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PubMedDate not supplied

Effects of attachment type on the mobility of implant-stabilized overdentures--an in vitro study.

PURPOSE: To stabilize overdentures, a wide range of attachments to implants is suggested. Although there is evidence that denture stability is an important factor for patient satisfaction, there are no data on how these attachments may reduce denture mobility. It was the purpose of this study to compare the effects of different types of attachments on the mobility of implant-stabilized overdentures in vitro, designing a measurement device that could also be used in vivo. MATERIALS AND METHODS: On an acrylic model with 2 implants in the canine areas, magnets were fixed to one of the implant abutments. Four Hall-effect devices were attached to the denture opposite the magnet, which allowed contact-free measurements of denture movements. RESULTS: In vitro experiments loading an overdenture showed very small, largely insignificant differences in denture mobility when different bar or ball attachments were used. Geometric aspects of load application were more important than the choice of attachment. CONCLUSION: The measurements gave no guide to the choice of an attachment. The similarity of the attachments must be confirmed by in vivo measurements.

Analysis of Variance↗
PubMed2002

Transforming an existing fixed provisional prosthesis into an implant-supported fixed provisional prosthesis with the use of healing abutments.

Maintaining a fixed provisional prosthesis through all phases of complex implant prosthodontic therapy for a soon-to-be completely edentulous arch is a difficult task. This article focuses on the treatment phase in which teeth and/or transitional implants supporting a provisional fixed partial denture are removed. The described technique makes use of healing abutments to support a modified provisional fixed partial denture. This protocol ensures patient comfort and allows proper soft tissue healing before definitive implant abutment selection. It also eliminates the placement of interim implant abutments.

Clinical Protocols↗
PubMed2002

A long-term follow-up study of non-submerged ITI implants in the treatment of totally edentulous jaws. Part I: Ten-year life table analysis of a prospective multicenter study with 1286 implants.

In this prospective multicenter study, non-submerged ITI implants were followed in order to evaluate their long-term prognosis in fully edentulous jaws. A total of 1286 implants were inserted in 233 consecutive patients and, after a healing period of three to six months, the successfully integrated implants were restored with 163 overdentures and 95 fixed full-arch bridges. This prospective study not only calculated the 10-year cumulative survival and success rates for the 1286 implants by life table analysis, but also evaluated the actual survival and success rates for 498 implants after at least five years of functional loading. In addition, cumulative success rates were calculated for implant subgroups according to implant length and location. Additional analyses were performed to evaluate the estimated and actual survival and success rates of the implants in relation to various prosthetic rehabilitation techniques. The 10-year cumulative survival and success rates were 95.9% and 92.7%, respectively. The actual 5-year survival and success rates of the first 498 implants that were inserted were 97.7% and 95.0%, respectively. The analysis of implant subgroups showed slightly more favourable cumulative success rates for 12 mm long implants (93%), in comparison to 10 mm and 8 mm long implants (91.6% and 89.6%, respectively). The cumulative success rate for mandibular implants (approximately 94%) was also more favourable than that for maxillary implants (approximately 91%). Patients who were loaded with both maxillary and mandibular prostheses maintained success rates well above 90%; while only implants that were inserted to support maxillary overdentures that were retained by Dolder bars showed a success rate below 90%.

Adult↗
PubMed2002

The transmandibular implant: a 5- and 15-year single-center study.

PURPOSE: Fifty-eight patients (average age, 60 years) with gross mandibular atrophy had transmandibular implants inserted between 1984 and 1988. This study reports on their progress at 5 and 15 years. PATIENTS AND METHODS: In both 1991 and 2000, 50 cases were reviewed, with the other 8 lost to follow-up. Detailed surveys, using exactly the same format, were conducted to determine the outcome of transmandibular implant treatment. The records were reviewed and surviving patients with transmandibular implants were examined. RESULTS: An overall success rate of 80% in 1991 had fallen to 56% by 2000, with a total of 22 implants being removed. CONCLUSION: Factors involved in failure were age and medical infirmity of the patients, gross mandibular atrophy, and the use of several surgeons, in particular, trainees. This survey shows that the TMI has a progressive long-term failure rate and that extreme care needs to be taken in both patient selection and implant placement.

