treatment of the atrophic maxilla using an onlay bone-grafting technique in combination with simultaneous insertion of endosteal implants (Branemark System) was performed in 17 patients. They were followed during a 3-year period. At the end of this period, 14 patients had stable bridges in use and one patient had an overdenture. Two patients had had to return to conventional dentures due to implant losses. The survival rate of the implants after 3 years use was 75%. It is concluded that, in spite of the implant losses, onlay bone grafting to the maxilla is a valuable method in cases of severe maxillary atrophy.

Adult↗
PubMed1996

Non-submerged implants in the treatment of the edentulous lower jar. A 2-year longitudinal study.

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 98% and after 2 years of 96%. The mean marginal bone loss during the first year of function was 0.1 mm. 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.

Adult↗
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↗
PubMed1995

Bridges supported by free-standing implants versus bridges supported by tooth and implant. A five-year prospective study.

The clinical question at issue, whether it is possible to combine implants and natural teeth via fixed bridges, is of current interest. The treatment of the subjects of this prospective study was performed between June 1984 and December 1986. This article presents the 5-year results of the study. The consecutive patient material comprised 23 patients with Applegate Kennedy Class I residual dentition in the mandible and a complete maxillary denture. All 23 patients were provided with implants ad modum Brånemark in each mandibular quadrant. One side was randomized to rehabilitation with fixed bridge between the distal tooth of the residual dentition and an implant; the other side received a free-standang bridge on 2 implants. The fixture survival rate was 88%. No difference was found between the two sides. Bridge stability was 89% for the implant bridges and 91% for the combination bridges. The change in marginal bone level at the implants was small during the 5-year follow up period (on average 0.1-0.3 mm) and with no difference between the two sides. In conclusion, it was not possible to demonstrate any higher risk of implant or prosthetic failure for tooth-implant fixed bridges compared with implant-supported bridges.

Alveolar Bone Loss↗
PubMed1995

Single-tooth replacement by osseointegrated Brånemark implants. A retrospective study of 82 implants.

The aim of the study was to evaluate the outcome of single-tooth restorations on Brånemark implants performed during the period 1984-1989. The material comprised 58 consecutive patients with 82 implants. The observation period varied from 1 to 5 years. Two implants were lost, both of them before loading. The overall survival rate was 97.6%. Radiographic follow-up was performed for 72 implants after 1 year and for 51 implants after 2 years. The bone loss during the first year was on average 9.6 +/- 0.1 mm and during the second year 0.1 +/- 0.1 mm. Although the observation time for most of the patients was only 2 years, the results indicate that the outcome of single-tooth restorations may be as favorable as for implants in edentulous jaws.

Adult↗
PubMed1994

Spatiotemporal pattern of quantal release of ATP and noradrenaline from sympathetic nerves: consequences for neuromuscular transmission.

The recent explosive development in research concerning the fundamental mechanisms of synaptic transmission helps put the present paper in context. It is now evident that not all transmitter vesicles in a nerve terminal, not even all those docked at its active zones, are immediately available for release (36). We watch, fascinated, the unraveling of the amazingly complex cellular mechanisms and molecular machinery that determine whether or not a vesicle is "exocytosis-competent" (77,78,39,79). Studies on quantal release in different systems show that neurons are fundamentally similar in one respect: that transmitter release from individual active zones is monoquantal (2). But they also show that active zones in different neurons differ drastically in the probability of monoquantal release and in the number of quanta immediately available for release (3). This implies that one should not extrapolate directly from transmitter release in one set of presynaptic terminals (e.g., in neuromuscular endplate or squid giant synapse) to that in other nerve terminals, especially if they have a very different morphology. As shown here, one should not even extrapolate from transmitter release in sympathetic nerves in one tissue (e.g., rat tail artery) to that in other tissues or species (e.g., mouse vas deferens). It is noteworthy that most studies of quantal release are based on electrophysiological analysis and therefore deal with release of fast, ionotropic transmitters from small synaptic vesicles at the active zones, especially in neurons in which these events may be examined with high resolution (49,48,46,33,32). Such data are useful as general models of the release of both fast and slow transmitters from small synaptic vesicles at active zones in other systems, provided that these transmitters are released in parallel, as are apparently ATP and NA in sympathetic nerves. They tell us little or nothing, however, about the release of transmitters (e.g., neuropeptides) from the large vesicles, nor about the spatiotemporal pattern of monoquantal release from small synaptic vesicles in the many neurons that have boutons-en-passent terminals. They show that the time course of effector responses to fast, rapidly inactivated transmitters such as ACh or ATP is necessarily release related. But they do not even address the possibility that the effector responses to slow transmitters such as NA, co-released from the same terminals, may obey completely different rules and perhaps rather be clearance related (7).(ABSTRACT TRUNCATED AT 400 WORDS)

Adenosine Triphosphate↗
PubMed1993

Histologic investigations on 33 retrieved Nobelpharma implants.

Thirty Nobelpharma implants were retrieved from 17 patients despite a remaining clinical stability, after between 1 and 16 years of clinical function. The reasons for implant removal were bone resorption in combination with soft tissue disorders, psychological causes, implant fracture and post mortem cases. When measured at the cortical passage, there was an average of 84.9% direct bone-to-implant contact and 81.8% average surface bone area in individual threads as evaluated in a computerized morphometric system at the light microscopic level.

Adult↗
PubMed1992

Implants in partially edentulous patients. A longitudinal study of bridges supported by both implants and natural teeth.

