bluuebunny/crossref_metadata_2025 huggingface dataset:
Accidental Deaths Caused by Electricity in Sweden, 1975–2000
Authors: Lindström Richard , Bylund Per‐Olof , Eriksson Anders
Published: October 2006

ABSTRACT: This study analyzes accidental fatalities caused by electricity—at work and during leisure time—to evaluate risk factors, the role of alcohol, and to identify possible preventive strategies. In Sweden, data on fatalities by electrocution from 1975 through 2000 were collected from the National Cause‐of‐Death Register. Additional cases were found in the archives of The Swedish National Electrical Safety Board. Suicides and deaths by lightning were excluded. Two hundred and eighty‐five deaths were found, including occupational (n=132), leisure time (n=151), and unknown (n=2). Most deaths were caused by aerial power lines, and the most common place for an electrical injury was a railway area or residential property. Postmortem blood from 20% (n=47) of the tested cases was found positive for alcohol, and these persons were killed mainly during leisure time. During the study period, the overall incidence of electricity‐related fatalities has decreased, in spite of increased use of electricity. This indicates that safety improvements have been successful.
Clinical and Histologic Findings for Microimplants Placed in One Stage and Loaded for Three Months: A Case Report
Authors: Becker William , Sennerby Lars , Becker Burton E. , Henry Patrick
Published: October 2006

Background: Implants are placed in either one or two stages. There is an absence of histologic human evidence relating to implant integration after loading.

Purpose: The purpose of this case report was to present clinical and histologic findings for smooth‐surfaced titanium turned microimplants placed in one stage and loaded after healing.

Materials and Methods: Five one‐piece microimplants were placed in a fully edentulous mandible. Three microimplants (tests) were placed in one stage and extended through the keratinized mucosa for 3 mm. Two additional microimplants (controls) were placed even with the mucosa. After 3 months of healing, three test implants were loaded for an additional 3 months. At this time, three loaded implants and one control were removed en bloc.

Results: Histologic and histometric evaluations were made. For all specimens, there was excellent bone‐to‐implant contact. The loaded implants had from two to four exposed threads. Using marginal bone levels as the reference, the highest percentage of bone‐to‐implant contact was noted with the unloaded control implant (92.2%). One nonaxially loaded implant had 66.9% bone‐to‐implant contact, whereas the axially loaded implants (n = 2) had 77.8% bone‐to‐implant contact.

Conclusions: Within the limits of this case report, smooth‐surfaced, titanium threaded microimplants placed in one stage and loaded for 3 months demonstrated excellent osseointegration, with varying bone‐to‐implant contact. The amount of bone‐to‐implant contact may be related to axial implant loading.
Histologic Evaluation of a Human Immediately Loaded Titanium Implant with a Porous Anodized Surface
Authors: Degidi Marco , Petrone Giovanna , Iezzi Giovanna , Piattelli Adriano
Published: October 2006

Background: Several researchers have demonstrated, in the past decade, in clinical and histologic studies, that immediate loading can be successfully used in implant dentistry. Many factors are thought to be of importance in obtaining mineralized tissues at the interface. One of these factors is the implant surface characteristics. Recently, an implant with a new porous anodized surface has been introduced in the market.

Purpose: The goal of this study was to histologically evaluate a clinically retrieved immediately loaded implant with a porous anodized surface.

Materials and Methods: After a 6‐month loading period, an immediately loaded implant with a porous anodized surface that had been inserted in the posterior maxilla was retrieved.

Results: Histology showed that mineralized tissue was present at the interface and the bone‐implant contact percentage was about 60%. No gaps or fibrous tissue or inflammatory infiltrate were present at the interface.

Conclusions: Results show that immediate loading of dental implants has no untoward effects on the formation of mineralized tissues at the interface. Immediate loading is a possible alternative in implant dentistry.
Nonsubmerged and Submerged Implants in the Treatment of the Partially Edentulous Maxilla
Authors: Åstrand Per , Engquist Bo , Anzén Bengt , Bergendal Tom , Hallman Mats , Karlsson Ulf , Kvint Sven , Lysell Leif , Rundcrantz Torgil
Published: October 2006

Background: Dental implants vary in design and surfaces. In addition, different surgical techniques have been used for implant insertion. The ITI Dental Implant System (Straumann AG, Waldenburg, Switzerland) has always required a one‐stage technique, whereas the Brånemark System (Nobel Biocare AB, Gothenburg, Sweden) requires a two‐stage technique.

Purpose: The aim of this study is to compare the outcome of fixed partial bridges in the maxilla supported by both ITI and Brånemark implants in a split‐mouth design.

Materials and Methods: Twenty‐eight patients with a residual anterior dentition in the maxilla were included in this split‐mouth study. The Brånemark implants were used on one side and the ITI implants on the other side of the residual dentition according to a randomization procedure. A blocking size of four was used, giving equal probability of placing ITI or Brånemark implants in the right or left side of the jaw. The surgical and prosthetic procedures followed the guidelines given by the manufacturers. The prosthetic treatment with the two‐implant systems was performed at the same time, and for that reason the healing period was 6 months for both systems. The observation period for all patients was 1 year after loading.

