Article

A 5-Year Prospective Study of Single-Tooth Replacements Supported by the Astra Tech� Implant: A Pilot Study

February 2004
Clinical Implant Dentistry and Related Research 6(1):1-8

February 2004
6(1):1-8

DOI:10.1111/j.1708-8208.2004.tb00021.x

Source
PubMed

Authors:

Klaus Gotfredsen

University of Copenhagen

Implant-supported single-tooth replacements are an increasingly used method to replace teeth, especially in young patients. Therefore, long-term validation of different treatment modalities with different implant systems is of great importance. The aim of the present study was to make a biologic, technical, and aesthetic evaluation of single-tooth replacement supported by the Astra Tech implant (Astra Tech AB, Mölndal, Sweden) during a 5-year period. Twenty patients were divided into two consecutively treated groups. In group A the implants were placed "early" in the extraction sockets, and standard single-tooth abutments were used. In group B the implants were placed "delayed," and preparable abutments were used. Clinical examinations including registration of plaque, bleeding, crown lengths, soft tissue marginal level, papilla height, complications, and radiography were performed yearly. At the 3-year control examination the patient and a dentist evaluated aesthetic appearance with a visual analog scale. An implant survival rate of 100% and a crown survival rate of 95% over a period of 5 years were found. The mean loss of marginal bone adjacent to implants and neighboring teeth was less than 0.5 mm during the 5-year period, and there was no significant difference after crown placement between the treatment modality for group A and that for B. There were fewer clinical complications and repairs in group B than in group A. Soft tissue dimensions were more natural around implant crowns in group B as compared to group A, but this was not reflected in the patients' satisfaction with aesthetic appearance. On the other hand the dentist judged the restorations in group B higher concerning aesthetics than in group A. Implant-supported single-tooth replacement with the Astra Tech system is a reliable treatment resulting in a good 5-year prognosis and only few complications.

Narrow diameter implants to replace congenital missing maxillary lateral incisors: A 1-year prospective, controlled, clinical study

Article

Full-text available

Jun 2022

Objectives: To report the clinical, radiographic, aesthetic and patient-reported outcomes after placement of a newly developed Narrow-Diameter Implant (NDI) in patients with congenitally Missing Lateral Incisors (MLIs). Materials and methods: Patients with MLIs with a mesio-distal distance between the canine and the central incisor of 5.9-6.3mm received a dental implant with a diameter of 2.9mm (Test), while a diameter of 3.3mm (Control) was used when the distance was 6.4-7.1mm. After healing, a cement-retained bi-layered zirconia crown was fabricated. At the 1-year follow-up (T2), implant survival rate, marginal Crestal Bone Level (CBL) changes, biological and technical complications were registered. The aesthetic outcome was assessed by using the Copenhagen Index Score, and the patient-reported outcomes were recorded using the OHIP-49 questionnaire. Results: One-hundred patients rehabilitated with 100 dental implants Ø2.9mm (n = 50) or Ø3.3mm (n = 50) were included. One Ø3.3mm implant was lost and 7 patients dropped out of the study, yielding an implant survival rate of 99% (p = 1.000). At T2 a CBL of -0.19 ± 0.25 mm (Test) and -0.25 ± 0.31 mm (Control) was detected, with no statistically significant difference between the groups (p = 0.342). Good to excellent aesthetic scores (i.e. 1-2) were recorded in most of cases. Technical complications (i.e. loss of retention, abutment fracture, chipping of veneering ceramic) occurred once in three patients with no statistically significant difference between the groups (p > 0.05). OHIP scores did not differ significantly at follow-ups between groups (p = 0.110). Conclusion: The use of Ø2.9mm diameter implants represents as reliable a treatment option as Ø3.3mm implants, in terms of CBL changes, biological and technical complications. Favorable aesthetics and patient-reported outcomes were recorded for both groups.

Performance of bone-level implants with conical connections in the anterior maxilla: A 5-year prospective cohort study

Article

Full-text available

Nov 2019

Objectives: To assess clinical, radiographic and aesthetic outcomes, and satisfaction of patients treated with single implant restorations in the maxillary aesthetic region 5 years after final restoration. Material and methods: Sixty patients (29 male/31 female, mean age 37 years) with a missing anterior tooth in the maxilla (39 central incisors/10 lateral incisors/5 cuspids/6 first premolars) received a bone level implant with conical connection. In 29 patients, a bone augmentation procedure was necessary before implant placement (autogenous bone grafts mixed with spongiosa granules). All implants (12 with 3.3 mm diameter/ 48 with 4.1 mm diameter) were loaded after 3 months of submerged healing. The restoration consisted of an individually designed full-zirconia abutment veneered with porcelain. Follow-up with clinical and radiographic assessment was conducted until 60 months after the final restoration. Aesthetic outcome of the restoration was determined with the Pink Esthetic Score-White Esthetic Score (PES-WES). Patient satisfaction was assessed with a VAS scale and satisfaction questionnaire. Results: Fifty patients completed the 5-year follow-up. Implant survival was 100%, restoration survival 98%. Mean bone level change was -0.13±0.66 mm with a median (IQR) pocket probing depth of 2.75[2.25;3.25]. The mean PES and WES scores were 6.6±1.7 and 7.8±1.5 respectively. Patient satisfaction was high (92.1±7.8 on 100 mm VAS-scale). There were no differences between patients with or without a bone augmentation procedure. Conclusion: Bone level implants with a conical connection are a reliable treatment option in single tooth replacements in the maxillary aesthetic zone.

Effectiveness and clinical performance of early implant placement for the replacement of single teeth in anterior areas: A systematic review

Article

Mar 2019

Aim To assess the effectiveness and clinical performance of early implant placement, 4‐8 (Type 2) or 12‐16 weeks (Type 3) after extraction, in single anterior sites. Methods Studies reporting on Type 2 and 3 implant placement were identified. Findings were summarized in evidence tables. Main outcome was implant survival. Peri‐implant soft and hard tissues changes, periodontal parameters, aesthetics and patient‐reported outcomes were also evaluated. Quality of reporting of the included studies was evaluated through Consort, Newcastle‐Ottawa scale and IHE quality appraisal checklist. Results 19 eligible articles (7 from 1 RCT, 3 from 2 CCTs, and 9 from 3 case series) reporting on 140 patients and 140 implants were included. Type 3 implants showed comparable results to Type 4: 95% vs. 100% survival rates. Studies reported high values of implant survival, minimal technical and biological complications and high aesthetic scores in both short and long‐term follow‐ups for both Type 2 and Type 3 implant placement. Quality evaluation highlighted important weaknesses in the included trials. Conclusions Limited data on Type 2 and Type 3 implant placement appear to indicate that they can perform well both short and long term. However, the limited number of cases, the significant heterogeneity of the included studies and the high risk of biases importantly reduce the generalizability of the findings. CRD42018117363 This article is protected by copyright. All rights reserved.

Outcome of early dental implant placement versus other dental implant placement protocols: A systematic review and meta‐analysis

Article

Full-text available

Nov 2018

Background The aim of this systematic review and meta‐analysis was to compare the clinical efficacy of the early dental implant placement protocol with immediate and delayed dental implant placement protocols. Methods An electronic and manual search of literature was made to identify clinical studies comparing early implant placement with immediate or delayed placement. Data from the included studies were pooled and quantitative analyses were performed for the implant outcomes reported as the number of failed implants (primary outcome variable) and for changes in peri‐implant marginal bone level, peri‐implant probing depth, and peri‐implant soft tissue level (secondary outcome variables). Results Twelve studies met the inclusion criteria. Significant difference in risk of implant failure was found neither between the early and immediate placement protocols (Risk difference = −0.018; 95%CI = −0.06, 0.025; p = 0.416) nor between early and delayed placement protocols (Risk difference = −0.008; 95%CI = ‐0.044, 0.028; p = 0.670). Pooled data of changes in peri‐implant marginal bone level demonstrated significantly less marginal bone loss for implants placed using the early placement protocol compared with those placed in fresh extraction sockets (p = 0.001; Weighted Mean Difference = −0.14 mm; 95%CI = −0.22, −0.05). No significant differences were found between the protocols for the other variables. Conclusion The available evidence supports the clinical efficacy of the early implant placement protocol. Present findings indicate that the early implant placement protocol results in implant outcomes similar to immediate and delayed placement protocols and a superior stability of peri‐implant hard tissue compared to immediate implant placement. This article is protected by copyright. All rights reserved

Clinical and Esthetic Outcomes of Implants Placed in Postextraction Sites

Conference Paper

Full-text available

Jan 2009

Purpose: The aim of this review was to evaluate the clinical outcomes for the different time points of implant placement following tooth extraction. Materials and Methods: A PubMed search and a hand search of selected journals were performed to identify clinical studies published in English that reported on outcomes of implants in postextraction sites. Only studies that included 10 or more patients were accepted. For implant success/survival outcomes, only studies with a mean follow-up period of at least 12 months from the time of implant placement were included. The following outcomes were identified: (1) change in peri-implant defect dimension, (2) implant survival and success, and (3) esthetic outcomes. Results and Conclusions: Of 1,107 abstracts and 170 full-text articles considered, 91 studies met the inclusion criteria for this review. Bone augmentation procedures are effective in promoting bone fill and defect resolution at implants in postextraction sites, and are more successful with immediate (type 1) and early placement (type 2 and type 3) than with late placement (type 4). The majority of studies reported survival rates of over 95%. Similar survival rates were observed for immediate (type 1) and early (type 2) placement. Recession of the facial mucosal margin is common with immediate (type 1) placement. Risk indicators included a thin tissue biotype, a facial malposition of the implant, and a thin or damaged facial bone wall. Early implant placement (type 2 and type 3) is associated with a lower frequency of mucosal recession compared to immediate placement (type 1). INT J ORAL MAXILLOFAC IMPLANTS 2009;24(SUPPL):186-217

Evaluation of a one‐piece ceramic implant used for single‐tooth replacement and three‐unit fixed partial dentures: a prospective cohort clinical trial