Adult↗
PubMed2000

Brånemark System Wide Platform implants for single molar replacement: clinical evaluation of prospective and retrospective materials.

BACKGROUND: The use of oral implants for single tooth replacement has become a predictable treatment modality. As single tooth loss is most common in posterior areas of the jaws, the use of the protocol is of specific interest in those regions. New implant designs aimed at this purpose have also been introduced. PURPOSE: The aim of the study was to present the outcomes for wide diameter implant treatment when being used in posterior areas of the jaws. MATERIALS AND METHODS: This paper presents the 3-year results of a prospective multicenter study (three clinics; n = 38 implants) and the 1-year results from a retrospective multicenter study (two clinics; n = 20 implants) on wide diameter implants for single molar replacement. Based on the hypothesis that dense bone in posterior mandibles would benefit from careful surgery and longer remodeling time, the influences of surgical technique and healing time on implant success and bone resorption were particularly addressed. RESULTS: The outcome demonstrated a good predictability for Brånemark System Wide Platform implants, at least short term, when used as single molar support (prospective group cumulative success rate [CSR] = 92% after 3 years; retrospective group CSR = 95% after 1 year). The increased mechanical strength of the wide platform implant/abutment complex also turned out to be important for mechanical stability. CONCLUSIONS: The study indicated that it was important to carefully perform surgery in posterior mandibles in order to preserve and optimally use the existing dense bone. It was suggested that from bone healing and remodeling aspects, posterior mandibles may be more demanding to handle than corresponding areas of maxillae.

Adult↗
PubMed2006

Fracture resistance of implant-supported screw- versus cement-retained porcelain fused to metal single crowns: SEM fractographic analysis.

OBJECTIVES: The present in vitro study aimed at evaluating the fracture resistance of both implant-supported screw- and cement-retained porcelain fused to metal (PFM) single crowns. A scanning electron microscope (SEM) evaluation of the mode of failure of the specimens was also performed. METHODS: Forty PFM premolar-shaped identical single crowns were realized. The restorations were divided into two groups: cement-retained (group 1) and screw-retained (group 2) prostheses. Compressive loading tests and SEM fractographic analyses were performed. The data were statistically analysed by means of the Student's t-test, with a confidence interval of 95%. RESULTS: The mean fracture load value was 1657 (+/-725) N in group 1 and 1281 (+/-747) N in group 2; the statistical analysis pointed out no significant differences between the two groups (p=0.115). The mean work at maximum load value was 0.775 (+/-0.619) J in group 1 and 0.605 (+/-0.526) J in group 2; the statistical analysis pointed out no significant differences between the two groups (p=0.355). All the samples were affected by cohesive fractures of the porcelain. Screw-retained crowns showed microcracks at the level of the occlusal access to the screw and extensive fractures in the whole thickness of the ceramics. On the contrary, cement-retained restorations were affected by less wide paramarginal fractures of the porcelain. SIGNIFICANCE: A stronger implant-prosthetic connection was noticed in cemented restorations group than in screw-retained single crowns. Even though negatively influenced by the presence of the occlusal access to the screw, the metal-ceramics bond can be considered predictable in both the implant-prosthetic connection systems analysed.

Cementation↗
PubMed2005

Horizontal distraction of the anterior maxilla in combination with bilateral sinuslift operation--preliminary report.

In many cases alveolar ridge atrophy causes severe alveolar ridge deficiency in horizontal and vertical direction. In cases of severe atrophy of the edentulous maxilla a maxillary retrognathism results. In this article, a new technique of solving this problem prior to implant placement is described. In six patients with severe atrophy of the edentulous maxilla a sinuslift operation and placement of dental implants were carried out in the posterior maxilla. In the anterior part of the maxilla a segmental split osteotomy and placement of two miniplate distractors were performed. One week after surgery distraction started with a distraction speed of 0.5 mm a day until a clinical correct position of the anterior maxilla resulted. Then, the stabilisation period of 12 weeks followed before the distractors were removed and two to four implants were placed in the anterior distracted maxilla. After a second healing period of 4 months the implants were used for loading by a fixed prosthetic superstructure. Six patients were treated by this regime and 58 implants were placed. All implants were loaded by a fixed prosthesis. Distraction was performed without disturbances. Three months after healing new bone was formed in the distraction gap. There was no implant loss. An aesthetic satisfying superstructure with good red and white aesthetics was achieved together with a correct interalveolar relation. Distraction of the anterior part of the maxilla in combination with sinuslift operation is an alternative technique for correction of interalveolar incongruences in the edentulous maxilla and augmentation prior to implant placement.