Results: Two Brånemark implants (in one patient) were lost before loading, and one ITI implant was lost 1 year after loading. There was no significant difference in survival rate. Radiographie examination of the bone level was performed at the time of delivery of the bridge and after 1 year. The mean marginal bone level at baseline was situated 1.9 mm from the reference point for the Brånemark implants and 1.5 mm for the ITI implants. With regard to the insertion depth used, these bone levels indicate that bone loss had taken place before baseline. However, between baseline and the 1‐year examination, there was no significant change of the marginal bone (0.2 ± 0.08 mm at the Brånemark implants and 0.1 ± 0.11 mm at the ITI implants). The difference between results with the two implants was not statistically significant. Crater‐form bone destructions were seen at some ITI implants, indicating periimplantitis. However, at only two implants were there clinical signs of periimplantitis.

Conclusions: No significant difference in survival rate or in marginal bone change could be demonstrated between the two systems. At some ITI implants (18%), crater‐form bone loss was observed.
Ten‐Year Results of a Prospective Study Using Porous‐Surfaced Dental Implants and a Mandibular Overdenture
Authors: Deporter Douglas , Watson Philip , Pharoah Michael , Todescan Reynaldo , Tomlinson George
Published: October 2006

Background: Numerous investigators have used osseointegrated dental implants as retention for mandibular overdentures, but few have reported 10‐year outcomes or incorporated carefully standardized radiographs to document crestai bone loss.

Purpose: The purpose of this study was to use a prospective clinical trial design to assess the performance of short sintered porous‐surfaced dental implants with a mandibular complete overdenture when all patients in the trial had undergone 10 years of continuous function.

Materials and Methods: Fifty‐two fully edentulous patients, most with advanced alveolar ridge resorption, each received three free‐standing Endopore implants (7–10 mm in length, mean length, 8.7 mm; Innova Corporation, Toronto, ON, Canada) in the mandibular symphysis region. After 10 weeks of submerged healing, these implants were used to support an overdenture. Carefully standardized radiographs, using a customized stainless steel filmholder attached to each implant and the x‐ray tube, were collected at baseline, 3 months, 6 months, yearly to 5 years, and then again at 7 and 10 years.

Results: Life table analysis revealed a 10‐year implant survival of 92.7% and a mean annual bone loss after year 1 of 0.03 mm.

Conclusion: Short free‐standing dental implants with a sintered porous surface used for implant fixation are a predictable and effective means of retaining a mandibular overdenture in patients with advanced mandibular ridge resorption.
Preservation of Esthetics with Implant Dentistry: a Clinical Report
Authors: Vergara Jaime A. , Caffesse Raúl G.
Published: October 2006

Background: The replacement of single teeth with implants in the anterior maxilla poses a significant challenge to the clinician because of its esthetic implications.

Purpose: The purpose of this article is to report a protocol in which single teeth are replaced by implants and temporarily restored without load, immediately after extraction.

Materials and Methods: Between June 2001 and July 2002, 16 cases were followed up in which this protocol was used. Briefly, the teeth are extracted with a Periotome (Friadent, Mannheim, Germany), using a napless technique, the sockets are evaluated and débrided, an osteotomy is performed following the direction of the socket, and a tapered implant is placed using the alveolar crest as the landmark. A temporary abutment is immediately custom made, and a temporary crown is placed without loading. The 16 cases are summarized, and 4 of them are presented to illustrate this approach.

Results: All four cases have provided excellent esthetic results maintaining an ideal implant‐to‐supporting‐tissue relationship. Furthermore, the overall time needed to restore the cases was considerably reduced when compared with time needed for the conventional approach.

Conclusion: The four cases presented support the use of the described protocol in the placement of single implants in areas of the maxillary anterior region where esthetics is a high priority.
Immediate and Early Function of Brånemark System® Implants Placed in the Esthetic Zone: A 1‐Year Prospective Clinical Multicenter Study
Authors: Maló Paulo , Friberg Bertil , Polizzi Giovanni , Gualini Federico , Vighagen Torbjörn , Rangert Bo
Published: October 2006

Background:

Immediate/early implant function means great benefits for patients and therapists because treatment time and cost can be substantially reduced. This concept has become an accepted alternative for complete arch fixed restorations in the mandible, and clinical documentation is emerging for other indications.

Purpose:

The purpose of this prospective clinical multicenter study was to evaluate the outcome of implants placed in incisor, canine, and premolar regions in maxillas or mandibles. Implants were loaded with provisional crowns and bridges on the same day or within a few days and were followed up for 1 year during function.

Materials and Methods:

Four centers treated 76 patients each in need of an implant‐retained prosthesis in the anterior and premolar regions in the maxilla or mandible. A total of 116 titanium implants with machined surfaces (Brånemark System®, Nobel Biocare AB, Gothenburg, Sweden) were placed: 74 in maxillas and 42 in mandibles. Eighty‐seven prostheses were made, of which 63 were single crowns and 24 were bridges (supported by 53 splinted implants). Twenty‐two implants in 14 patients were placed in fresh extraction sites. The goal with the preparation and insertion technique was to achieve good primary implant stability and a minimum implant insertion torque of 30 Ncm before the implant was completely seated. The occlusion was adjusted to eliminate direct contact with the provisional prostheses. After 6 months, the patients received their permanent prostheses. Sixty‐seven patients were followed for 1 year.