Article

Jul 2015
CLIN ORAL IMPLAN RES

The aim of this clinical trial was to evaluate the safety and efficiency of a one-piece zirconia oral implant after 1 year of function. Two centers included 60 subjects in need of implant-supported single-tooth restorations or three-unit bridges. A total of 71 zirconia one-piece implants were placed and immediately restored with a temporary reconstruction for at least 2 months. The final veneered zirconia restorations were then cemented and followed for 6 months and 1 year after insertion of the restorations. At each visit, a clinical evaluation was performed to analyze biological parameters of the implants and the neighboring teeth. A standardized periapical radiograph was taken at implant insertion, at the placement of the restorations and at the 1-year follow-up. Sixty patients with 71 implants (48 in the mandible, 23 in the maxilla) were included in this study and provided with 11 bridges and 49 crowns. Two patients with three implants (one bridge and one single crown) could not be evaluated. One patient lost his implant 5 weeks after implant insertion. Based on 58 patients, the mean survival rate was 98.3% after one year when the implants of the two patients that did not show up were not counted as lost. The mean marginal bone loss from implant insertion to the 1-year follow-up after the final prosthetic restoration was 0.78 mm with a standard deviation of 0.79 mm. The probing depth around the implants increased from 2.7 mm at insertion of the prosthetic reconstruction to 3.5 mm one year after insertion. The probing depth around the adjacent teeth remained stable at 2.5 mm. At the 1-year recall, the difference was significant. The clinical attachment levels at implants and teeth were not different at the 1-year follow-up with 3.1 mm at tooth and implant sites. The presently tested one-piece ceramic implant was successful in replacing single tooth and three-unit gaps after one year of function. Further long-term data are necessary to verify these initial findings. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The use of CAD CAM For Fixed Partial Prostheses

Thesis

Full-text available

Apr 2016

Nawaf Almustafa

Due to the increasing demand from patients and dentists for highly aesthetic and strong, metal-free restorations there has been a rapid increase in research into dental CAD CAM technique and zirconia based restorations over the last decade. Such new technology has the potential to take the place of conventional techniques and materials for fabricating indirect dental restorations in the future. In this PhD thesis, five laboratory studies were designed to investigate zirconia bridges constructed using dental CAD CAM. The studies concentrated on: 1. Ideal force applied by dentists for cementing zirconia bridges and the impact on seating. 2. The effect of firing cycles and zirconia thickness on the fit of zirconia bridges. 3. The effect of span length on the fit of three and four unit all zirconia bridges. 4. The effect of veneering on the strength of three unit zirconia bridges. 5. The fit of three unit all zirconia bridges produced by digital and conventional techniques. For these laboratory studies an ideal three unit (and four unit for study 3) fixed-fixed all ceramic bridge preparation was carried out on two plastic teeth and all SLA models and zirconia based bridges were made using the Lava COS and Lava™ CAD CAM system (3M, ESPE). In addition to the laboratory studies, a clinical audit was carried out to assess satisfaction (dentist, dental technician and patient) with zirconia based restorations (through a series of questionnaires) made and fitted at Dundee Dental Hospital and School. In addition, as part of this audit a simple cost analysis was carried out to explore the differences in cost between zirconia based restorations and high fusing gold alloy based metal ceramic restorations. Four of the studies (studies 1, 2, 3 and 5) investigated the internal and marginal fit of the zirconia based restorations under differing laboratory and clinical procedures and conditions. It was found that the seating force used to cement a zirconia based bridge had no impact upon fit (Study 1). Whilst the thickness of zirconia (all-zirconia bridge and un-veneered zirconia framework) did not affect the fit of the restoration, veneering the framework did lead to a statistically significant deterioration in fit (Study 2). Although leading to a poorer fit veneering did have a positive effect in strengthening the zirconia framework, but neither un-veneered nor veneered frameworks were as strong as monolithic/all zirconia bridges (Study 4). Despite the high shrinkage during post milling sintering and the potential for greater distortion on longer span bridges, the longer span bridges investigated in Study 3 did not impact upon fit. In study 1, 2, 3 and 4 the Lava COS intra-oral scanner was used to create a digital impression of the tooth preparations and study 5 confirmed that the fit of bridges made from these impressions were better than those made using conventional addition cured silicone putty and wash impressions (Study 5). The results of the questionnaires used in the audit revealed high satisfaction rates with all stake holders and the cost analysis showed that producing zirconia based restorations can be five to six times cheaper than conventional gold based restorations. Despite the variations in fit which were found in Studies 2 and 5, all bridges produced were within what would be regarded as clinically acceptable and comparable to those produced with more traditional techniques.

Esthetic Outcomes of Implant-Supported Single Crowns Related to Abutment Type and Material: A Systematic Review

Article

Mar 2021

Purpose: To systematically review the influence of abutment material and configuration on the soft tissue esthetic outcomes of implant-supported single crowns (iSCs) after 3 years. Materials and methods: An electronic search on MEDLINE (PubMed) from January 2000 to July 2019 was conducted for clinical trials with no language restrictions. The focus question was: In partially edentulous patients with iSCs, does the abutment material (metal vs ceramic) or the configuration (standardized vs customized) have an effect on the soft tissue esthetic outcomes? Randomized controlled trials, controlled clinical trials, and prospective or retrospective case series with at least 10 patients and a minimum of 3 years of follow-up were included. The esthetic outcomes Pink Esthetic Score (PES), PES/White Esthetic Score (WES; ie, modPES), Papilla Index (PI), soft tissue recession, and papilla height change were extracted. Meta-analysis was performed when applicable. Results: Of the 6,399 titles identified, 27 studies were included. Combined mean PES/modPES scores, translated into a scale of 0 to 100, were 68.8 for ceramic, 74.2 for metal (P = .392), 71.9 for customized, and 71.3 for standard (P = .981) abutments. Mean soft tissue recession was also similar between the abutment groups, abutment material (P = .850), and configuration (P = .849), ranging from -1.09 mm to +0.59 mm gain. Papilla height changes ranged from -1.22 mm to +1.0 mm gain. The reported mean PI was 2.16 for customized, 2.06 for standard (P = .552), 2.01 for ceramic, and 2.28 for metallic (P = .04) abutments. Conclusion: This systematic review showed that the abutment material and configuration had minimal impact on the evaluated soft tissue esthetic outcomes. Future research focusing on the included parameters in a randomized controlled manner is needed to validate the present findings.

Esthetic outcomes of implant‐supported single crowns related to abutment type and material‐ a systematic review

Article

Sep 2019

Orthodontic Implant Site Development

Chapter

Mar 2016

Post-extractive tissue remodeling can often result in an edentulous site inadequate for implant placement and/or esthetically compromised. Orthodontic implant site development (OISD) uses the phenomenal potential of forced extrusion to move the alveolar apparatus, even for teeth with great attachment loss, making it an excellent alternative to surgical methods to improve quality and quantity of hard and soft tissue of the edentulous sites, developing a proper scenario for immediate implant placement and highly esthetic restorative outcome stable in time.

Findings of a Four-Year Randomized Controlled Clinical Trial Comparing Two-Piece and One-Piece Zirconia Abutments Supporting Single Prosthetic Restorations in Maxillary Anterior Region

Article

Full-text available

Jan 2016
BMRI

The purpose of this randomized controlled study is to investigate the clinical results obtained over four years and incidence of complications associated with one - versus two -piece custom made zirconia anchorages, in single tooth implant-supported restorations of the maxillary anterior region. Sixty-five patients, with a total of 74 missing maxillary teeth, were selected in the period from February 2007 to July 2010. Two different ways of custom made zirconia abutment and final prosthetic restoration were evaluated: a standard zirconia abutment associated with a pressed layer of lithium disilicate with an all-ceramic cemented restoration versus one-piece restoration with the facing porcelain fired and pressed straight to the custom made zirconia abutment. In 29 cases, the restoration consisted of an all-ceramic restoration for cementation (two pieces); in 45 cases the restoration was a screw-retained restoration (one piece). Three all-ceramic restorations broke during the observation time. Two one-piece restorations fractured after 26 months. At follow-up examination there were no significant differences between one-piece and two-piece groups regarding the PI, BI, and MBL. Awaiting studies with longer follow-up times, a careful conclusion is that zirconia anchorages for single-implant restorations seem to demonstrate good short-term technical and biological results.

Esthetic Failure in Implant Dentistry

Data

Full-text available

Oct 2015

Three‐Dimensional buccal bone anatomy and aesthetic outcome of single dental implants replacing maxillary incisors

Article

Jul 2015
CLIN ORAL IMPLAN RES

This case series investigated by means of CBCT, buccal bone three-dimensional anatomy at delayed, two-stage implants in the maxillary incisal tooth region. Moreover, the relation between buccal bone anatomy and soft tissue aesthetics was assessed. Twelve implants were analysed after on average 8.9 years in function. Baseline and re-evaluation photographs were assessed using the pink aesthetic score (PES). Marginal bone changes were measured from intraoral X-rays. The buccal bone volume associated with the implant and the implant surface not covered by visible buccal bone was computed on CBCT data sets. Buccal bone thickness and level were assessed, as well as the thickness of the crest distally and mesially of the implant. Changes in soft tissue forms and correlation between aesthetics and bone anatomy were calculated by nonparametric statistics. Buccal bone level was located 3.8 mm apical of the implant shoulder, and none of the implants had complete bone coverage. Buccal bone volume was 144.3 mm(3) , and 4.29 mm(3) in the more coronal 2 mm portion. PES did not differ at re-evaluation (9.7) and baseline (9.2). PES was directly correlated with crestal thickness mesially and distally of the implant shoulder. No other significant correlations were observed between bone anatomy and PES or buccal peri-implant health. Marginal bone gain over time was associated with greater coronal bone volume buccally and with greater buccal and marginal bone thickness, while loss was related to less or no bone. Within present limitations, acceptable and stable aesthetics are not jeopardized by a thin or missing buccal bone. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Screw- Versus Cement-Retained Implant Prostheses: A Systematic Review of Prosthodontic Maintenance and Complications

Article

Full-text available

Mar 2015
INT J PROSTHODONT

Purpose: This systematic review aimed to identify different prosthodontic outcomes between screw- and cement-retained implant prostheses. Materials and methods: The relevant articles were retrieved from the following electronic databases: MEDLINE, EMBASE, PubMed (using medical subject headings), and the Cochrane Central Register of Controlled Trials (CENTRAL). The search was performed up to December 31, 2013, and was restricted to studies on human subjects reported in English. A further search was conducted through the reference lists of the articles found as well as from early online articles. Reviewed studies were those on fixed implant prostheses using different retention mechanisms such as screws or cement. Information on types of screws and mechanisms of preloading, as well as different luting cements, was collected in correlation with prosthodontic maintenance/complication issues seen in the clinical studies. Results: Sixty-two papers met the review criteria. There were only six randomized controlled trials and none of them included an equivalent number of screw- and cement-retained single implant crowns for comparison. Studies used different types of screws and only a few reported the preloading procedure for the prosthetic screws. Other studies involving cement-retained implant prostheses used a range of dental cements; however, some did not specify the type used. Studies reported various prosthodontic maintenance/complication issues such as screw loosening, porcelain fracture, loss of retention, and esthetic concerns. Five studies did not report any prosthodontic maintenance issues during their observation periods. More recent studies also did not report any incidence of screw loosening. Only two studies stated the standardized criteria for reporting their prosthodontic maintenance/ complication issues. Conclusions: With inadequate information and various study designs, it was difficult to compare the prosthodontic outcomes between screw and cement-retained fixed implant prostheses. Both retention mechanisms showed prosthodontic maintenance/complication issues that must be considered and this review showed that the introduction of newer implant components may assist in minimizing these issues. It is also recommended that standardized criteria be used when reporting prosthodontic maintenance/complication issues to allow better comparison of data.

