bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immediate Functional Loading of Brånemark System® Implants with Enhanced Initial Stability: A Prospective 1– to 2‐Year Clinical and Radiographic Study
Authors: Calandriello Roberto , Tomatis Massimiliano , Rangert Bo 
Published: October 2006

ABSTRACTBackground:The interest in the benefits of immediate loading of titanium implants has recently involved fixed prostheses for partially edentulous areas. The advantages of this approach well justify the need for extending the procedure to all regions of the mouth. Current available clinical literature on this subject is incomplete.Purpose:The purpose of this study is to investigate the clinical outcome of the immediate loading of Brånemark System® implants (Nobel Biocare AB, Gothenburg, Sweden) inserted with enhanced initial stability principally in posterior sites (78%).Materials and Methods:The present study was conducted in 26 consecutively treated patients. A total of 50 Brånemark System machined surface implants were placed supporting 30 fixed temporary partial dentures in light occlusion. All implants were followed up for a minimum of 1 year of function. Minimum requirements for immediate loading were proposed. Bone quality and quantity were classified according to Lekholm and Zarb's criteria. Stability of the marginal bone level, both mesial and distal, was measured on the basis of radiographic analysis. Implant survival rate was calculated according to Kaplan‐Meier analysis. The peak insertion torque employed during fixture placement was between 40 and 72 Ncm, except in the case of one implant that was lost.Results:Overall survival rate was 98%. An unpaired t‐test revealed bone remodeling conforming to biologic width establishment (p < .005).Conclusions:Within the limit of this study, immediate loading appears to be a viable procedure in posterior sites and for a growing number of clinical indications. Enhanced implant stability and light occlusion seem to be security factors. In spite of unfavorable conditions such as the presence of quality 4 bone and a lack of splinting, all implants with enhanced primary stability survived.
Immediate Loading in the Maxilla Using Flapless Surgery, Implants Placed in Predetermined Positions, and Prefabricated Provisional Restorations: A Retrospective 3‐Year Clinical Study
Authors: Rocci Antonio , Martignoni Massimiliano , Gottlow Jan 
Published: October 2006

ABSTRACTBackground:Immediate loading of dental implants shortens the treatment time and makes it possible to give the patient an esthetic appearance during the whole treatment period.Purpose:The aim of the present study was to evaluate an immediate‐loading treatment protocol, which included flapless surgery, implants placed in predetermined positions and connected to prefabricated provisional restorations, and the 3‐year clinical results.Materials and Methods:A total of 97 Brånemark System® Mk IV implants (Nobel Biocare AB, Gothenburg, Sweden) with a machined surface were inserted in the maxillas of 46 patients. A presurgical three‐dimensional model of the patients' soft tissue and underlying alveolar bone anatomy was created, which allowed the clinician to place the implants in predetermined positions and connect them to prefabricated provisional restorations. A surgical template with drilling guides corresponding to each implant was used. The apical part of the master guide was equipped with a circular “mucotome,” which punched out a 5 mm hole in the mucosa to eliminate the need for flap elevation. The patients received 25 fixed partial prostheses and 27 single‐tooth restorations. Bone quality and quantity were assessed. Radiographic examinations were performed on the day of surgery/loading and at the 1‐, 2‐, and 3‐year follow‐up visits.Results:All implant sites showed intact buccal and lingual bone walls during surgery, confirming the accuracy of the bone‐mapping procedure. The prefabricated temporary restorations fitted, meaning that the implants were positioned clinically in the same way as on the cast. Nine implants in eight patients failed during the first 8 weeks of loading. This resulted in a cumulative survival rate of 91% after 3 years of prosthetic load. The survival rate of splinted implants was 94%. The number of failed implants was significantly higher in cases of single‐tooth replacements and placement in soft bone sites and smokers. The failed implants were successfully replaced according to a two‐stage protocol. All patients finally received the expected restoration. The marginal bone resorption was on average 1.0 mm during the first year of loading, 0.4 mm during the second year, and 0.1 mm during the third year.Conclusions:The study confirmed the feasibility of an immediate‐loading treatment protocol in the maxilla, which included flapless surgery, implants and abutments placed in predetermined positions, and prefabricated provisional restorations. All failures occurred within the first 2 months of loading. The unchanged survival rate and the low average bone loss found during the following 34‐month study period indicate a good long‐term prognosis for the performed immediate‐loading treatment.
Immediate Occlusal Loading of Brånemark TiUnite™ Implants Placed Predominantly in Soft Bone: 1‐Year Results of a Prospective Clinical Study
Authors: Glauser Roland , Lundgren AnnaKarin , Gottlow Jan , Sennerby Lars , Portmann Michael , Ruhstaller Petra , Hämmerle Christoph H.F. 
Published: October 2006