Results:

Five implants were lost in five patients, three in the maxilla and two in the mandible. Four of the lost implants were single‐tooth replacements and one was splinted. The cumulative survival rate (CSR) was 95.7% for all implants after 1 year and 93.7% and 98.1% for single‐tooth and splinted implants, respectively. There were no implant losses in the extraction sites.

Conclusions:

The CSR of 96% at 1 year indicates that immediate function of Brånemark System implants placed in incisor to premolar regions in both jaws is a viable concept. More failures occurred with single‐tooth replacements (6.3%) than with splinted implants (1.9%).
Immediate Loading of Brånemark System® TiUnite™ and Machined‐Surface Implants in the Posterior Mandible: A Randomized Open‐Ended Clinical Trial
Authors: Rocci Antonio , Martignoni Massimiliano , Gottlow Jan
Published: October 2006

Background:

Immediate loading of osseointegrating implants shortens the treatment time and makes it possible to give the patient an esthetic appearance during the whole treatment period. A previous retrospective clinical study showed a success rate of 94.2% after 1 year of immediate loading of fixed partial constructions in the maxilla supported by machined‐surface implants. The recently introduced Brånemark System® TiUnite™ (Nobel Biocare AB, Gothenburg, Sweden) surface has been shown to better maintain primary implant stability and to help achieve secondary stability earlier compared with the machined surface.

Purpose:

The aim of the present study was to compare TiUnite and machined‐surfaced Brånemark System implants when applying immediate loading of partial fixed bridges in the posterior mandible.

Materials and Methods:

Forty‐four patients were randomized for test and control therapy. In the test group, 22 patients received 66 Brånemark System TiUnite surface implants supporting 24 fixed partial bridges, all of which were connected on the day of implant insertion. In the control group, 22 patients received 55 Brånemark System machined‐surface implants supporting 22 fixed partial bridges, which also were connected on the day of implant insertion. All constructions were two‐ to four‐unit bridges. Bone quality and quantity were assessed. Radiographic examinations were performed on the day of surgery/loading and at the 1‐year follow‐up visit.

Results:

Three TiUnite and eight machined‐surface implants failed during the first 7 weeks of loading. This resulted in a cumulative success rate of 95.5% for TiUnite surface implants after 1 year of prosthetic load in the posterior mandible. The corresponding cumulative success rate for machined‐surface implants was 85.5%. When using the machined‐surface implants, the number of failed implants was significantly higher in smokers and in bone quality 4 sites. Such findings were not seen with the use of TiUnite implants, despite the fact that there were more smokers and more implants placed in bone quality 4 in this group. The marginal bone resorption after 1 year of loading was on average 0.9 mm (SD 0.7 mm) with the TiUnite implants and 1.0 mm (SD 0.9 mm) with the machined implants.

Conclusions:

The present study demonstrated a 10% higher success rate following immediate loading of partial fixed bridges in the posterior mandible supported by TiUnite surface implants compared with success with machined implants. When using the machined implants, the number of failed implants was significantly higher in smokers and in bone quality 4 sites. Such findings were not seen following the use of TiUnite implants.
Spontaneous Bone Formation in the Maxillary Sinus after Removal of a Cyst: Coincidence or Consequence?
Authors: Lundgren Stefan , Andersson Sten , Sennerby Lars
Published: October 2006

Background: Maxillary sinus floor‐augmentation techniques are frequently used to increase the bone volume in the posterior edentulous maxilla to enable placement and integration of titanium implants.

Purpose: The purpose of this report is to document an unexpected healing pattern after maxillary sinus surgery and to discuss the implications for future bone‐augmentation techniques.

Materials and Methods: In a patient referred for sinus augmentation, an intrasinus mucosal cyst was removed 3 months prior to the planned augmentation procedure. A replaceable bone window was prepared in the lateral aspect of the sinus wall. The cyst was removed, the ruptured mucosa was sutured, and the bone window was replaced, resulting in a secluded space in the sinus.

Results: After 3 months of healing, the space between the replaced bony window and the lifted sinus membrane was filled with newly formed bone. The surgical technique was repeated in a second patient and resulted in a similar bone reformation pattern.

Conclusion: Surgical trauma and the creation of a secluded space between the bone surfaces and the sinus mucosa result in spontaneous bone formation in the maxillary sinus. The surgical approach described may be used to achieve bone reformation to enable placement of dental implants without the addition of any grafting material.
Space‐Providing Expanded Polytetrafluoroethylene Devices Define Alveolar Augmentation at Dental Implants Induced by Recombinant Human Bone Morphogenetic Protein 2 in an Absorbable Collagen Sponge Carrier
Authors: Wikesjö Ulf M.E. , Qahash Mohammed , Thomson Robert C. , Cook Aionzo D. , Rohrer Michael D. , Wozney John M. , Hardwick W. Ross
Published: October 2006

Background: Surgical implantation of recombinant human bone morphogenetic protein 2 (rhBMP‐2) in an absorbable collagen sponge carrier (ACS) significantly enhances bone regeneration in horizontal alveolar defects; however, sufficient quantities of bone for implant dentistry are not routinely obtained.

Purpose: The objective of this proof‐of‐principle study was to evaluate the potential of a space‐providing macroporous expanded polytetrafluoroethylene (ePTFE) device to control volume and geometry of rhBMP‐2/ACS‐induced alveolar bone augmentation.