Factors Associated with Bone Level Alterations at Implants with Inner-Cone Connection and Platform Switching

Article

Full-text available

Feb 2014
JDS

Purpose . This retrospective cohort study evaluated factors for peri-implant bone level changes (ΔIBL) associated with an implant type with inner-cone implant-abutment connection, rough neck surface, and platform switching (AT). Materials and Methods . All AT placed at the Department of Prosthodontics of the University of Bern between January 2004 and December 2005 were included in this study. All implants were examined by single radiographs using the parallel technique taken at surgery ( T 0 ) and obtained at least 6 months after surgery ( T 1 ). Possible influencing factors were analysed first using t -test (normal distribution) or the nonparametric Wilcoxon test (not normal distribution), and then a mixed model q variance analysis was performed. Results . 43 patients were treated with 109 implants. Five implants in 2 patients failed (survival rate: 95.4%). Mean ΔIBL in group 1 ( T 1 : 6–12 months after surgery) was - 0.65 ± 0.82 mm and - 0.69 ± 0.82 mm in group 2 ( T 1 : >12 months after surgery) ( P = 0.801 ). Greater implant insertion depth in diameter 3.5 mm implants might be associated with increased ΔIBL ( P < 0.05 ). In the anterior region, the bone alteration was more pronounced ( P < 0.01 ). Conclusions . ΔIBL values indicated that the implant system used in this study fulfilled implant success criteria.

A randomized, clinical study of implant-supported all-ceramic crowns and abutments

Conference Paper

Jul 2010

Objective: The purpose of this study was to compare the aesthetical results of implant-supported all-ceramic crowns retained on zirconia abutment with porcelain-fused-to-metal crowns retained on titanium abutment. Methods: Twenty five patients with tooth agenesis of one or more premolars were treated with 53 single tooth implants (Astra Tech, Sweden). The prosthodontic treatments were randomized between all-ceramic crowns on zirconia abutments (AC-group, test, n=27) and conventional porcelain-fused-to-metal (PFM) crowns on titanium abutments (PFM-group, control, n=26). The biological, technical and aesthetical results were evaluated at the baseline examination (1-2 months after crown cementation). The aesthetical outcome was measured using Copenhagen Index Score (CIS) including 6 variables: 1. Harmony and symmetry; 2. Color match of the crowns; 3. Crown morphology; 4. Discoloration of buccal mucosa; 5. Papilla level, mesially; 6. Papilla level, distally. Each score ranged between 1 for optimal and 4 for poor aesthetic, resulting in CIS-scores between 6 and 24. Mann-Whitney U test was used to analyse difference in CIS-scores and for each variable. Results: No biological or technical complications were registered. Difference in CIS scores between AC-group and PFM-group wasn't statistic significant (p= 0.087, AC-group median: 11.0, 25% and 75% quartile: 10 and 13, PFM-group median: 12.5, 25% and 75% quartile: 11 and 13). Significant (p= 0.0332) higher discoloration scores were registered in the PFM-group (median: 2) compared to the AC-group (median: 1). The other aesthetic variables demonstrated no significant differences. Conclusion: The overall aesthetical result of the all-ceramic superstructures was almost the same as for the PFM crowns retained on titanium abutments in the premolar region. However, less buccal discoloration was seen at the all-ceramic crowns on zirconia abutments, compared to PFM crowns on titanium abutment.

RETROSPECTIVE EVALUATION OF SUCCESS OF IMPLANT SUPPORTED PROSTHESIS: EARLY RESULTS

Article

Full-text available

Jun 2020

Introduction: The interpretation of clinical results of dental implant supported prosthesis treatment is very crucial to be able to make a comparison between different implant systems and treatment options and furthermore to benefit the experiences of the other clinicians. However, the clinical outcomes of these studies should be reported in an objective way and be independent from the system used and also be prepared in accordance with certain criteria and standards that have been accepted scientifically world-wide for being reliable and describing long-term results. Aim: Three-hundred and eighty-two consecutive NTA implants were performed on ninety-nine patients. The implants used in 2016 and the constructed restorations were retrospectively analyzed. In addition, the effect of the experience of clinician was evaluated related with the success of the implant therapy. Materials and Method: This retrospective study was conducted in the Department of Prosthodontics Süleyman Demirel University. Three-hundred and eighty-two consecutive NTA implants were performed on ninety-nine patients. The implants used in 2016 and the constructed restorations were retrospectively analyzed. Results: The implants were followed for at least 2 years. In total, 239 implants were inserted. It was found in 143 mandibles. Prosthetic restorations were determined to be partial prosthetics (219), single crown (81) and overdenture prosthetics (64). During the evaluation period, 6 implants failed before prosthetic treatment, ten decementations, six retentive screw loosening and five porcelain chipping were detected. Discussion and Conclusions: The early results of our study are consistent with the results of other studies. However, long-term follow-up is required for more accurate assessments.

RETROSPECTIVE EVALUATION OF SUCCESS OF IMPLANT SUPPORTED PROSTHESIS: EARLY RESULTS

Article

Full-text available

May 2019

Introduction: The interpretation of clinical results of dental implant supported prosthesis treatment is very crucial to be able to make a comparison between different implant systems and treatment options and furthermore to benefit the experiences of the other clinicians. However, the clinical outcomes of these studies should be reported in an objective way and be independent from the system used and also be prepared in accordance with certain criteria and standards that have been accepted scientifically worldwide for being reliable and describing long-term results. Aim: Three-hundred and eighty-two consecutive NTA implants were performed on ninety-nine patients. The implants used in 2016 and the constructed restorations were retrospectively analyzed. In addition, the effect of the experience of clinician was evaluated related with the success of the implant therapy. Materials and Method: This retrospective study was conducted in the Department of Prosthodontics Süleyman Demirel University. Three-hundred and eighty-two consecutive NTA implants were performed on ninety-nine patients. The implants used in 2016 and the constructed restorations were retrospectively analyzed. Results: The implants were followed for at least 2 years. In total, 239 implants were inserted. It was found in 143 mandibles. Prosthetic restorations were determined to be partial prosthetics (219), single crown (81) and overdenture prosthetics (64). During the evaluation period, 6 implants failed before prosthetic treatment, ten decementations, six retentive screw loosening and five porcelain chipping were detected. Discussion and Conclusions: The early results of our study are consistent with the results of other studies. However, long-term follow-up is required for more accurate assessments.

Clinical Recommendations for Implant Abutment Selection for Single-Implant Reconstructions: Customized vs Standardized Ceramic and Metallic Solutions

Article

Jan 2020
INT J PERIODONT REST

The present paper presents clinical guidelines for the selection of the abutment material and level of customization for single-implant reconstructions. A systematic literature search was conducted previous to a Consensus Conference, resulting in two systematic reviews. One review focused on esthetic clinical outcomes, including esthetic indices and linear measurements, and the second focused on peri-implant soft tissue color outcomes, evaluated with spectrophotometry. The outcomes of esthetic indexes and linear measurement were highly heterogenic, hence, a meta-analysis was not feasible. All-ceramic and customized solutions showed a trend for improved results of the esthetic outcomes. Regarding soft tissue color outcomes, all-ceramic abutments induced significantly less soft tissue color changes. Both metallic and all-ceramic abutments/standard and customized components may result in clinically and esthetically acceptable reconstructions.

Therapeutic alternatives for addressing pink esthetic complications in single‐tooth implants: A proposal for a clinical decision tree

Article

Full-text available

May 2019

Objective Esthetic complications in implant therapy today represent a clinical challenge, when the aim is to overcome the sequelae and obtain a pleasing result. The current scientific literature about this topic is scarce and often based on case reports and the personal opinions of clinicians. Clinical considerations The aim of this article is to introduce a decision tree for diagnosis and treatment of complications, focusing on the pink esthetic of single‐tooth implants and based on three diagnostic pillars (3D implant position, peri‐implant hard‐tissue anatomy, and peri‐implant soft‐tissue anatomy). Different shortcomings have been identified for each of the three diagnostic areas. Conclusions Following this tree, the article proposes treatment alternatives including soft‐ and hard‐tissue reconstruction, implant submergence, orthodontic extrusion, and implant extraction in order to help clinicians establish a logical therapeutic sequence. Clinical Significance Guidelines for adequate diagnosis and management of single implant‐supported restorations with compromised esthetics is mandatory when attempt to overcome shortcoming in the pink esthetic result.

The Effects of Annual Maintenance on Peri-implant Health in Patients Rehabilitated with Overdentures: A Retrospective Cohort Study

Article

Jan 2019

Purpose: The aim of this retrospective cohort study was to assess the effects of annual maintenance over a 7-year period on the peri-implant health of patients rehabilitated with overdentures using clinical and radiographic parameters. Materials and methods: In order to be considered for inclusion in the study, patients had to have been rehabilitated with overdentures that had at least two implants placed in the mandible and four implants in the maxilla. Patients were divided into two groups: group 1 comprised individuals who had undergone annual maintenance over the previous 7 years, and group 2 comprised those who had not attended any dental appointment over the previous 7 years. All patients were submitted to clinical peri-implant examinations and radiographic assessments. Results: Sixty-six patients received 396 implants of the external hexagon type, 132 in the mandible and 264 in the maxilla. Group 1 (44 patients with 264 implants) had a mean probing depth of 2.72 mm, while group 2 (22 patients with 132 implants) had a mean probing depth of 3.10 mm. It can be concluded that the mean of the variable probing depth is influenced by the presence of bleeding (P = .0005) and the implementation of maintenance (P = .0188), whereas plaque and local variables were not otherwise significant (P = .0605 and .0796, respectively). Conclusion: In this study, it was possible to observe better clinical conditions in individuals who had attended annual appointments for maintenance purposes.