ABSTRACTBackground:The original Brånemark protocol for dental implant treatment was based on submerged healing prior to loading. However, immediate loading has been reported possible with high success rates for various indications, provided that good bone quality and quantity are present. In many of these studies, machined‐surface implants have been used. Recently, a new surface texture has been developed, based on an oxidation processing, that aims to enhance the early bone response (Brånemark System® Mk IV TiUnite™, Nobel Biocare AB, Gothenburg, Sweden). It has been documented that this surface texture may help to better maintain primary implant stability during the early healing period and that secondary implant stability can be reached earlier compared with results when using a machined surface. Such a positive influence on implant stability might be an advantage when applying an immediate‐loading protocol, especially in soft bone regions where a tendency toward reduced success rates has been reported.Purpose:The aim of this report was to present the short‐term success rates of TiUnite‐surfaced immediate occlusally loaded Brånemark System Mk IV implants placed in various regions of the jaws.Materials and Methods:Thirty‐eight patients received a total of 51 prosthetic reconstructions, all of which were connected on the day the implants were inserted. Of these, 20 were single‐tooth restorations, 30 were fixed partial dentures, and 1 was a complete fixed lower jaw restoration. These prostheses were supported by 102 Brånemark System Mk IV TiUnite implants (38 maxillary and 64 mandibular), the majority of which were placed in posterior regions (88%) and mainly in soft bone (76%). Cutting resistance measurements were performed during implant insertion, and resonance frequency measurements were conducted during the course of the study. Furthermore, radiographic examinations were performed in connection with the delivery of the prostheses and at the 1‐, 6‐, and 12‐month follow‐up visits. This article reports on the results after 1 year of loading.Results:Three maxillary implants were removed, although stable, in one patient at the 8‐week follow‐up because of postoperative infection in the adjacent area of guided bone regeneration (GBR). This resulted in a cumulative success rate of the implants of 97.1% after 1 year of prosthetic loading. The mean marginal bone resorption after 1 year of loading was 1.2±0.9 mm (SD).Conclusions:The applied immediate loading protocol in combination with a slightly tapered implant and a modified implant surface texture was shown to be a successful treatment alternative even in regions exhibiting soft bone.
Immediate Occlusal Loading of Single Lower Molars Using Brånemark System® Wide‐Platform TiUnite™ Implants: An Interim Report of a Prospective Open‐Ended Clinical Multicenter Study
Authors: Calandriello Roberto , Tomatis Massimiliano , Vallone Roberto , Rangert Bo , Gottlow Jan 
Published: October 2006