Materials and Methods: Bilateral critical‐size supra‐alveolar periimplant defects were created in four Hound‐Labrador mongrel dogs. Two turned and one surface‐etched 10 mm titanium dental implants were placed 5 mm into the surgically reduced alveolar ridge creating 5 mm supra‐alveolar defects. rhBMP‐2/ACS (0.4 mg rhBMP‐2) was placed around the exposed dental implants. Additionally, one jaw quadrant in each animal was randomly assigned to receive the domeshaped macroporous ePTFE device. Mucoperiosteal flaps were advanced for primary wound closure. The animals were euthanized at 8 weeks post surgery for histometric analysis.

Results: The space‐providing macroporous ePTFE device defined the volume and geometry of rhBMP‐2/ACS‐induced bone formation, whereas bone formation at sites receiving rhBMP‐2/ACS alone varied considerably. Vertical bone gain at turned dental implants averaged (SD) 4.7 ± 0.2 mm at sites receiving rhBMP‐2/ACS and the ePTFE device compared with 3.5 ± 0.9 mm at sites receiving rhBMP‐2/ACS only. The corresponding values for rhBMP‐2/ACS‐induced bone area were 9.6 ± 0.7 mm 2 and 7.5 ± 6.2 mm 2. There was a highly significant correlation between induced bone area and the space provided by the ePTFE device (p .001). There was no difference in induced bone density or bone‐implant contact between the two technologies. These observations were consistent with those observed at surface‐etched dental implants.

Conclusions: The data from this study suggest that a space‐providing macroporous ePTFE device defines rhBMP‐2/ACS‐induced alveolar augmentation to provide adequate bone quantities for implant dentistry. The dental implant surface technology does not appear to substantially influence bone formation.
Prospective Multicenter Study on Immediate Rehabilitation of Edentulous Lower Jaws According to the Brånemark Novum Protocol
Authors: Henry Patrick J. , van Steenberghe Daniel , Blomback Ulf , Polizzi Giovanni , Rosenberg Ruben , Pi Urgell Joan , Wendelhag Inger
Published: October 2006

Background: During recent years a new treatment concept, Brånemark Novum, has been developed in which implants are inserted in the edentulous lower jaw and immediately connected to a prefabricated titanium bar. A fixed prosthesis is then attached to the bar during or immediately following surgery.

Purpose: The aim of the present study was to investigate the application of this concept under various settings, to determine technique sensitivity, and to evaluate the clinical outcome after 1 year of follow‐up.

Materials and Methods: Fifty‐one patients were included in a prospective multicenter investigation and followed up for 1 year. Cumulative implant survival rates were evaluated by life table analysis. In addition, clinical comparisons were performed to evaluate implant loss in relation to patient characteristics. Questionnaires were used to evaluate the treatment protocols and to obtain patients' opinions.

Results: The prosthetic treatment was completed on the same or the following day in 76% of the patients. The cumulative implant survival rates for implants and prostheses were 91% and 94%, respectively, after 12 months.

Conclusions: The present study demonstrated that single‐stage surgery and immediate loading of implants with prefabricated bridgework in the mandible can result in high implant success and significant reduction in treatment time, with patient satisfaction.
Tapered Implants in Jaws with Soft Bone Quality: A Clinical and Radiographie 1‐Year Study of the Brånemark System Mark IV Fixture
Authors: Åstrand Per , Billström Camilla , Feldmann Hartmut , Fischer Kerstin , Henricsson Vincent , Johansson Björn , Nyström Elisabeth , Sunzel Bo
Published: October 2006

Background: The survival rate of oral implants in soft‐quality bone has been demonstrated to be inferior to that of implants inserted in good‐quality bone. A possible way to increase the survival rate in soft‐quality bone may be to use a tapered implant. Such an implant has been developed and manufactured by Nobel Biocare AB, Gothenburg, Sweden. So far, there have been only a few publications regarding this implant.

Purpose: The aim of the study was to compare the outcome of using the tapered Branemark System Mark IV fixture with the outcome of using earlier Brånemark fixtures in a controlled prospective study.

Materials and Methods: The study was performed as a multicenter study including seven specialist centers. The material consisted of 40 patients in need of implant‐supported bridges in the maxilla. Twenty‐five patients belonged to the test group, in which the tapered Mark IV implants were inserted, and 15 patients belonged to the control group, in which Branemark Standard or Mark II implants were used. The patients were allocated to the test group or the control group according to randomization schedules. The implants were inserted according to the guidelines for Branemark implants. A two‐stage surgical protocol was used, and abutment connection was made 6 months after fixture insertion. The test group comprised 97 Mark IV implants, and the control group made up 92 implants. The prosthetic procedure followed the guidelines for Brånemark implants, and all patients were provided with full fixed maxillary bridges. The patients were followed up with clinical and radiographie records for 1 year after loading.

Results: The survival rate was 96.9% for the Mark IV implants and 98.9% for the control implants. There was no significant difference between the two groups. There was a mean marginal bone loss of 0.2 mm during the observation period, and there was no difference between test implants and control implants.