THE EFFECT OF DIFFERENT SUPERSTRUCTURE MATERIALS OF IMPLANT SUPPORTED RESTORATION. A SYSTEMATIC REVIEW.

Article

Full-text available

Feb 2018

Esthetic assessments in implant dentistry: objective and subjective criteria for clinicians and patients

Article

Feb 2017
PERIODONTOL 2000

In recent years the scientific community has shown a clear interest in the esthetic outcome of implant treatment. The present paper provides an overview of the esthetic ratings that have been used in implant dentistry. A distinction can be made between objective evaluations by clinicians and subjective evaluations by patients. The former mainly include: midfacial and interproximal soft-tissue levels; two-dimensional/three-dimensional soft-tissue alterations; assessment of the color match between the natural dentition, on the one hand, and the peri-implant tissues and the reconstruction, on the other hand; and ordinal indices, such as the pink and white esthetic score. Patient's needs and judgment may differ from objective indicators of implant success and esthetics. As a result, assessing treatment on the basis of patient-reported outcomes measures should be considered important. Validated questionnaires have been used that mainly assess the impact of oral health on the overall well-being of individuals. The esthetic judgment of patients is usually based on nonstandardized questions with varying scoring methods, including visual analog scales, Likert and other category scales and open questions. The heterogeneity in scoring systems between studies may compromise proper comparison of objective and subjective esthetic outcomes between studies and therapeutic concepts.

Dimensional changes in the supporting tissues following immediate placement and restoration of dental implants in the aesthetic zone: a retrospective study

Thesis

Full-text available

Mar 2010

Nabil Khzam

Prognosis of Furcation Involved Teeth: Cost-Effectiveness over Implant Placement

Article

Full-text available

Jan 2016

Prognosis of Furcation Involved Teeth: Cost-Effectiveness over Implant Placement The severe intrusion of dental implants in everyday clinical practice tends to replace conservative therapeutic approaches of maintaining teeth with dubious prognosis. Furcation-involved (FI) molars pose a great dilemma to the clinician, as in most cases their treatment requires significant effort using surgical interventions as well. Prognosis for multi-rooted is usually worse than single-rooted teeth and additionally, furcation degree III is associated with signiﬁcantly increased rates of tooth loss. However, clinical studies have shown that retention of teeth with poor prognosis have little effect on the proximal bone loss around adjacent teeth and possibly can be maintained over 10 years in patients who receive regular supportive periodontal treatment. The decision to retain furcation involved teeth is complex and based on multiple aspects such as the extent of dental caries, the remaining tooth structure, the extent of previous reconstructions, post and core build-ups, the extent of periodontal destruction, and the risks associated with endodontic therapy. On the other hand, implant therapy is not panacea. Implants which have been place in periodontal patients are possible to develop peri-implantitis after 5 years of function, with multiple factors to be asociated with the prevalence of disease. The purpose of the current review is to determine the cost-effectiveness of furcation involved molars replacement with dental implants. Many studies, which have been carried out recent years, indicated that maintenance of a furcated-molar with severe bone loss and the patient’s obliance to the supportive periodontal treatment is of paramount importance in order to establish their retention in patient’s dentition. Recent studies have been shown that maintenance of molars with FI is less costly than their replacement with implants and the treatment they might later require, regardless patient’s risk profile. When periimplantitis occurs, initial and follow-up therapies generate further and high costs. Therefore, dentists should reconsider the benefits regarding effortless extractions and implant replacements and measures in order to preserve the permanent dentition.

Quality Assessment of Systematic Reviews on Oral Implants Placed Immediately into Fresh Extraction Sockets

Article

Oct 2015
INT J ORAL MAX IMPL

Purpose: During the last two decades, many clinical trials and systematic reviews (SRs) have evaluated the clinical outcomes of immediate implant placement and its effects on soft and hard tissue. Despite the increased popularity and knowledge of immediate implant placement, the evidence about its benefits is still not conclusive. The aim of this review was to assess the quality of published SRs with meta-analyses of immediate implant placement and provide an overview of the key findings. Materials and methods: Searches of MEDLINE, EMBASE, the Cochrane Library, and the Database of Abstracts of Reviews of Effects were performed to include SRs with meta-analysis of immediate implant placement. Two independent reviewers assessed the methodologic quality of SRs using A MeaSurement tool to Assess Reviews (AMSTAR), the 2003 checklist of Glenny et al, and the Critical Appraisal Skills Program (CASP). Results: A total of 742 articles were found; 5 were included. All included SRs were published after 2007. Implant survival rate was the most commonly reported outcome. There was insufficient information in the primary studies, and hence in the SRs, about other outcomes and any adverse events. However, the methodologic quality of the SRs was considered to be high. Conclusion: There is a general consensus among the included SRs that it is still premature to draw definite conclusions about the potential benefits of immediate implant placement because of the limited number of well-designed controlled clinical trials. Improvements in future SRs are still required and can be achieved by following established quality criteria, namely researching the unpublished literature and literature not in English and by reporting the quality assessment of primary studies and any sources of bias.

Evaluation of peri-implant buccal bone by computed tomography: An experimental study

Article

Jul 2015
CLIN ORAL IMPLAN RES

To evaluate the accuracy of measuring peri-implant buccal bone when using three different computed tomography devices. Sixty tissue-level or bone-level dental implants were placed in bovine ribs with either buccal bone full coverage, dehiscence or fenestration. For each site, the distance from the bone defect to the implant neck and the buccal bone thickness 1 mm apical to the crest were measured using a calliper. Subsequently, all sites were scanned in a reproducible position using a multi-slice computed tomography (CT) (Brightspeed, voxel size 0.625 mm) and two cone-beam computed tomography devices (i-CAT NG, voxel size 0.3 mm and Newtom VGi, voxel size 0.2 mm). Bone thickness was measured on images from the three systems similar to direct measurements and differences were evaluated. Factors that could influence the buccal bone identification were assessed by multiple binary logistic regression. Buccal bone ranged from 0.1 mm to 2.75 mm in thickness and was not visible in 68%, 63% and 60% of cases when using CT, i-CAT and Newtom, respectively. For each mm of bone thickness increment, the odds of radiographic identification increased by 30.6 (P < 0.001). Bone defects negatively affected radiographic visibility (P < 0.05). All devices underestimated bone dimensions although differences among them were not significant. Within these experimental conditions, the investigated devices have equivalent low accuracy in diagnosing peri-implant buccal bone. Accuracy was significantly influenced by buccal bone thickness, especially if <1 mm, and in presence of peri-implant marginal defects. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Do short implants have similar survival rates compared to standard implants in posterior single crown?: A systematic review and meta‐analysis

Article

Full-text available

Jul 2018

Background Short implants have been presented as an option for posterior rehabilitation in cases of poor bone height. Purpose To compare the survival rate of short implants and standard implants when used in posterior single crowns, in addition to reporting marginal bone loss, prosthetic failures, and surgical complications. Materials and methods Electronic search (PubMed, LILACS, Cochrane Library, Scopus, and Web of Science) and hand search were performed to identify all randomized controlled trials (RCTs) and controlled clinical trials (CCTs) that evaluated both short and standard implants in posterior single crowns. Results Out of 345 articles identified by both electronic and hand search, four studies were selected (one CCT and three RCTs). The meta‐analysis for the survival rate showed that there was no significant difference between the short implants and the standard ones (P = 1.00; RR:1.00; CI:0.97‐1.03) performed with three RCTs for a one‐year follow‐up. The mean marginal bone loss ranged from 0.1 mm to 0.54 mm. Only one study reported the presence of prosthetic failures and surgical complications. Conclusions The survival rate of short implants was similar to the standard ones in posterior single crowns, for the one‐year follow‐up period. They also presented low surgical complications, prosthetic failures and marginal bone loss, being a predictable treatment for single rehabilitation in posterior tooth loss.

Frakturverhalten von implantatgetragenen und implantatzahngetragenen vollkeramischen Seitenzahnbrücken unter Verwendung von Zirkoniumoxid-Abutments

Thesis

Jan 2010

Sabine Merker

Prosthetic protocols in implant-based oral rehabilitation: A systematic review on the clinical outcome of monolithic all-ceramic single- and multi-unit prosthesis

Article

Sep 2017

Aim: The purpose of this systematic review was to assess the clinical performance of implant-supported monolithic all-ceramic single- and multi-unit restorations. Materials and methods: The electronic databases of MEDLINE via PubMed, the Cochrane Library (CENTRAL) and EMBASE were searched for clinical studies on monolithic all-ceramic single and multi-unit implant-supported fixed dental prostheses. Human studies with a mean follow-up of at least 2 years and published in English or German language peer-reviewed journals up until August 2016 were included. Two independent examiners conducted the literature search and review process. Results: The search resulted in 2510 titles and of these, 57 studies were selected for full-text evaluation. Three studies were included on the basis of the pre-determined criteria. Two articles reported on monolithic lithium disilicate implant-supported single crowns (SC) and revealed a survival rate of 97,8 and 100% after 3 years. One study investigated implant- supported monolithic zirconia SCs and fixed partial dentures (FPD) and showed a survival rate of 100% after 5 years. No studies could be identified on the clinical performance of monolithic resin matrix ceramic restorations. Clinical studies are lacking on the long-term outcome of implant-supported monolithic all-ceramic single- and multi-unit restorations. Conclusions: Preliminary clinical data indicate high short-term survival for implant-supported monolithic lithium disilicate and zirconia single- and multi-unit restorations. Randomised clinical studies and observations with a longer duration are necessary to validate the broad application of this therapy.

Early intervention services are effective and must be defended

Article

Full-text available

Oct 2017
WORLD PSYCHIATRY

A retrospective study of treatment outcomes of single implants in the most posterior area of the jaw in Koreans: 3-10 year follow-up

Article

Sep 2015

Modern Day Treatment Planning Dilemmas; Natural Tooth Versus Implants

Chapter

Dec 2017

Decision-making about a treatment plan whether to preserve a compromised tooth with endodontic therapy and a protective, functional restoration or to extract and replace it with an implant requires evidence-based diagnosis and recommendations based on patient factors, tooth and periodontium-based factors, and treatment-based factors. The first consideration should be the preservation of the natural dentition as long as possible, since the extraction and implant placement can be done at anytime and the implant treatment is not without risk. This component of the chapter outlines the evidence to recommend and plan the most appropriate treatment when faced with restoring the compromised tooth.