ABSTRACTBackground:First and second molars in the lower jaw are the most commonly missing teeth. As in other jaw regions with tooth loss, implant therapy is an attractive concept. Owing to the wide dimension of the molar teeth, wide implants seem to be a natural choice. However, wide implants in posterior mandibular regions sometimes present a problem. As an oxidized surface seems to facilitate implant integration and to result in a stronger fixation to bone, it was hypothesized that this surface would improve the performance of wide implants in posterior mandibles. As high initial stability most often is achieved in this region, it was hypothesized that the load per se is not a problem.Purpose:The purpose of the present study is to evaluate immediate loading of Brånemark System® TiUnite™ Wide‐Platform implants (Nobel Biocare AB, Gothenburg, Sweden) supporting single molar crowns in the lower jaw.Materials and Methods:The study includes 44 patients treated in three separate private dental offices between March 2001 and June 2002. A total of 50 implants were placed, and all implants have passed the 6‐month follow‐up; 24 have been followed up for 1 year. All implants were provided with provisional crowns in centric occlusion at the time of surgery.Results:No implant has been lost. Marginal bone levels were found in accordance with normal biologic width requirements. Resonance frequency analysis showed high and consistent implant stability. No biomechanical problems were found associated with the use of wide implants, and the potential physiologic problem in dense mandibular bone was eliminated.Conclusion:Although limited by being a short‐term study, the result encourages immediate loading of single Brånemark System TiUnite Wide‐Platform implants placed in the molar regions in the lower jaw.
Early Functional Loading in the Fully Edentulous Mandible after Mandibular Resection and Reconstruction due to an Ameloblastoma: Case Report
Authors: Becker William , Wong James 
Published: October 2006

ABSTRACT Background: Immediate or early functional loading of implants in fully edentulous mandibles can enhance patient comfort and the ability to masticate within a few days after implant placement. Recently there has been evidence that this method of restoring edentulous mandibles is predictable. Purpose: The goal of this case report is to present the treatment of a patient diagnosed with a large ameloblastoma in the mandible. After removal of the tumor and mandibular reconstruction, the patient had complete anesthesia in the right mandible, with an alveolar ridge deformity. Methods: Two years after removal of an ameloblastoma in the right mandibluar sextant, five implants were installed between the mental foramina. One implant was installed for safety reasons in the event one of the others was lost. This implant remains buried. A denture was used as a drilling guide. Abutments were attached to the implants, and impression copings were fixed to the abutments. The denture was used for the “pickup” impression. Flaps were sutured, maintaining exposure of the abutments. In the laboratory, gold cylinders were heat cured to the tissue side of the denture. The cylinders were attached to the cast with laboratory screws. The gold cylinders were heat cured to the intaglio side of the denture. Five days after implant placement, the nonmetal reinforced acrylic denture was fixed to the implants with laboratory screws. The bridge is removed annually, and the implants are examined for mobility and periapical radiographs are taken. Results: The patient has worn the prosthesis for 2.5 years without loss of implants and without breakage of the nonmetal reinforced denture. At 2.5 years the implants are stable, implant sites demonstrate stable crestal bone, and the patient is eating comfortably and without limitations. Conclusion: Early functional loading of implants in the edentulous mandible may offer patients the option of wearing implant‐supported prosthesis immediately or shortly after implant insertion.
Resorbable and Nonresorbable Hydroxyapatite Granules as Bone Graft Substitutes in Rabbit Cortical Defects
Authors: Liljensten Elisabeth , Adolfsson Erik , Strid Karl‐Gustav , Thomsen Peter 
Published: October 2006

ABSTRACT Background: The use of various synthetic calcium phosphate compositions for the promotion of bone in bone defects is of potential interest because such materials may be tailor made and may bond to bone. There is yet an inadequate knowledge of the role of calcium phosphate composition and resorbability for the bone response. Purpose: The aim of the present study was to compare the ability of resorbable versus nonresorbable hydroxyapatite (HA) granules to promote new bone formation in cortical bone defects. Resorbable and nonresorbable HA granules, used as bone graft substitutes, were evaluated after 6 weeks and 3 months in the rabbit tibia. Circular defects (diameter 5.0 mm) were made in both tibias of 18 New Zealand white rabbits. The 36 defects were divided into three groups (six observations per group and time, respectively). The first group was augmented with resorbable HA granules, the second group was augmented with ceramic nonresorbable HA granules, and the third group was left without augmentation (control). The animals were killed after 6 weeks and 3 months, and the tissue was evaluated with light microscopic (LM) morphology and morphometry, scanning electron microscopy (SEM), and energy dispersive x‐ray analysis (EDX). Results: After 3 months LM morphometry revealed significantly more newly formed bone in the two HA augmented groups compared with that in the control. A close contact was found between both kinds of HA granules and new bone as viewed with light microscopy and SEM. A relatively slow degradation process was indicated by the small reduction of the total granule area in the cortical defects. However, LM observations showed a change of granule form. Pilot experiments using SEM‐EDX indicate that Ca and P contents had decreased in the resorbable HA granules between 6 weeks and 3 months. Further, a higher content of Ca and P was found in the newly formed bone close to granules, in comparison with more distant newly formed bone. Conclusions: Our results suggest that both resorbable and nonresorbable HA granules promote new bone formation in rabbit cortical defects, which does not occur in control defects.
Clinical Assessment and Surgical Implications of Anatomic Challenges in the Anterior Mandible
Authors: Mraiwa Nuri , Jacobs Reinhilde , van Steenberghe Daniel , Quirynen Marc 
Published: October 2006