Bone Substitutes↗
PubMed2005

A 3-year prospective follow-up study of implant-supported fixed prostheses in patients subjected to maxillary sinus floor augmentation with a 80:20 mixture of deproteinized bovine bone and autogenous bone Clinical, radiographic and resonance frequency analysis.

The purpose of this prospective clinical study was to evaluate the 3-year outcome of 30 maxillary sinus floor augmentations with an autogenous bone-deproteinized bovine bone mixture (20:80). A total of 108 dental implants were placed after 6 months of graft healing. After another 6 months, the occlusion was restored with fixed prostheses and followed for 3 years of functional loading. Clinical and radiographic examinations of the sinuses and implants, including computerized tomography (CT) were performed. The stability of the implants was evaluated by means of resonance frequency analyses (RFA). After 3 years of functional loading with fixed bridges, 15 of 108 implants were lost giving a cumulative survival rate (CSR) of 86%. All followed patients, except one, had fixed bridges in function after 3 years of loading. The mean marginal bone loss was 1.3+/-1.1 mm after 3 years. RFA showed a mean implant stability quotient (ISQ) value of 66+/-4.1 after 3 years with no significant difference between implants in grafted and residual bone. Examination with CT showed that 67% of the maxillary sinuses were healthy prior to treatment and 71% after 3 years of loading. It was concluded that grafting of the maxillary sinus with a mixture of autogenous bone and deproteinized bovine bone is a reliable procedure.

Aged↗
PubMed2006

Mechanical interactions of an implant/tooth-supported system under different periodontal supports and number of splinted teeth with rigid and non-rigid connections.

OBJECTIVES: This study investigated the mechanical interactions of implant-teeth splinting systems under different periodontal supports and number of splinted teeth with rigid and non-rigid connectors using non-linear finite element (FE) approach. METHODS: Two FE models with normal and compromised periodontal supports containing a Frialit-2 implant splinted to the first and second premolars were constructed. Non-linear contact elements were used to simulate a realistic interface fixation within the implant system and the sliding function of the non-rigid connector. ANOVA was used to test for relative importance of the investigated factors and main effects for each level of the three investigated factors (periodontal supports, teeth splinting and connector designs) in terms of the stress values were performed. RESULTS: The simulated results indicated that the cross-interaction of the periodontal support and the splinting situation was a major factor affecting the stress value in alveolar bone. An additional splinting decreased the stress values of bone significantly for a compromised periodontal support. The individual factor of periodontal support also influenced the stress found in the alveolar bone (28%) and implant (72%), and the stress values increased when the periodontal support was reduced. Using different connectors affected the stresses found in bone (15%), implant (21%) and prosthesis (99%). The stress values of the implant and prosthesis increased, but were decreased in bone when the splinting system used non-rigid connectors. The mobility of natural teeth and the implant system between non-rigid and rigid connections showed only small differences. CONCLUSIONS: A non-rigid connector should be used with caution since it breaks the stress transfer and increases the unfavorable stress values in the implant system and prosthesis. The tooth/implant-supported system with an additional splinting is more efficient in compromised periodontal supports.

Alveolar Process↗
PubMed2004

Single-stage Straumann dental implants in the aesthetic zone: considerations and treatment procedures.

The aim of this paper was to identify factors significant to the use of single-stage dental implants in the aesthetic zone and discuss treatment considerations related to them. In view of available literature and clinical experiences, treatment outcomes associated with the use of single-stage Straumann implants (Institut Straumann AG, Waldenburg, Switzerland) in the aesethetic zone can be considered positive and predictable.

Biocompatible Materials↗