Timing of single implant placement and long-term observation of marginal bone levels

Article

Jan 2016

Aim: To assess the outcome of immediate or early placement of implants after tooth extraction supporting a single-tooth restoration with focus on the marginal bone level and its stability over time. Material and methods: An electronic literature search without time restrictions was conducted of the Medline/PubMed database accompanied by a handsearch. Clinical human studies reporting on periimplant marginal bone level (BL) and/or changes in bone level (BLC) and with a follow-up period of at least 12 months were selected for the present review. Results: The search strategy resulted in 816 articles and 115 relevant publications were included for full-text analysis. Only few randomised controlled trials exist comparing immediate or early implant placement with placement in healed bone (the conventional protocol). Summarising the results from prospective studies, it was found that the mean marginal bone loss around immediately or early placed implants from baseline (at implant placement or placement of restoration) to the latest followup visit (between 1 and 10 years) was less than 1.5 mm. Conclusion: The current literature indicates that immediate or early placement of single-tooth implants after tooth extraction may be a viable treatment with long-term survival rates and marginal bone level conditions matching those for implants placed conventionally in healed bone ridges.

Are Zirconia Implant Abutments Safe and Predictable in Posterior Regions? A Systematic Review and Meta-Analysis

Article

May 2016
INT J PROSTHODONT

Purpose: This systematic review aimed to evaluate whether the survival rate and predictability of zirconia abutments are similar to those of titanium abutments for single implant crowns in the posterior area. Materials and methods: A systematic search of two databases (Medline/PubMed and Cochrane Library) was performed by two independent reviewers for articles published between January 2004 and July 2014. The electronic search was complemented by a hand search of the following journals from the same period: Journal of Periodontology, Clinical Oral Implants Research, International Journal of Prosthodontics, and International Journal of Oral and Maxillofacial Implants. Studies included were published in English, evaluated single implant crowns, and performed a mean observation ≥ 1 year. Any disagreement between the reviewers was solved by means of a discussion. Forest plot and funnel were used to compare zirconia and titanium abutments. Results: The search strategy identified 669 studies. Of these, 11 studies were included and only 6 studies were selected for meta-analysis. The pooled results for fixed implant single crowns in posterior areas showed a 5-year success rate of 99.3% for zirconia abutments and 99.57% for titanium abutments. There was no statistical difference regarding veneer failure (P = .26). The pooled results of these studies showed that the mean bone loss was 0.38 ± 0.87 mm for zirconia and 0.2 ± 0.13 mm for titanium abutments. Conclusion: The use of zirconia abutments for single implant-fixed crowns in posterior regions is questionable due to the absence of long-term data. The short-term results of zirconia abutments regarding mechanical and biologic responses are similar to titanium abutments. Caution when using zirconia abutments in posterior regions is necessary until further clinical evidence shows favorable long-term results.

Anterior Single-Tooth Implants in the Esthetic Zone

Chapter

Jan 2010

Arun K. Garg

44 Orale implantaten

Chapter

Jan 2009

G. De Mars

De behandelende tandarts of parodontoloog heeft een groeiend arsenaal aan technieken, materialen en middelen ter beschikking om een (partieel) edentate of oraal verminkte patiënt adequaat te behandelen met enossale implantaten.

Aesthetic perception of single implants placed in the anterior zone. A cross-sectional study

Article

Full-text available

Mar 2016

Background: Several aesthetic indexes have been described to assess implant aesthetics. The aim of this study was to compare the aesthetic assessment made by dental professionals and students of single-tooth implants placed in the upper incisors. Materials and methods: A cross-sectional survey study using a subjective questionnaire to assess the aesthetics in 3 implant supported single-tooth cases in the anterior maxilla was performed. The interviewed subjects were divided into 4 groups: dentist with experience in implant treatment, dentists without experience in implants and 3rd and 5th year dental students. The questionnaire consisted of 2 visual analogue scales (VAS) to evaluate aesthetics, the pink esthetic score (PES), the white esthetic score (WES) and the simplified papilla index (PI). Results: One-hundred dentists and one-hundred dental students filled the aesthetic assessment questionnaire. The results showed that the subjects were more critical than reference values, specially concerning prosthetic issues. The differences between groups were more obvious in the case with the best result. On the other hand, few differences were detected in the remaining cases. Regarding soft tissue and crown features, experienced dentists in implant dentistry were the most demanding. Cronbach's Alpha showed values ≥ 0,8 in the questionnaire in every case, which indicates an adequate reliability. Conclusions: Dentists and dental students have different opinions when assessing aesthetics of single tooth implant supported cases. Experience and area of expertise seem to influence the evaluation of aesthetics in the anterior region.

Abutment screw loosening in single-implant restorations: A systematic review

Conference Paper

Jul 2008

Purpose: The purpose of this study was to systematically review clinical studies on the incidence of abutment screw loosening in single-implant restorations with different implant-abutment connection geometries. Materials and Methods: The literature search was conducted using several electronic databases. Specific terms were used for the database search, which spanned the years 1990 to 2006. The search was augmented by using the option of "related articles" as well as hand searching of references and relevant journals. Relevant studies were selected according to predetermined inclusion and exclusion criteria. Agreement between reviewers was determined by using Cohen's kappa coefficients. Three-year complication-free rates (survival proportions) were calculated with the aid of a survival function, assuming constant failure rates. Summary estimates per group for complication-free rate after 3 years (M-estimator) were calculated using Tukey's biweight estimator. Results: The initial database search yielded 1,526 relevant titles. After the subsequent filtering process, 27 studies were finally selected. Interexaminer agreement ranged from good to perfect. The external-connection group comprised 12 studies following 586 single-implant restorations for a mean follow-up time that ranged from 3 to 5 years. The estimated percent of complication-free single-implant restorations after 3 years was 97.3% (95% Cl: 95.6-98.3). The internal connection group comprised 15 studies following 1,113 single-implant restorations for a mean follow-up time that ranged from 3 to 10 years. The estimated percentage of complication-free single-implant restorations after 3 years was 97.6% (95% Cl: 96.5-98.3). Conclusion: The results show that abutment screw loosening is a rare event in single-implant restorations regardless of the geometry of implant-abutment connection, provided that proper antirotational features and torque are employed.

Données récentes et acquises en implantologie

Chapter

Dec 2011

Anodized Surface and Its Clinical Performance

Article

Nov 2015

Many implant surfaces and surface-modification techniques have been examined, and anodized surface on dental implant has been in continued clinical use and has demonstrated good stability during the healing phase. This proof has provided the basis for treatment modality of immediate function. In this chapter, the evidences based on the clinical and basic study reporting the success of osseointegrated implants regarding anodized surface will be reviewed. An understanding of the current evidence may facilitate the most appropriate utilization of this important dental resource.

Prospective randomized controlled clinical study comparing two types of two-piece dental implants supporting fixed reconstructions - results at 1 year of loading

Article

Oct 2015
CLIN ORAL IMPLAN RES

Objectives: To analyze clinical, esthetic, radiographic, and prosthetic outcomes of implants and implant-supported reconstructions using two types of dental implants with non-matching implant abutment junctions. Materials and methods: A total of 64 patients in need of dental implant therapy with fixed reconstructions were consecutively enrolled. They were randomly assigned to either one of two implant systems (S1: Astra Tech Osseospeed and S2: Straumann Bone Level). Baseline (day of loading) and 1-year measurements included demographics, radiographic, clinical, biologic, prosthetic, and esthetic outcomes. All data were analyzed at the patient level and at the implant level. The nonparametric Mann-Whitney U-test was used to detect differences in continuous variables between two independent groups. Results: Ninety-seven implants (S1 = 54, S2 = 43) were placed and loaded with fixed reconstructions in 64 patients. No implant was lost during the 1-year observation period resulting in a 100% survival rate for both implant systems. At the patient level, the mean marginal bone level at implant insertion was -1.30 mm (SD ± 1.00 mm) for S1 and -1.26 mm (±1.22 mm) for S2 (negative values indicating bone levels coronal to the implant shoulder). At the time of loading, these distances measured 0.29 mm (±0.44 mm) for S1 and 0.22 mm (±0.43 mm) for S2. At the 1-year follow-up, these distances were 0.37 mm (±0.39 mm) for S1 and 0.39 mm (±1.02 mm) for S2. Technical complications of the reconstructions only occurred in Group S1, with a rate of 12% (patient level) (P > 0.05). Biologic complications were observed at a rate of 6% (S1) and 3.2% (S2) at the patient level (P > 0.05). Conclusions: Both implant systems revealed 100% survival rates and minimal changes of the marginal bone levels during 1 year of loading. Few technical and biologic complications occurred. Therefore, both implant systems can be recommended for fixed reconstructions.

Frakturverhalten von implantatgetragenen und implantatzahngetragenen vollkeramischen Seitenzahnbrücken unter Verwendung von Zirkoniumoxid-Abutments

Article

Nov 2011

Sabine Merker

A systematic review of the complications of single implant-supported restorations

Article

Full-text available

Jan 2006

Moontaek Chang

The aim of this study was to systematically investigate the complications of single implant-supported restorations followed more than 5-year.

Influence of Prosthesis Type and Retention Mechanism on Complications with Fixed Implant-Supported Prostheses: A Systematic Review Applying Multivariate Analyses

Article

Jan 2015
INT J ORAL MAX IMPL

Purpose: To identify the influence of fixed prosthesis type on biologic and technical complication rates in the context of screw versus cement retention. Furthermore, a multivariate analysis was conducted to determine which factors, when considered together, influence the complication and failure rates of fixed implant-supported prostheses. Materials and methods: Electronic searches of MEDLINE (PubMed), EMBASE, and the Cochrane Library were conducted. Selected inclusion and exclusion criteria were used to limit the search. Data were analyzed statistically with simple and multivariate random-effects Poisson regressions. Results: Seventy-three articles qualified for inclusion in the study. Screw-retained prostheses showed a tendency toward and significantly more technical complications than cemented prostheses with single crowns and fixed partial prostheses, respectively. Resin chipping and ceramic veneer chipping had high mean event rates, at 10.04 and 8.95 per 100 years, respectively, for full-arch screwed prostheses. For "all fixed prostheses" (prosthesis type not reported or not known), significantly fewer biologic and technical complications were seen with screw retention. Multivariate analysis revealed a significantly greater incidence of technical complications with cemented prostheses. Full-arch prostheses, cantilevered prostheses, and "all fixed prostheses" had significantly higher complication rates than single crowns. A significantly greater incidence of technical and biologic complications was seen with cemented prostheses. Conclusion: Screw-retained fixed partial prostheses demonstrated a significantly higher rate of technical complications and screw-retained full-arch prostheses demonstrated a notably high rate of veneer chipping. When "all fixed prostheses" were considered, significantly higher rates of technical and biologic complications were seen for cement-retained prostheses. Multivariate Poisson regression analysis failed to show a significant difference between screw- and cement-retained prostheses with respect to the incidence of failure but demonstrated a higher rate of technical and biologic complications for cement-retained prostheses. The incidence of technical complications was more dependent upon prosthesis and retention type than prosthesis or abutment material.