The aim of the study was to compare the outcome of bridges supported by implants with bridges supported by a combination of implants and natural teeth abutments. The study comprised 23 patients with Applegate Kennedy Class I dentition in the mandible and a full upper denture. Implants ad modum Brånemark were inserted in the posterior areas of both mandibular quadrants. On one side, a bridge supported by 2 implants was constructed (Type I) and on the other side, a bridge supported by 1 tooth (mostly the canine or first premolar) and 1 implant was made (Type II). A total of 46 bridges were made and during the 3-year follow-up period, 4 Type I and 2 Type II bridges were lost. 8 out of 69 implants were lost during the 3-year follow-up, resulting in an implant survival rate of 88.4%. Marginal bone loss, one of several parameters, was evaluated on standardized intraoral radiographs. This was performed during the 1st and 2nd year of function and the total mean bone loss from loading was 0.46 mm and 0.56 mm, respectively. The bone loss during the 2nd year of function was significantly less, adjacent to implants supporting Type II bridges, than adjacent to implants supporting Type I bridges. Summarily, no disadvantages of combining of teeth and implants in the same bridge were found in this study. On the contrary, the slightly lower marginal bone loss adjacent to implants in Type II bridges may indicate that the bone reactions could be more favorable when bridges are connected to both implants and teeth.

Alveolar Bone Loss↗
PubMed1991

A calcium-dependent component of the action potential in sympathetic nerve terminals in rat tail artery.

A pharmacological approach was employed in order to visualize a Ca2(+)-dependent component of the extracellularly recorded nerve terminal impulse in the secretory regions of the sympathetic postganglionic nerves in the rat tail artery. Application of potassium-channel-blocking agents within the recording electrode caused the nerve terminal impulse to acquire a delayed negative deflection, which we have termed the late negative component (LNC) of the nerve terminal impulse. The time course and the latency of the LNC differed from that of the postjunctional transmitter-induced excitatory junction current, and the LNC persisted when the excitatory junction current was blocked by adenosine [alpha,beta-methylene]triphosphate, and was resistant to the alpha 1-antagonist prazosin and the alpha 2-antagonist yohimbine. Probably, therefore, the LNC was exclusively prejunctional in origin. For the following reasons it seems likely that the LNC, at least in part, was caused by influx of Ca2+ into the secretory regions of these nerves: (a) the LNC occurred only when potassium-blocking agents were present within the recording electrode; (b) the LNC amplitude increased with the Ca2+ concentration inside the recording electrode and was reduced by the removal of Ca2+; (c) the LNC was enhanced by replacing Ca2+ in the medium inside the recording electrode with Ba2+; (d) the LNC was depressed by the inorganic Ca2(+)-channel blocker cadmium or the Ca2(+)-channel-blocking peptide omega-conotoxin added within the recording electrode only, or by addition of cadmium or cobalt (but not the organic Ca2(+)-channel blocker nifedipine) inside and outside the recording electrode.(ABSTRACT TRUNCATED AT 250 WORDS)

Action Potentials↗
PubMed1991

Combination of natural teeth and osseointegrated implants as prosthesis abutments: a 2-year longitudinal study.

Twenty-three patients with Kennedy Class I mandibular dentition were supplied with prostheses in the posterior parts of the mandible. On one side they were given a prosthesis supported by two implants (prosthesis Type I) and on the other side they received a prosthesis supported by one implant and one natural tooth (prosthesis Type II). Sixty-nine fixtures were inserted and 46 prostheses constructed. Eight of the fixtures were lost during the observation period. The failure rate of the implants was about the same in the two types of prostheses; five fixtures belonged to prostheses Type I (10.9%) and two fixtures belonged to prostheses Type II (8.7%), while one fixture was lost prior to loading. From a theoretical point of view, the combination of a tooth and an osseointegrated implant should encounter problems with regard to the difference in bone anchorage and there should be a risk of biomechanical complications. However, the results of this study did not indicate any disadvantages in connecting teeth and implants in the same restoration.

Adult↗
PubMed1990

Planning and control of vertical dimension in Le Fort I osteotomies.

Depending on the different anatomy of the soft and hard tissues, concavity or convexity of the face, measurements of inferior or superior repositioning of the maxilla may be less predictable when using only the osteotomy site for this calculation. A more reliable method would be to measure the distance from a bone mark in the forehead to the incisor edges. This method has been practiced by our clinic during the past five years. The method is thought to offer a more accurate estimation of the position of the upper anterior teeth in relation to the lip, although one must anticipate a certain degree of postoperative relapse especially concerning inferior repositioning. In order to evaluate the accuracy of our method, a comparison has been made of the calculated vertical repositioning and the surgical results in two groups. In group I (12 individuals) conventional estimation of maxillary repositioning in the osteotomy line was made; in group II (12 individuals) measurements were made from a bone mark on the forehead to the incisor edges. A satisfying correlation was found between calculated and achieved results in both groups. In comparison between calculated and immediate postoperative measurements the results showed no statistically significant difference between the two methods.

Adult↗
PubMed1990

Presynaptic receptors and modulation of noradrenaline and ATP secretion from sympathetic nerve varicosities.

Our results in the model tissues examined show (1) that alpha 2 agonist(s) depressed the secretion of NA and ATP caused by nerve stimulation at low frequency, (2) that the secretion of both NA and ATP was moderately autoinhibited, under conditions when endogenous NA was shown to accumulate extracellularly, (3) that a K+ channel blocking agent increased much more strongly than alpha 2-adrenoceptors block the secretion of both NA and ATP, and also amplified enormously the NA-mediated neurogenic contraction, (4) that, therefore, a high K+ efflux is likely to be much more important than alpha 2-adrenoceptor-mediated autoinhibition for maintaining a low release probability in sympathetic nerve varicosities, and (5) that the alpha 2-adrenoceptor agonist, clonidine, or the Ca2+ channel blocking agent, Cd2+, inhibited transmitter secretion, at least in part, via targets "upstream" of the varicosity.

Adenosine Triphosphate↗