Conclusions: With regard to survival rate and marginal bone level changes, no differences could be demonstrated between the Mark IV tapered implant and the Brånemark implants used earlier. However, compared with earlier results of Brånemark implants in soft‐quality bone, the Mark IV implant demonstrated an improved survival rate.
Microbiologic Diagnostics at Titanium Implants
Authors: Leonhardt Åsa , Bergström Christina , Lekholm Ulf
Published: October 2006

Background: The microbiota found at periimplant lesions have been shown to contain putative periodontal pathogens as well as opportunistic species such as Staphylococcus spp, enterics, and Candida spp. Therefore, a microbiologic diagnosis may be of value as guidance before treatment of such lesions.

Purpose: The aim of this study was to evaluate the prevalence of some putative pathogens associated with long‐term fol‐lowed‐up cases using two different microbiologic procedures.

Malerials and Methods: Fifteen subjects contributed with plaque samples from teeth and implants; these were analyzed with respect to 18 putative periimplant pathogens using cultural methods and a deoxyribonucleic acid DNA‐DNA hybridization technique.

Results: The number of individuals positive for the analyzed pathogens was similar in samples taken from teeth and implants when analyzed with the DNA‐DNA hybridization technique. When comparing detection frequency by culture procedure and by “checkerboard” technique at implants, the number of individuals positive for these species was lower with the traditional culture technique than with the checkerboard analyses. Using a higher cutoff point (4) with the checkerboard technique, the number of positive individuals was generally lower than that found with the culture technique. When comparing the techniques on an implant site level, the prevalence obtained by culture was lower for all analyzed species. If the specific species were present in the samples analyzed by the checkerboard technique, they were present only in every second sample analyzed with the culture technique. The high specificity values showed that if the checkerboard technique did not detect any Porphyromonas gingivalis, Prevotla intermedia, Actinobadllus actinomycetem‐comitans, or Fusobacterium nudeatum, the bacteria were also undetectable by the culture technique. The two methods therefore did not overlap but did supplement each other.

Conclusions: Based on the current results it is recommended that the technique used when analyzing microbiota around titanium implants should be a combination of the two protocols mentioned as they seem to give the most comprehensive outcome when used together.
Influence of Implant Length and Bicortical Anchorage on Implant Stress Distribution
Authors: Pierrisnard Laurent , Renouard Franck , Renault Patrick , Barquins Michel
Published: October 2006

Background: Short implants present superior failure rates for everybody.

Purpose: The aim of this theoretic study was to assess to what extent implant length and bicortical anchorage affect the way stress is transferred to implant components, the implant proper, and the surrounding bone.

Materials and Methods: Stress analysis was performed using finite element analysis. A three‐dimensional linear elastic model was generated. All implants modeled were of the same diameter (3.75 mm) but varied in length, at 6, 7, 8, 9, 10, 11, and 12 mm (Branemark System®, Nobel Biocare AB, Gothenburg, Sweden). Each implant was modeled with a titanium abutment screw and abutment, a gold cylinder and prosthetic screw, and a ceramic crown. The implants were seated in a supporting bone structure consisting of cortical and cancellous bone. An occlusal load of 100 N was applied at a 30° angle to the buccolingual plane.

Results: With the selected model and bone properties, the coronal cortical anchorage was dominating, and the bone stress concentrated to that area.

Conclusions: The maximum bone stress was virtually constant, independent of implant length and bicortical anchorage. The maximum implant stress, however, increased somewhat with implant length and bicortical anchorage.
Implant Stability, Tissue Conditions, and Patient Self‐Evaluation after Treatment with Osseointegrated Implants in the Posterior Mandible
Authors: Farzad Payam , Andersson Lars , Gunnarsson Sten , Sharma Prem
Published: October 2006

Background:

Implant treatment in the posterior mandible is considered challenging because of bone resorption and the presence of the inferior alveolar nerve, which may result in the use of short implants.

Purpose:

To evaluate implant stability, tissue conditions, and patient opinion after treatment with implant‐supported bridges in the posterior mandible.

Materials and Methods:

Thirty‐four patients treated with implant‐supported bridges in the posterior mandible according to a two‐stage protocol were clinically and radiographically examined and interviewed after a mean functional time of 3.9 years. One hundred five Brånemark® implants (Nobel Biocare AB, Gothenburg, Sweden) were placed in premolar and molar regions to support 40 bridges. Twenty‐eight implants were placed anterior to the mental foramen, and 77 implants were placed posterior to the mental foramen. Bridges were supported either by two or by three implants. After 2 to 6 years, the bridges were removed to analyze the resonance frequency of the implants with the use of a special instrument (Osstell™ instrument, Integration Diagnostics AB, Gothenburg, Sweden), and an implant stability quotient (ISQ) was recorded for each implant.

Results:

One implant was lost. An ISQ range of 59 to 90 (mean, 70.05) expressed stability of fully integrated implants in the posterior mandible. Significantly higher (p < .024) ISQ values were found in implants in three‐implant bridges when compared with implants in two‐implant bridges. There were no differences in ISQ values between molars/premolars, implant types, implant widths, implant lengths, anchoring depth, or uni‐ or bilateral mandibular bridges. Good mucosal health in the periimplant soft tissue and minor bone resorption around the implants were observed. Patients were generally very satisfied with the treatment outcome.

Conclusions:

High implant stability can be reached in the posterior mandible. The implants were more stable in three‐implant bridges than in two‐implant bridges. The patients were highly satisfied with the treatment, and few complications were seen.
A Comparison of Two Methods of Enhancing Implant Primary Stability
Authors: O'Sullivan Dominic , Sennerby Lars , Jagger Daryll , Meredith Neil
Published: October 2006

Background:

Surgical technique and implant design have an effect on the primary stability of oral implants, which in turn increases resistance to implant micromotion during healing.