10-year survival rate and the incidence of peri-implant disease of 374 titanium dental implants with a SLA surface: A prospective cohort study in 177 fully and partially edentulous patients

Article

Nov 2014
CLIN ORAL IMPLAN RES

PurposeThis prospective cohort study evaluates the 10-year survival and incidence of peri-implant disease at implant and patient level of sandblasted, large grid, and acid-etched titanium dental implants (Straumann, soft tissue level, SLA surface) in fully and partially edentulous patients.Material and methodsPatients who had dental implant surgery in the period between November 1997 and June 2001, with a follow-up of at least 10 years, were investigated for clinical and radiological examination. Among the 506 inserted dental implants in 250 patients, 10-year data regarding the outcome of implants were available for 374 dental implants in 177 patients. In the current study, peri-implantitis was defined as advanced bone loss (≧1.5 mm. postloading) in combination with bleeding on probing.ResultsAt 10-year follow-up, only one implant was lost (0.3%) 2 months after implant surgery due to insufficient osseointegration. The average bone loss at 10 year postloading was 0.52 mm. Advanced bone loss at 10-year follow-up was present in 35 dental implants (9.8%). Seven percent of the observed dental implants showed bleeding on probing in combination with advanced bone loss and 4.2% when setting the threshold for advanced bone loss at 2.0 mm. Advanced bone loss without bleeding on probing was present in 2.8% of all implants.Conclusion In this prospective study, the 10-year survival rate at implant and patient level was 99.7% and 99.4%, respectively. Peri-implantitis was present in 7% of the observed dental implants according to the above-mentioned definition of peri-implantitis. This study shows that SLA implants offer predictable long-term results as support in the treatment of fully and partially edentulous patients.

Esthetic Failure in Implant Dentistry

Chapter

Dec 2014
Dent Clin

The definition of failure for dental implants has evolved from lack of osseointegration to increased concern for other aspects, such as esthetics. However, esthetic failure in implant dentistry has not been well defined. Although multiple esthetic indices have been validated for objectively evaluating clinical outcomes, including failure of an implant-supported crown, only one author has determined a failure threshold. On the basis of objective indices, esthetic failures in implant dentistry can be categorized as pink-tissue failures and white-tissue failures. This article discusses esthetic failures, the factors involved in these failures, and their prevention and treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

Prosthetic Failure in Implant Dentistry

Article

Dec 2014
Dent Clin

Although osseointegrated dental implants have become a predictable and effective modality for the treatment of single or multiple missing teeth, their use is associated with clinical complications. Such complications can be biologic, technical, mechanical, or esthetic and may compromise implant outcomes to various degrees. This article presents prosthetic complications accompanied with implant-supported single and partial fixed dental prostheses. Published by Elsevier Inc.

Clinical evaluation of submerged and non-submerged implants for posterior single-tooth replacements: A randomized split-mouth clinical trial

Article

Dec 2014
INT J ORAL MAX SURG

The aim of this study was to evaluate clinical and radiographic results of submerged and non-submerged implants for posterior single-tooth replacements and to assess patient-based outcomes. Twenty patients were included in the study. A split-mouth design was used; implants inserted using a submerged technique were compared to those inserted with a non-submerged technique. Implants were restored with metal–ceramic crowns after 3 months. Reconstructions were examined at baseline, 6, 12, and 24 months. Standardized radiographs were made. Radiographic crestal bone level changes were calculated, as well as soft tissue parameters, including pocket probing depth, bleeding on probing, plaque index, and gingival index. Results were analyzed by two-way repeated measures of variance (ANOVA). To evaluate patient-based outcomes, patients were asked to complete a questionnaire at the 6-month follow-up; the Wilcoxon paired signed rank test was used to compare scores. The data of 18 patients were reviewed. During 24 months, non-submerged implants (0.57 ± 0.21 mm) showed significantly lower bone loss than submerged implants (0.68 ± 0.22 mm) (P < 0.01). Patient satisfaction with non-submerged implants (median 87.5) was significantly higher than with submerged implants (median 81.5) (P < 0.01). Non-submerged implants showed comparable clinical results to submerged implants and resulted in higher patient satisfaction due to decreased surgical intervention.

Retrospective Study of Sintered Porous-Surfaced Dental Implants Placed in the Augmented Sinus

Article

Jul 2014

The purpose of this study was to analyze clinical and radiographic outcomes of sintered porous-surfaced dental implants placed in partially edentulous posterior maxillae. The study group consisted of 42 partially edentulous patients who received sinus augmentation using the lateral window technique or crestal approach at Catholic University Hospital of Daegu and one private clinic. The 42 patients received a total of 92 sintered porous-surfaced dental implants in the edentulous posterior maxillae. All implants were restored with fixed prostheses. Of the 92 implants, 17 implants were restored with individual (nonsplinted) crowns, while 75 implants were splinted to other implants. Panoramic views and periapical radiographs using the standardized long-cone paralleling technique were taken at the first visit, postoperatively, at the time of prosthesis seating, and at a follow-up visit. Survival rates of implants in relation to location, length, diameter, crown-to-implant (C/I) ratio, and type of prosthesis were investigated. Statistical data were analyzed using software with the chi-square test. Of the 92 implants, 8 (8.7%) were removed, and the cumulative survival rate was 91.3% after a maximum 9-year functional period (mean: 72.8 months; range: 11 to 107 months). There were no statistical differences in relation to the location of implants, C/I ratio, or type of prosthesis. However, there were statistical differences in relation to the length and diameter of implants. Average crestal bone loss was 0.68 mm at 1-year follow-up and 1.13 mm at final examination. All implants were inserted in the augmented maxillary sites. The cumulative survival rate of sintered porous-surfaced implants in posterior maxillae was 91.3%. Sintered porous-surfaced implants showed satisfactory results in the edentulous posterior maxillae.

Biological factors contributing to failures of osseointegrated oral implants, (II). Etiopathogenesis

Article

Full-text available

Jul 1998

The aim of the present review is to evaluate the English language literature regarding factors associated with the loss of oral implants. An evidence-based format in conjunction, when possible, with a meta-analytic approach is used. The review identifies the following factors to be associated with biological failures of oral implants: medical status of the patient, smoking, bone quality, bone grafting, irradiation therapy, parafunctions, operator experience, degree of surgical trauma, bacterial contamination, lack of preoperative antibiotics, immediate loading, nonsubmerged procedure, number of implants supporting a prosthesis, implant surface characteristics and design. Excessive surgical trauma together with an impaired healing ability, premature loading and infection are likely to be the most common causes of early implant losses. Whereas progressive chronic marginal infection (peri-implantitis) and overload in conjunction with the host characteristics are the major etiological agents causing late failures. Furthermore, it appears that implant surface properties (roughness and type of coating) may influence the failure pattern. Various surface properties may therefore be indicated for different anatomical and host conditions. Finally, the histopathology of implant losses is described and discussed in relation to the clinical findings.

Stability of the Mucosal Topography Around Single-Tooth Implants and Adjacent Teeth: 1-Year Results

Article

Full-text available

Mar 2000

Ueli Grunder

This study evaluated the soft tissue stability around 10 single-tooth implants. All cases were treated following the same protocol, which included guided bone regeneration and connective tissue grafting. One year after prosthesis insertion the soft tissue shrinkage on the buccal side of the implant crown was 0.6 mm on average. The soft tissue volume in the papilla area increased on average by 0.375 mm, and none of the papillae lost volume.

A 5-Year Prospective study of implant-supported single-tooth replacements

Article

Full-text available

Mar 2002

Because osseointegration has been successful in the management of completely edentulous patients, it is tempting to extrapolate these results and infer the success of single-tooth replacement. Yet there are major clinical differences between edentulous and partially edentulous patients. This prospective study is a follow-up to one started at the University of Toronto in 1986. The purpose of this study was to continue longitudinal assessment of implant-supported single-tooth replacements. The original study comprised 42 consecutively treated patients with a total of 49 implants. The patient group consisted of all University of Toronto patients treated with single Br nemark implants whose treatment had been completed more than 5 years previously (i.e., before 1994). No exclusion criteria applied. One implant was not osseointegrated at the time of stage 2 surgery, and 6 patients with reportedly successful osseointegrated implants were not available for recall. For the preparation of this report, 30 of the remaining 42 implants were assessed during recall examinations. Assessment of success was based on published criteria. In addition, soft-tissue appearance, implant immobility, occlusal contacts in centric occlusion and excursions, proximal contacts, tightness of crown and abutment screws, and patients' responses on satisfaction questionnaires were evaluated. The criteria defining success of treatment in implant prosthodontics were met by all 30 of the single-tooth implants, which had been in place for 5 or more years. Each implant was immobile, and each had a mean vertical bone reduction of less than 0.2 mm annually. Stable long-term results can be achieved with single Brånemark implant-supported crowns.

Orthodontic aspects of the use of oral implants in adolescents: A 10-year follow-up study

Article

Full-text available

Jan 2002

The aim of the present study was to evaluate the long-term effect of implants installed in different dental areas in adolescents. The sample consisted of 18 subjects with missing teeth (congenital absence or trauma). The patients were of different chronological ages (between 13 and 17 years) and of different skeletal maturation. In all subjects, the existing permanent teeth were fully erupted. In 15 patients, 29 single implants (using the Brånemark technique) were installed to replace premolars, canines, and upper incisors. In three patients with extensive aplasia, 18 implants were placed in various regions. The patients were followed during a 10-year period, the first four years annually and then every second year. Photographs, study casts, peri-apical radiographs, lateral cephalograms, and body height measurements were recorded at each control. The results show that dental implants are a good treatment option for replacing missing teeth in adolescents, provided that the subject's dental and skeletal development is complete. However, different problems are related to the premolar and the incisor regions, which have to be considered in the total treatment planning. Disadvantages may be related to the upper incisor region, especially for lateral incisors, due to slight continuous eruption of adjacent teeth and craniofacial changes post-adolescence. Periodontal problems may arise, with marginal bone loss around the adjacent teeth and bone loss buccally to the implants. The shorter the distance between the implant and the adjacent teeth, the larger the reduction of marginal bone level. Before placement of the implant sufficient space must be gained in the implant area, and the adjacent teeth uprighted and paralleled, even in the apical area, using non-intrusive movements. In the premolar area, excess space is needed, not only in the mesio-distal, but above all in the bucco-lingual direction. Thus, an infraoccluded lower deciduous molar should be extracted shortly before placement of the implant to avoid reduction of the bucco-lingual bone volume. Oral rehabilitation with implant-supported prosthetic constructions seems to be a good alternative in adolescents with extensive aplasia, provided that craniofacial growth has ceased or is almost complete.

