Jacobs R, Pittayapat P, van Steenberghe D, De Mars G, Gijbels F, Van Der Donck A, Li L, Liang X, Van Assche N, Quirynen M, Naert I. A split‐mouth comparative study up to 16 years of two screw‐shaped titanium implant systems. J Clin Periodontol 2010; doi: 10.1111/j.1600‐051X.2010.01626.x. Abstract Introduction: Many studies have dealt with the clinical outcome of oral implants, yet none applied a randomized split‐mouth design for a long‐term follow‐up of similar implant systems. Aim: To evaluate two oral implant systems with different surface characteristics in a randomized split‐mouth design and to radiologically analyse peri‐implant bone level and density over an up to 16‐year period. Materials and Methods: The study comprised clinical and radiographic records of 18 partially edentulous patients treated with both implant types randomly placed in either left or right jaw sides. Outcome was evaluated over time. Results: Clinical and radiographic parameters showed no significant differences over time for both systems. Ten years after implant placement, a significantly increasing peri‐implant bone density was noted, while Periotest values were found to be significantly decreasing. Fifteen years after implant loading, mean bone loss was 0.02 mm (range −1.15 to 1.51; SD 0.45) for Astra Tech ® implants ( n =24) and 0.31 mm (range −0.98 to 2.31; SD 0.69) for Brånemark ® implants ( n =23). Conclusions: The study failed to demonstrate significant differences in the outcome of the peri‐implant bone for two implant systems with different surface characteristics. The marginal bone level around oral implants changed <0.5 mm after 15 years of loading.
Abstract. So far, preprosthetic surgery for oral defects improved prosthetic retention problems for only a limited amount of time and led to many side‐effects. The alternative offered by the osseointegration technique developed by P.–I. Brånemark changed the concept of preprosthetic surgery dramatically. By means of a few permucosal titanium screws, bridges or overdentures can be retained even in cases of advanced jaw bone resorption. When the latter is extreme, an autologous free bone graft fixed by means of self‐tapping titanium implants can offer the necessary support for sometimes elaborate prosthetic reconstructions. The marginal bone loss around Brånemark implants is very limited after a 1st year of bone remodelling, even when an autologous transplant has been used.
Abstract Background The importance of an adequate amount of peri‐implant keratinized tissue and attached mucosa has recently been emphasized. This manuscript presents preliminary findings of a novel approach for increasing the width of keratinized mucosa (KM) around dental implants using a mesh free gingival graft (mesh‐FGG). Methods Two healthy adults were treated as part of this study. After implant placement, a large edentulous alveolar ridge with shallow vestibule and minimal amount of KM was treated in both subjects (one in the posterior mandible and the other in the anterior mandible) with the combination of an apically positioned flap and a mesh‐FGG. Clinical, esthetic and patient‐reported outcomes were observed at approximately 4‐month time points. Results All sites healed uneventfully after the treatments. In both cases, increased vestibule depth, soft‐tissue thickness, and width of peri‐implant KM were obtained. The patients did not report any accessory discomfort. Four months following the grafting procedure, good overall esthetic outcome was observed with minimal color disparity and graft demarcation. Conclusions Width of KM around dental implants can be increased using a mesh‐FGG. Randomized controlled clinical studies comparing mesh‐FGG to conventional FGG and other commonly applied techniques are required to assess the long‐term efficacy of this novel technique in terms of soft‐tissue thickness, width of peri‐implant KM, and patient‐reported outcomes. Key points Principal Findings: Meshed‐FGG allowed an expansion of the length of the harvested graft. This results in coverage of large recipient sites, increase in height of KM and good aesthetic integration of the graft.
Clinical data indicate different medium and long‐term outcomes of endosseous implants for different implant configurations and in particular implant surfaces. The present study compares 2 very similar implant systems but with different surface characteristics in a split‐mouth‐randomized design. The Astra‐Tech (A) system (Astra‐Tech AB, Mölndal, Sweden) consisted of selftapping TiO 2 ‐blasted screw‐shaped implants made of commercially pure titanium, and the Brånemark (B) System (Nobel Biocare, Gothenburg, Sweden) comprised selftapping Mark II implants with machined surface irregularities. Throughout the 2‐years' observation period, no significant differences could be found concerning probing depths, presence of plaque or change in marginal bone level. A statistically significant difference in location of the marginal bone level in relation to the shoulder of the implant was found in favor of the A system both at baseline and after 2 years. Cumulative success rates of 100% (A) and 97.7% (B) were not statistically different. From a prosthetic point of view, more soldering points were needed for A compared to B to reach clinical acceptable fit. More years of observation are needed to compare the fate of the soft and hard tissues surrounding two different implant surfaces.
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.
Abstract Background Peri‐implant soft tissues esthetics varies and depends on the restoration type such as implant‐supported single crowns, adjacent multiple single crowns, and fixed partial dentures (FPD). Purpose The aim of this prospective study was to assess the esthetic outcome of the peri‐implant soft tissues of (NobelBiocare™) implant‐supported single crowns, adjacent multiple single crowns, and FPD. A potential association between the esthetic risk profile and the esthetic outcome was assessed. Materials and methods Between 03/11 and 03/17, 300 NobelActive implants were installed in 153 partially edentulous patients. Prior to the fabrication of the final restoration, the esthetic risk profile (ERP) of the patient was determined. The pink esthetic score (PES) and white esthetic score (WES) were assessed by three investigators at 6 and 12 months post‐insertion of the final restoration. Patients' appreciation was assessed on a visual analogue scale (VAS) at the 1‐year follow‐up. Results The clinical acceptable limit for PES (≥6) was achieved in 56% to 68% of the single crowns at 6 and 12 months, respectively. Clinically unacceptable PES scores were recorded for 48% of the adjacent multiple single crowns and 63% of the FPDs at both time points. The association of a high ERP with WES and PESWES was noticed for single implant‐supported crowns. For the latter restoration type, a ≤5 mm distance between the crestal bone level and the proximal contact positively influenced the PES and combined PESWES scores. No correlation was found between PES or WES and patient satisfaction. Mesial papilla formation was more pronounced compared to the distal one for the single implant crowns and for implant‐supported FPD. Conclusion When high esthetic demands are expected, assessment of ERP prior to implant treatment is advised in order to estimate a realistic outcome.
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