Purpose:

This study was designed to compare the parameters associated with implant insertion using two different methods of enhancing implant primary stability and to identify any relationship between these parameters and changes in the stability of implants during the initial 6‐month healing period following implant insertion. A comparison was made between two methods of enhancing primary implant stability: method 1, standard Brånemark System® implants (Nobel Biocare AB, Gothenburg, Sweden) inserted with a technique designed to enhance primary stability, and method 2: Brånemark Mk IV implants (Nobel Biocare AB) inserted according to the manufacturer's instructions.

Materials and Methods:

Thirteen patients were selected for inclusion in the study. A total of 42 implants were placed. Insertion torque data were recorded, and bone quality at the implant site was assessed at implant insertion. Resonance frequency analysis measurements were taken at implant insertion as well as at second‐stage surgery 6 months later.

Results:

A statistically significant difference was recorded between the mean maximum insertion torque for type 4 bone and bone types 2 and 3. No significant difference was recorded between bone types 2 and 3. A significantly lower resonance frequency value was seen for standard implants placed into type 4 bone (p < .05). Across all implant types a significant difference in the energy required when inserting implants into type 4 bone and bone types 2 and 3 was seen. A significantly lower mean energy requirement was seen between the Mk IV implants placed into type 4 bone and the other combinations of implant types and bone.

Conclusions:

Within the limitations of this study, the results agree with the manufacturer's claim that when compared with standard implants, the design of the Mk IV implant increases implant primary stability with a reduction in the energy imparted into the bone at the implant site.
Measurements of Soft Tissue Volume in Association with Single‐Implant Restorations: A 1‐Year Comparative Study after Abutment Connection Surgery
Authors: Henriksson Kristina , Jemt Torsten
Published: October 2006

Background:

Patients with buccal defects due to tooth extraction seem to regain some of the contour at the time of abutment surgery and connection of single‐implant crown restorations. It can then be assumed that different abutment systems could restore the buccal contour to different degrees.

Purpose:

To measure changes in buccal tissue volume after placing restorations with single‐implant crowns using two different abutment systems and to measure soft tissue change during the 1 year after single‐implant treatment.

Materials and Methods:

Eighteen patients were provided with single‐implant restorations in the central incisor area. Nine patients in each group were treated with single‐implant crowns supported by either CeraOne® abutments (Nobel Biocare AB, Göteborg, Sweden) or customized Procera® ceramic abutments (Nobel Biocare AB). Study casts were made before abutment connection, at crown placement, and after 1 year. After the casts were scanned, they were analyzed with a computer, using the model before abutment as a reference. In the area of the single implant, sagittal projections provided images of the models that allowed measurements between the contours at the different situations. Radiography and photography for measuring papillary volume were also performed.

Results:

All patients exhibited increased “buccal volume” after abutment connection and crown placement (p < .01). A trend to greater increase was observed for the Procera group. Both groups also showed a reduction of buccal tissue 1 year later (p < .05–.01), leaving on average more volume in the Procera group. The papillae recovered spontaneously, and no relationship was observed between the presence of papilla and underlying bone support (p > .05).

Conclusions:

The buccal tissue increased significantly after placement of the abutment cylinder and the implant crown. This increase of buccal contour was reduced after 1 year. Furthermore, no relationship was established between the presence of papillae and the distance between the contact point and the underlying bone crest.
Fixed Implant‐Supported Prostheses in Elderly Patients: A 5‐Year Retrospective Study of 133 Edentulous Patients Older than 79 Years
Authors: Engfors Ingela , Örtorp Anders , Jemt Torsten
Published: October 2006

Background:

An increasing number of elderly patients are treated with implants, but results for the elderly patient in terms of implant success and adaptation to implant prostheses are contradictory.

Objective:

To retrospectively study the 5‐year clinical and radiologic performances of fixed implant‐supported prostheses placed in edentulous elderly patients and to compare those results with the results of using similar prostheses in a control group of younger patients.

Materials and Methods:

The study group comprised 133 edentulous patients who were 80 or more years of age and who were consecutively treated with fixed implant‐supported prostheses between January 1986 and August 1998. Altogether 761 Brånemark System® implants (Nobel Biocare AB, Göteborg, Sweden) were placed in 139 edentulous jaws. The control group comprised 115 edentulous patients who were younger than 80 years and who were treated consecutively from March 1996 to November 1997 with similar prostheses. In this group 670 implants were placed in 118 edentulous jaws. Information was collected from all postinsertion visits, including the fifth annual checkup, and changes of marginal bone levels were analyzed from intraoral radiographs.

Results:

The 5‐year cumulative survival rate (CSR) for implants in the maxilla was 93.0% in the study group and 92.6% in the control group; the corresponding CSRs for implants in the mandible were 99.5% and 99.7%. The most common complications for patients in the study group were soft tissue inflammation (mucositis) and cheek and lip biting (p < .05) whereas resin veneer fractures were the most common complications for the control group. Overall 5‐year marginal bone loss for the study group was 0.7 mm (standard deviation [SD], 0.45) in the upper jaw and 0.6 mm (SD, 0.50) in the lower jaw. Differences in bone levels and bone loss between the two groups did not reach significant levels (p > .05).