A 5-Year Prospective Study on Implant-Supported Single-Tooth Replacements

Conference Paper

Apr 2000

Biologic and Mechanical Stability of Single-Tooth Implants:4- to 7Year Follow-up

Article

Oct 2001
CLIN IMPLANT DENT R

Michael R Norton

Background: Single-tooth implants have been reported to achieve a high level of surgical and prosthetic success. However, close inspection of the literature reveals a paucity of data on the follow-up of single-tooth implants in function for 5 years or more. Since unsplinted implants may be considered to be subject to greater functional stresses, there is a need to report on the long-term biologic and mechanical integrity of such implant-supported restorations. Purpose: To report on the long-term follow-up of single-tooth implants, restored and in function for 4 to 7 years. Materials and Methods: Twenty-seven Astra Tech single-tooth implants were subject to a clinical audit to evaluate implant and prosthetic success as well as response of both hard and soft tissues over a 1- to 4-year follow-up. This current report presents data on the biologic and mechanical integrity of 23 of these single-tooth implants, which have been in function for up to 7 years (mean, 63 mo). Data are provided with respect to implant survival, maintenance of marginal bone levels, soft-tissue health, and the recording of any adverse events, including prosthetic complications. Results: Only 14 implants in 13 patients were available for review, with no failures for this group of implants. One patient from the original group, who was lost to follow-up, was known to have suffered an implant failure. Furthermore, in accordance with established criteria, the remaining 13 implants that are not included in this report must at this time also be considered as potential failures. As such, the best-case scenario would be a 95.6% success rate for the 23 implants included in this review and the worst-case scenario would be a 60.8% success rate. Mean marginal bone loss measured 0.49 mm mesially and 0.76 mm distally, with a frequency of bone loss of 50%. Soft tissues were clinically healthy. There were few adverse events, with only one case of abutment screw loosening, detected at the 6-year review. In addition, crown decementation was recorded three times in two patients. Conclusions: It can be concluded that the Astra Tech single-tooth implant can achieve long-term biologic and mechanical stability when used to restore single missing teeth, over the long-term.

The microbiota associated with successful or failing osseointegrated titanium implants

Article

Dec 1987
ORAL MICROBIOL IMMUN

Abstract In this study the microbiota associated with oral endosteal titanium hollow cylinder implants (ITI) was studied using microscopic, immunochemical and cultural methods. Samples from 5 edentulous patients with successfully incorporated implants serving as abutments for overdentures for more than one year were compared with samples from 7 patients with clinically failing implants. Unsuccessful sites were characterized by pocket probing depths of 6 mm or more, suppuration and visible loss of alveolar bone around the implant as visualized on radiographs. These sites harbored a complex microbiota with a large proportion of Gram-negative anaerobic rods. Black-pigmented Bacteroides and Fusobacterium spp. were regularly found. Spirochetes, fusiform bacteria as well as motile and curved rods were a common feature in the darkfield microscopic specimens of these sites. Control sites in the same patients harbored small amounts of bacteria. The predominant morphotype was coccoid cells. Spirochetes were not present, fusiform bacteria, motile and curved rods were found infrequently and in low numbers. The microbiota in control sites in unsuccessful patients and in site in successful patients were very similar. On the basis of these results, it is suggested that “periimplantitis” be regarded as a site specific infection which yields many features in common with chronic adult periodontitis.

Regeneration of Gingival Papillae after Single-Implant Treatment

Article

Aug 1997

Torsten Jemt

An index to assess the size of the interproximal gingival papillae adjacent to single implant restorations was described and preliminary tested in a pilot study of retrospective material comprising 25 crowns in 21 patients. The result indicated a significant spontaneous regeneration of papillae (P < .001) after a mean follow-up period of 1.5 years. Based on these results, the general conclusion was made that the proposed index allows scientific assessment of soft tissue contour adjacent to single-implant restorations. The results also indicated that soft tissue changed in a systematic manner during the time period between insertion of the crowns and follow-up 1 to 3 years later.

Long-term follow-up study of osseointegrated implants in the treatment of totally edentulous jaws

Article

Feb 1990

This study reviews the long-term outcome of prostheses and fixtures (implants) in 759 totally edentulous jaws of 700 patients. A total of 4,636 standard fixtures were placed and followed according to the osseointegration method for a maximum of 24 years by the original team at the University of Göteborg. Standardized annual clinical and radiographic examinations were conducted as far as possible. A lifetable approach was applied for statistical analysis. Sufficient numbers of fixtures and prostheses for a detailed statistical analysis were present for observation times up to 15 years. More than 95% of maxillae had continuous prosthesis stability at 5 and 10 years, and at least 92% at 15 years. The figure for mandibles was 99% at all time intervals. Calculated from the time of fixture placement, the estimated survival rates for individual fixtures in the maxilla were 84%, 89%, and 92% at 5 years; 81% and 82% at 10 years; and 78% at 15 years. In the mandible they were 91%, 98%, and 99% at 5 years; 89% and 98% at 10 years; and 86% at 15 years. (The different percentages at 5 and 10 years refer to results for different routine groups of fixtures with 5 to 10, 10 to 15, and 1 to 5 years of observation time, respectively.) The results of this study concur with multicenter and earlier results for the osseointegration method.

The microbiota associated with succesful or failing titanium osseointegrated implants

Article

Jan 1988

Single-Tooth Replacement by Osseointegrated Astra Tech Dental Implants: A 2-Year Report

Article

Jul 1997
INT J PROSTHODONT

This study presents the outcome of single-tooth restorations supported by Astra Tech single-tooth implants followed for 2 years. Forty-seven implants were placed in the same number of patients. Forty-three patients attended the second recall visit, and none of the evaluated implants have been removed. The mean marginal bone loss after 2 years of service was 0.31 (SD = 0.48) mm. Overall, few complications were recorded during the 2-year period, the most frequent of which were loose crowns (7). Int J Prosthodont.

A 5-Year Multicenter Study on Implant-Supported Single Crown Restorations

Article

Mar 1998

In this multicenter prospective study, the results achieved with the use of Brånemark implants for single tooth replacement were evaluated. The overall cumulative success rate was 95.9% for implants and 91.1% for crowns. Two of the 99 implants placed had to be removed before the prosthodontic stage of treatment; thus, 97 were restored with CeraOne crowns. Seventy-seven implants were evaluated radiographically at the 1-year follow-up, 57 at 3 years, and 47 at 5 years. Mean marginal bone resorption was well within the limits set by Albrektsson et al in 1986. The status of the soft tissue around crowns and adjacent teeth remained stable over the evaluation period. The gold abutment screw in the CeraOne system seems to have eliminated the problem of loosening abutment screws in single tooth replacements. The results suggest that the Brånemark system can be safely used for tissue-integrated replacement of single teeth.

Meta-analysis of implants in partial edentulism

Article

May 1998

A meta-analytic technique was used to estimate the survival of implants supporting bridges or single crowns in partially edentulous patients. A survey of the literature revealed 66 studies, published between 1986 and 1996. Nine studies on single implants and 10 studies on fixed partial dentures met the inclusion criteria for the meta-analysis. Data from a total of 2686 implants, 570 single crowns (SC) and 2116 in fixed partial dentures (FPD), were analyzed. In order to calculate annual survival rates for individual studies a life-table analysis was conducted. Maximum follow-up time ranged between 1 and 8 years. After 1 year the success rate was calculated to be at least 85.7% for FPD and 97.2% for SC. When the results from the FPD studies were pooled the survival rate was 93.6% after 6-7 years. The corresponding value for SC was 97.5%.

Five-year prospective follow-up report of the Astra Tech Dental Implant System in the treatment of edentulous mandibles

Article

Sep 1998

This report of the 1st 2 prospective studies using the Astra Tech Implant System and fixed detachable bridges for rehabilitation of mandibular edentulism, presents clinical and radiographic data at the 5-year follow-up. The original material comprised 109 subjects, 56 of whom had been included in the original study, using the 1st generation Astra Tech Implant. Two subjects were excluded and the 3-year follow-up report was based on the remaining 54 subjects and 310 fixtures. After some minor changes to the fixture and the abutment, the 2nd generation Astra Tech Implant was used in 53 subjects and 308 fixtures. In all 16 subjects were lost to follow-up and the 5-year results are based on the remaining 91 subjects with 517 fixtures in function: 5 fixtures were lost due to mobility at abutment installation and during the 1st year, 2 fixtures were removed due to pain, and after 4 years in situ 1 fixture failed. As no clinical or radiographic differences were obvious in the annual registrations of the 2 studies the results have been combined. The fixed bridges were removed at 3 and 5 years to test each fixture and none was mobile. The cumulative fixture survival rate at 5 years was 98.7% and the bridge survival rate was 100%. Of the sites 82% were plaque free, and 96.8% showed no signs of inflammation. Over the 5-year period after bridge insertion, i.e. from baseline registration, there was only minor deterioration in marginal bone levels as measured on standardized intraoral radiographs: the mean differences in mm and standard deviations (SD) were -0.09 (0.27) in the 1st year, -0.20 (0.40) in the 3rd year, and -0.26 (0.53) in the 5th year. According to the stringent clinical and radiographic criteria by Albrektsson and co-workers, the successful treatment outcome and the survival rate in 91 subject over 5 years, indicates that the Astra Tech Dental Implant System with fixed detachable bridges is an appropriate method for rehabilitation of mandibular edentulism.