ABSTRACT Background: The anterior mandible is generally considered a rather safe surgical area, involving few risks of damage to vital anatomic structures. Nevertheless, both neurosensory disturbances and hemorrhages have been reported after implant surgery in that particular area. Purpose: With the increasing demand for oral implant placement, the anatomy of the anterior mandible should receive more attention. This review will focus on the anatomic peculiarities of the anterior mandible and the related clinical implications. Methods: The scientific evidence on the anatomic, histologic, physiologic, and clinical aspects of the neurovascularization of the anterior mandible will be reviewed. Results: Surgical complications may be attributed to the existence of a mandibular incisive canal with a true neurovascular supply. Potential risks may also be related to the presence of the lingual foramen and anatomic variations, such as an anterior looping of the mental nerve. Conclusions: Preoperative radiographic planning for oral implant placement in the anterior mandible should therefore not only consider all esthetic and functional demands but should also pay particular attention to the anatomic peculiarities of this region to avoid any neurovascular complications.
Mk III: A Third Generation of the Self‐Tapping Brånemark System® Implant, Including the New Stargrip Internal Grip Design. A 1‐Year Prospective Four‐Center Study
Authors: Widmark Göran , Friberg Bertil , Johansson Björn , Sindet‐Pedersen Steen , Taylor Åsa 
Published: October 2006

ABSTRACT Background: Many prospective studies have shown predictable long‐term results of the Brånemark System (Nobel Biocare AB, Gothenburg, Sweden) turned‐surface implants in totally edentulous, partially edentulous, and single cases. The Mk III self‐tapping implant was introduced by Nobel Biocare in 1999 as part of a new implant generation that improved on the Mk II self‐tapping implant that had been introduced in 1992. A new implant design should always be evaluated, preferably in prospective multicenter studies. Purpose: The aim of the present prospective multicenter study was to evaluate the short‐term success rate of the Br † nemark Mk III machined‐ and turned‐surface self‐tapping implant and to evaluate the clinical handling of the new Stargrip (Nobel Biocare AB) internal grip design. Materials and Methods: The open prospective 1‐year multicenter study was performed at four clinics. Sixty‐four patients (38 females, 26 males) with a mean age of 51 years (range, 16 to 80 years) were included. Seventeen of the patients were totally edentulous, 26 were partially edentulous, and 21 had single‐tooth losses. In total, 194 Mk III implants were inserted, 89 in the maxillas and 105 in the mandibles. Results: Fifty‐eight patients were observed for 1 year after prosthetic loading. Three of 194 implants were lost, corresponding to a cumulative success rate of 98.4% after 1 year, 100% for maxillary implants and 97.1% for mandibular implants. The implant driver carried the implants reliably in 99.5% of all treated patients. Sixty‐two patients received the planned prosthetic reconstruction. All but one prosthetic reconstruction survived after 1 year of loading. The mean marginal bone resorption, analyzed from radiographs of 143 implants, was 1.15 mm (standard deviation [SD], 1.09 mm) from the second‐stage surgery to the 1 ‐year follow‐up. Conclusion: The 1‐year success rate of the Mk III implant was high, and the clinical handling of the internal grip design (Stargrip) improved the surgical technique and was well appreciated by both surgeons and assisting staff.
Cutting Torque Measurements in Conjunction with Implant Placement in Grafted and Nongrafted Maxillas as an Objective Evaluation of Bone Density: A Possible Method for Identifying Early Implant Failures?
Authors: Johansson Björn , Bäck Tomas , Hirsch Jan‐Michael 
Published: October 2006