Conclusions:

Implant treatment in the elderly patients showed treatment results comparable to those observed in younger age groups. However, indications of more problems with adaptation could be observed and were reflected in more postinsertion problems. Cleaning problems and associated soft tissue inflammation (mucositis) as well as tongue, lip, and cheek biting were significantly more often observed among the elderly patients (p < .05).
A Three‐Year Follow‐Up Report of a Comparative Study of ITI Dental Implants® and Brånemark System® Implants in the Treatment of the Partially Edentulous Maxilla
Authors: Åstrand Per , Engquist Bo , Anzén Bengt , Bergendal Tom , Hallman Mats , Karlsson Ulf , Kvint Sven , Lysell Leif , Rundcranz Torgil
Published: October 2006

Background: Many longitudinal studies of different implant systems have been published but few controlled randomized investigations have been reported. A 1‐year report of a comparative study of ITI Dental Implant System® implants (Straumann AG, Waldenburg, Switzerland) and Brånemark System® implants (Nobel Biocare AB, Gothenburg, Sweden) has been published by the present authors. This paper is a 3‐year follow‐up of that randomized study.

Purpose: The aim of the study was to compare the outcome of fixed partial prostheses supported by ITI or Branemark implants. The outcome was evaluated primarily in terms of survival rates and changes in marginal bone level.

Material and Methods: The study group comprised 28 patients with anterior residual dentition in the maxilla. The patients were provided with two to four implants on each side of the dentition and were randomly allocated to Brånemark implants or ITI implants; 77 ITI implants and 73 Brånemark implants were inserted. After 6 months abutment connections were made to both ITI and Brånemark implants. All patients were provided with fked partial prostheses of gold‐ceramic. The patients were followed up annually with clinical and radiographic examinations for 3 years.

Results: Two Brånemark implants and two ITI implants were lost. The Brånemark implants were lost before loading whereas the ITI implants were lost because of periimplantitis. The survival rate for both groups was 97.3%. The mean marginal bone level of the Brånemark implants was situated 1.8 mm from the reference point at both the baseline and the 3‐year examinations. The corresponding values for the ITI implants were 1.4 mm at baseline and 1.3 mm after 3 years. There was no significant difference between the implant systems with regard to bone level or bone level change. A steady state of the marginal bone level was calculated to have been reached after 3 years for 95.5% of the Brånemark implants and 87.1% of the ITI implants. Periimplantitis (infection including pus and bone loss) was observed with seven ITI implants but with none of the Brånemark implants. This difference was statistically significant.

Conclusions: No statistically significant differences were found between the implants studied, except for the frequency of periimplantitis, which was higher for the ITI implants. The survival rates were high, and the marginal bone loss was small for both systems.
Effects of Bleaching with Carbamide Peroxide Gels on Microhardness of Restoration Materials
Authors: CAMPOS INGER , BRISO ANDRÉ LUIZ FRAGA , PIMENTA LUIZ ANDRÉ FREIRE , AMBROSANO GLAUCIA
Published: October 2006

The objective of this in vitro study was to quantitatively assess the effects of bleaching with 10 and 15% carbamide peroxide (CP) on restoration materials by performing superficial micro‐hardness analysis. Acrylic cylindrical containers (4 × 2 mm) were filled with the following restoration products: Charisma (Heraues Kulzer, Vila Santa Catarina, São Paulo, Brazil), Durafill VS (Heraeus Kulzer), Vitremer (3M, Sumaré, São Paulo, Brazil), Dyract (Dentsply, Petropölis, Rio de Janeiro, Brazil), and Permite C (SDI, São Paulo, São Paulo, Brazil). Sixty samples were prepared of each restoration material. Twenty samples received bleaching treatment with 10% CP, 20 samples received bleaching treatment with 15% CP, and 20 samples were kept submerged in artificial saliva, which was replaced daily. The treatment consisted of immersion of the specimens in 1 cm3 of CP at 10 and 15% for 6 hours per day during 3 weeks, whereupon the test specimens were washed, dried, and kept immersed in artificial saliva for 18 hours. Then the test and control specimens were analyzed using a microhardness gauge. The Knoop Hardness Number (KHN) was taken for each test and control specimen at five different locations by applying a 25 g force for 20 seconds. The values obtained were transformed into KHNs and the mean was calculated. The data were submitted to statistical analysis by analysis of variance and Tukey test, p < .05. The means/standard deviations were as follows: Charisma: CP 10% 38.52/4.08, CP 15% 34.31/6.13, saliva 37.36/4.48; Durafill VS: CP 10% 18.65/1.65, CP 15% 19.38/2.23, saliva 18.27/1.43; Dyract AP: CP 10% 30.26/2.81, CP 15% 28.64/5.44, saliva 33.88/3.46; Vitremer: CP 10% 28.15/3.04, CP 15% 17.40/3.11, saliva 40.93/4.18; and Permite C: CP 10% 183.50/27.09, CP 15% 159.45/5.78, saliva 215.80/26.15. A decrease in microhardness was observed for the materials Dyract AP, Vitremer, and Permite C after treatment with CP at 10 and 15%, whereas no effect on either of the two composites (Charisma and Durafill) was verified.