Implant supported single-tooth replacements compared to contralateral natural teeth - Crown and soft tissue dimensions

Article

Jul 1999

The aim of this study was to make a comparative evaluation of crown and soft tissue dimensions between implant-supported single-tooth replacements and the contralateral natural tooth. Twenty patients, who had been treated with an implant-supported single-tooth replacement in the esthetic zone of the maxillary jaw and had i) a non-restored contralateral natural tooth and ii) completed the implant-supported crown restoration at least 6 months prior to the scheduled follow-up examination, were included in the study. At the re-examination various variables describing crown form, soft tissue dimensions and soft tissue conditions were assessed. In addition, the patient's overall satisfaction with the esthetic outcome of the implant-supported single crown was scored using a Visual Analogue Scale (VAS). In 12 of the subjects clinical photographs were available from the time of crown insertion for evaluation of longitudinal alterations of the papilla height. The results revealed that, in comparison to the contralateral natural crown, the implant supported crown i) was longer, ii) had a smaller facio-lingual width, iii) was bordered by a thicker facial mucosa, iv) had a lower height of the distal papilla, v) showed a higher frequency of mucositis and bleeding on probing and vi) showed greater probing depths. The longitudinal evaluation of the papillae adjacent to the implant crown showed an improved proximal soft tissue fill at the follow-up examination. The VAS scoring of the patients' satisfaction with the appearance of their single implant-supported restorations revealed a median value of 96% with a range from 70 to 100%. Hence, observed differences in clinical crown height and soft tissue topography between implant-supported single-tooth replacements and the contralateral natural tooth may in most patients be of minor importance for the appreciation of the esthetic outcome of implant therapy.

Esthetic Outcome of Implant-Supported Single-Tooth Replacements Assessed by the Patient and by Prosthodontists

Article

Jul 1999
INT J PROSTHODONT

The objective of this study was to assess and compare patients' and clinicians' judgments of the esthetic outcome of implant-supported single-tooth replacements. In all, 29 patients with 41 single implant-supported crowns in the maxillary anterior region participated in the study. The esthetic outcome of the implant-supported crowns was assessed by the patients and by 5 prosthodontists by means of a questionnaire in which various esthetics-related variables were addressed and responded to using visual analogue scales. Multiple regression analyses were used to evaluate the influence of the variables on the "overall satisfaction" with the implant-supported crown. Most variables in the patients' assessments revealed mean values above 90% and median values close to 100%. No single factor used in the multiple regression analysis was found to influence a patient's satisfaction with appearance of the crown at a statistically significant level. The clinicians' degree of satisfaction was for all variables lower than that of the patients. In 89% of the cases the clinicians could correctly locate the single implant-supported crown. Among the variables assessed, surrounding soft tissue appearance and form of the crown had the strongest influence on the clinician's overall satisfaction with the appearance of the crown. Appreciation of the esthetic outcome of the single implant-supported crowns was rated higher by the patients than by the prosthodontists. Furthermore, factors considered by professionals to be of significance for the esthetic result of the restorative treatment may not be of decisive importance for the patient's satisfaction.

A Systematic review of single-tooth restorations supported by implants

Article

Jun 2000
J DENT

To make an inventory of clinical studies on single-tooth restorations supported by implants using a systematic review procedure and to aggregate overall survival results. Papers referring to single-tooth implants were located by a MEDLINE search 1990 to April 1998. Three hundred and twenty references were found, and they were subjected to a systematic review procedure. A three-step inclusion/exclusion procedure was applied to identify papers that represented: good scientific practice (GSP), reported results of all patients, implants and crowns for more than 2years, and had sufficient data to generate life-table analyses. The outcomes were 'implant failure' and 'crown completion'. Nine studies survived. These data showed an overall mean GSP of 0.37 with a predicted 4year implant survival of 97% (n=459), and an uncomplicated crown maintenance of 83% (n=240). Single-tooth implants show an acceptable short-term survival of 4years, but crown complications are common.

A Retrospective Evaluation of 259 Single-Tooth Replacements by the Use of Brånemark Implants

Article

Nov 1999
INT J PROSTHODONT

S Scholander

The main purpose of this retrospective study was to investigate the clinical outcome of the treatment with 259 consecutively placed Brånemark system implant-supported single crowns. There were 259 implants placed in 183 patients with a mean age of 29.8 years; 230 (89%) were placed in the maxilla and 29 (11%) were placed in the mandible. Of the prosthetic restorations, 165 were all-ceramic (68%), 79 were metal-ceramic (31%), and 4 were gold-acrylic (1%). The observation period ranged from 1 to 9 years. A total of 9 patients (10 implants) was lost to follow-up. There were 3 implant failures registered, one before loading and one during the first year in function; one implant fractured after 6 years in service, giving a cumulative success rate for implants of 98.3%. A total of 8 crowns was remade following prosthetic complications; otherwise, the frequency of adverse events was low. The bone loss was of the same magnitude as in other studies on Brånemark implants as support for single crowns. In general, the soft tissue conditions around the restorations were healthy and comparable to those of the patients' natural teeth. This study confirms the favorable results presented in other studies on Brånemark implants to support single-tooth restorations.

A 5-year prospective study of Astra Tech single tooth implants

Article

May 2000

To evaluate the AstraTech Implant ST (Molndal, Sweden) for single tooth replacement clinically and radiographically after 5 years in function. Fifteen patients (age range 16 to 48) with missing maxillary anterior teeth (6 central incisors, 8 laterals, 1 bicuspid) had four 13 mm and eleven 15 mm single tooth implants provided. All patients were seen at 4- to 6-monthly intervals for oral hygiene maintenance. Periapical radiographs using Rinn holders and a long cone technique were taken at the crown insertion and after 1 year, 3 and 5 years. No implant losses were observed in 14 of the 15 patients available for evaluation. No abutment screw loosening or soft tissue problems were observed. At crown insertion the mean bone level was 0.46 +/- 0.55 to 0.48 +/- 0.56 mm apical to the top of the implant neck and there were no statistically significant changes in the radiographic bone level over the 5 years of the study (0.36 +/- 0.37 to 0.43 +/- 0.46 mm at year 5). One crown was recemented after 18 months in function and 1 crown was replaced because of a fracture to the porcelain incisal edge. The Astra Tech Implants ST were highly successful in single tooth replacement and bone levels during 5 years of function were stable.

Biologie Outcome of Single-Implant Restorations as Tooth Replacements: A Long-term Follow-up Study

Article

Feb 2000

The replacement of a single tooth or several teeth by means of single-implant restorations is an increasingly used method that needs long-term validation. The goal of this study was to evaluate the outcome of single-implant restorations by means of fixed restorations and to define the prognosis through marginal bone level estimations. From November 1986 to June 1998, 270 Brånemark implants (215 in the upper jaw) were installed in 219 patients (106 males). Both anterior and posterior sites were involved. Of the 263 single restorations, 28 were placed in private dental offices. The patients were followed until June 1999. Twelve implants failed before or at abutment connection or within 6 months afterward. Only four implants failed later. The cumulative success rates were 93% for the implants and 96.5% for the restorations over a period of 11 years. The marginal bone loss during the first 6 months after abutment connection reached 0.71 mm and then dropped to 0.036 mm annually over a period of 10 years. Single-implant restorations (Brånemark System) are a reliable treatment with a good long-term prognosis. Failures were concentrated during the healing period and early loading phase.

Clinical evaluation and prosthetic complications of single tooth replacements by non-submerged implants

Article

Aug 2001

The aim of the present study was to evaluate single tooth replacements by non-submerged implants. In the time period from 1990 to 1998, 72 patients were consecutively admitted for treatment with a total of 109 solid screw ITI-implants supporting single crowns. All crowns were ceramic to metal fused with a ceramic occlusal surface and mounted to the octa-abutment. The mean observation time was 4.3 years, ranging from >1 to 9 years. The implants were monitored regularly by periimplant parameters. Periapical radiographs using the parallel technique were taken after the healing period and in 1999 for comparative measurements. No implant was lost during the healing phase, while 3 failures occurred after a loaded period of 2.5 and >5 years, respectively. The 5-year cumulative survival rate was 99.1%. In the course of the study, only 2 implants exhibited marginal inflammation that required treatment. The radiographically measured distance (DIB) from the implant shoulder to the first implant-bone contact was significantly increased in 1999 and different between the two readings. However, this difference in DIB was not significant between implants with a short (1 year) and long (>5 years) observation period. It was concluded that changes in the crestal bone level occur mostly in the first postsurgical year. Prosthetic complications were rare, mostly encountered in the first year after loading and often limited to re-tightening of the occlusal screw.

Predictability of soft tissue form around single-tooth implant restorations

Article

Mar 2003

George Priest

The objective of this study was to answer important questions about gingival responses to single-tooth implants: (1) Are papilla regeneration and sulcular recession expected results? (2) Do soft tissue profiles retain their sulcular form over an extended period? and (3) Do single-implant replacements require special restorative handling to achieve predictable soft tissue form? A retrospective, photographic examination was used to follow 55 single-implant restorations in 51 patients for a period from 1 to 9 years (mean 3.5 years). Papillae regenerated in 83.9% of implants for a mean growth of 0.65 mm mesially and 0.62 mm distally. The sulcular apex receded in 59% of patients for a mean of 0.06 mm. Complete papilla fill was noted in 75% of patients examined. Short- to long-term measurements revealed that papilla regrowth continued slightly and that sulcular recession abated. Papilla regeneration around single implants was a predictable outcome in this population; sulcular recession was not a predictable finding. Papilla levels demonstrated a tendency toward increasing height, and sulcular levels remained fairly constant over the long term. Predictable soft tissue profiles were achieved with a simplified implant prosthetic protocol, progressing directly from healing abutments to definitive crowns in most cases.

Consensus report of session IV

Jan 1994
365-369

T Albrektsson
Isidor

Albrektsson T, Isidor F. Consensus report of session IV. In: Lang NP, Karring T, eds. Proceedings of the 1st European Workshop on Periodontology. London: Quintessence, 1994:365 – 369.

The A 5-Year Prospective Study of Single-Tooth Replacements Supported by the Astra Tech R Implant 7 microbiota associated with successful or failing osseointe-grated titanium implants

Jan 1987
145-151

A Mombelli
Van Oosten Mac
E Schü
Lang
Np

Mombelli A, van Oosten MAC, Schü E, Lang NP. The A 5-Year Prospective Study of Single-Tooth Replacements Supported by the Astra Tech R Implant 7 microbiota associated with successful or failing osseointe-grated titanium implants. Oral Microbiol Immunol 1987; 2:145 – 151.

A 5-Year Prospective Study of Single-Tooth Replacements Supported by the Astra Tech� Implant: A Pilot Study

Abstract

No full-text available

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