ABSTRACTBackground:Bone grafts are frequently used to enable the placement of dental implants in atrophied jaws. The biomechanical properties of bone grafts used in one‐ or two‐stage implant procedures (in comparison with the use of nongrafted bone) are not well known.Purpose:The purpose of this study was (1) to measure cutting torques during the placement of self‐tapping dental implants in nongrafted bone and in bone grafts, either as blocks or in a milled particulate form, in patients undergoing implant treatment in an edentulous maxilla and (2) to identify implants with reduced initial stability and to correlate these findings with a clinical classification of jawbone quality.Materials and Methods:The study included 40 consecutive patients with edentulous maxillas, 27 of whom were subjected to bone grafting prior to or in conjunction with implant placement (grafting group) and 13 of whom received implants without grafting (nongrafted group). Grafted bone from the iliac crest bone was used (1) as onlay blocks, (2) as maxillary sinus inlay blocks, or (3) in particulate form in the maxillary sinus. Implants were placed after 6 to 7 months of healing, except in the maxillary sinus inlay blocks, where implants were placed simultaneously. Cutting torque values were obtained from 113 grafted implant sites and from 109 nongrafted implant sites.Results:Significantly lower cutting torque values were assessed in grafted regions than in nongrafted regions, irrespective of grafting technique. Lower values were also seen for implants placed in block grafts after 6 months when compared to other grafting techniques used. The cutting torque values revealed an inverse linear relation to the Lekholm and Zarb bone quality index.Conclusion:The cutting torque values correlated well with the Lekholm and Zarb index of bone quality. Significantly lower cutting torque values were seen in grafted bone than in nongrafted bone.
Carbon Dioxide Laser and Hydrogen Peroxide Conditioning in the Treatment of Periimplantitis: An Experimental Study in the Dog
Authors: Persson Leif G. , Mouhyi Jafaar , Berglundh Tord , Sennerby Lars , Lindhe Jan 
Published: October 2006

ABSTRACTBackground:Various methods have been applied for the treatment of periimplantitis lesions. It has been reported that the procedures used have been effective in eliminating the inflammatory lesion but that re‐osseointegration to the once‐contaminated implant surface has been difficult or impossible to achieve.Purpose:The aim of this study was to examine the use of carbon dioxide (CO2) laser in combination with hydrogen peroxide in the treatment of experimentally induced periimplantitis lesions.Materials and Methods:Three dental implants (ITI Dental Implant System®, Straumann AG, Waldenburg, Switzerland) were placed in each side of the edentulous mandible of four beagle dogs. Implants with a turned surface and implants with a sand‐blasted large‐grit acid‐etched (SLA) surface (SLA®, Straumann AG, Waldenburg, Switzerland) were used. Experimental periimplantitis was induced during 3 months. Five weeks later each animal received tablets of amoxicillin and metronidazole for a period of 17 days. Three days after the start of the antibiotic treatment, full‐thickness flaps were elevated, and the granulation tissue in the bone craters was removed. In the two anterior implant sites in both sides of the mandible, a combination of CO2 laser therapy and application of a water solution of hydrogen peroxide was used. The implant in the posterior site of each quadrant was cleaned with cotton pellets soaked in saline. Biopsy specimens were obtained 6 months later.Results:The amount of re‐osseointegration was 21% and 82% at laser‐treated turned‐surface implants and SLA implants, respectively, and 22% and 84% at saline‐treated turned‐surface implants and SLA implants, respectively.Conclusions:The present study demonstrated the following: (1) a combination of systemic antibiotics and local curettage and debridement resulted in the resolution of experimentally induced periimplantitis lesions; (2) at implants with a turned surface, a small amount of re‐osseointegration was observed at the base of the bone defects whereas a considerable amount of re‐osseointegration occurred at implants with an SLA surface; and (3) the use of CO2 laser and hydrogen peroxide during surgical therapy had no apparent effect on bone formation and re‐osseointegration.