CLINICAL SIGNIFICANCE

The application of the carbamide peroxide gels at 10 and 15% did not alter the microhardness of the composite resins Charisma and Durafill. In situ and clinical studies are necessary to enable one to conclude that the reduction in microhardness of the materials effectively results in clinical harm to the restorations.
Bonding Characteristics of Self‐etching Adhesives to Intact versus Prepared Enamel
Authors: PERDIGÅO JORGE , GERALDELI SAULO
Published: October 2006

Purpose: This study tested the null hypothesis that the preparation of the enamel surface would not affect the enamel microtensile bond strengths of self‐etching adhesive materials.

Materials and Methods: Ten bovine incisors were trimmed with a diamond saw to obtain a squared enamel surface with an area of 8 × 8 mm. The specimens were randomly assigned to five adhesives: (1) ABF (Kuraray), an experimental two‐bottle self‐etching adhesive; (2) Clearfil SE Bond (Kuraray), a two‐bottle self‐etching adhesive; (3) One‐Up Bond F (Tokuyama), an all‐in‐one adhesive; (4) Prompt L‐Pop (3M ESPE), an all‐in‐one adhesive; and (5) Single Bond (3M ESPE), a two‐bottle total‐etch adhesive used as positive control. For each specimen, one half was roughened with a diamond bur for 5 seconds under water spray, whereas the other half was left unprepared. The adhesives were applied as per manufacturers' directions. A universal hybrid composite resin (Filtek Z250, 3M ESPE) was inserted in three layers of 1.5 mm each and light‐cured. Specimens were sectioned in X and Y directions to obtain bonded sticks with a cross‐sectional area of 0.8 ± 0.2 mm2. Sticks were tested in tension in an Instron at a cross‐speed of 1 mm per minute. Statistical analysis was carried out with two‐way analysis of variance and Duncan's test at p <. 05. Ten extra specimens were processed for observation under a field‐emission scanning electron microscope.

Results: Single Bond, the total‐etch adhesive, resulted in statistically higher microtensile bond strength than any of the other adhesives regardless of the enamel preparation (unprepared = 31.5 MPa; prepared = 34.9 MPa, not statistically different at p < 05). All the self‐etching adhesives resulted in higher microtensile bond strength when enamel was roughened than when enamel was left unprepared. However, for ABF and for Clearfil SE Bond this difference was not statistically significant at p > 05. When applied to ground enamel, mean bond strengths of Prompt L‐Pop were not statistically different from those of Clearfil SE Bond and ABF. One‐Up Bond F did not bond to unprepared enamel. Commercial self‐etching adhesives performed better on prepared enamel than on unprepared enamel. The field‐emission scanning electron microscope revealed a deep interprismatic etching pattern for the total‐etch adhesive, whereas the self‐etching systems resulted in an etching pattern ranging from absent to moderate.

CLINICAL SIGNIFICANCE

For the recently introduced all‐in‐one self‐etching dental adhesives, instrumentation of enamel may be critical for their ability to optimally bond to enamel.
Six‐Month Storage‐Time Evaluation of One‐Bottle Adhesive Systems to Dentin
Authors: GIANNINI MARCELO , MARCELINO CARLA ALESSANDRA , FIGUEIREDO ANDRE , FREIRE LUIZ ANDRÉ
Published: October 2006

Purpose: The goal of this study was to evaluate the 1‐week, 3‐month, and 6‐month performance of eight commercially available one‐bottle adhesive systems to dentin.

Materials and Methods: Lingual and buccal surfaces from human third molars were ground wet on 600‐grit SiC paper to obtain a flat dentinal surface. The specimens were randomly divided into 24 groups (n = 10), which were established to measure the shear bond strengths of Bond‐1 (B1), ONE‐STEP (OS), OptiBond SOLO (OP), Prime & Bond 2.1 (PB), Single Bond (SB), STAE (ST), Syntac Sprint (SS), and Tenure Quick (TQ) after 1‐week, 3‐month, and 6‐month water storage at 37°C. One‐bottle adhesives were applied according to manufacturers' instructions and Z100 composite cylinders were applied on the bonded dentinal surfaces. The 3‐month water‐storage groups were thermocycled for 1500 cycles at 5°C and 55°C and 6‐month groups for 3000 cycles. After storage periods, specimens were tested in shear in a universal testing machine (0.5 mm/min). Results were statistically analyzed by analysis of variance and Tukey test.

Results: The changes in shear bond strengths were not uniform over time. Over the test period, OS, PB, SB, and SS exhibited bond strength stability, however, SS presented low bond strengths on all tested periods. A significant decrease in bond strength was observed for B1, OP, ST, and TQ after the 6‐month storage period.

CLINICAL SlGNlFlCANCE

Bonding is only clinically significant if long lasting. Three one‐bottle adhesive systems presented remarkable stability over the storage period and thermal cycling regimen. However, decreased bond strengths were verified for the other bonding agents.
Critical Appraisal
Authors: Coleman Thomas A. , Swift Edward J.
Published: October 2006

Cervical dentin hypersensitivity affects a large proportion of the adult population. This Critical Appraisal reviews an article about the mechanism of dentin hypersensitivity and a series of articles on a novel method for assessing cervical hypersensitivity. The final review presents some interesting new information on a possible relationship between cervical dentin hypersensitivity and occlusal microtrauma.