|
Zygomatic bone: anatomic bases for osseointegrated implant anchorage.
Int J Oral Maxillofac Implants. 2005 May-Jun;20(3):441-7.
Rigolizzo MB, Camilli JA, Francischone CE, Padovani CR, Branemark PI.
PURPOSE: The aim of the present study was to evaluate zygomatic bone thickness considering
a possible relationship between this parameter and cephalic index (CI) for better use of
CI in the implant placement technique. MATERIALS AND METHODS: CI was calculated for 60
dry Brazilian skulls. The zygomatic bones of the skulls were divided into 13 standardized
sections for measurement. Bilateral measurements of zygomatic bone thickness were made on
dry skulls. RESULTS: Sections 5, 6, 8, and 9 were appropriate for implant anchorage in
terms of location. The mean thicknesses of these sections were 6.05 mm for section
5, 3.15 mm for section 6, 6.13 mm for section 8, and 4.75 mm for section 9.
In only 1 section, section 8, did mean thickness on 1 side of of the skull differ
significantly from mean thickness on the other side (P <.001). DISCUSSION: For
the relationship between quadrant thickness and CI, sections 6 and 8 varied
independently of CI. Section 5 associated with brachycephaly, and section 9
associated with subbrachycephaly, presented variations in the corresponding thickness.
CONCLUSION: Based on the results, implants should be placed in sections 5 and 8,
since they presented the greatest thickness, except in brachycephalic subjects,
where thickness was greatest in section 5, and in subbrachycephalic subjects,
where thickness was greatest in section 9. CI did not prove to be an appropriate
parameter for evaluating zygomatic bone thickness for this sampling. (More than 50 references.)
A clinical evaluation of the Zygoma fixture: one year of follow-up at 16 clinics.
J Oral Maxillofac Surg. 2004 Sep;62(9 Suppl 2):22-9.
Hirsch JM, Ohrnell LO, Henry PJ, Andreasson L, Branemark PI, Chiapasco M, Gynther G, Finne K, Higuchi KW, Isaksson S, Kahnberg KE, Malevez C, Neukam FW, Sevetz E, Urgell JP, Widmark G, Bolind P.
PURPOSE: To evaluate treatment outcome with Zygoma fixtures
(Nobel Biocare, Goteborg, Sweden) with regard to fixture survival, patient satisfaction,
and function of prosthesis replacement. MATERIALS AND METHODS: The treatment outcome of
76 patients treated with 145 Zygoma fixtures at 16 centers was evaluated. Patient's and
dentist's evaluations of the functional and aesthetic outcome of the treatment were
assessed at delivery of prosthesis and at the 1-year follow-up visit. At the 1-year
follow-up visit, the status of the peri-implant mucosa around the abutments and the
amount of plaque were registered. RESULTS: Sixty-six of the 76 patients, with 124
Zygoma fixtures supporting the prosthetic restorations, were evaluated at the 1-year
follow-up. The overall survival rate for the Zygoma fixtures was 97.9% after 1-year
of follow-up. Eighty percent of the patients were fully satisfied with both aesthetic
and functional outcome at the time of prosthetic insertion and at the 1-year follow-up.
All reported data from the dentists, with the exception of one restoration with several
abutment screw loosenings, scored from acceptable to excellent for the aesthetic and
functional outcome of the treatment. The status of peri-implant mucosa was recorded
as normal in approximately 60% of the sites. Plaque, when present, was more often
detected on the palatal surfaces compared with the buccal surfaces. CONCLUSION:
This 1-year follow-up of Zygoma fixtures has shown good results with an acceptable
number of minor complications and a majority of satisfied patients.
Prospective follow-up study of 95 patients with edentulous mandibles treated according to the Branemark Novum concept.
Clin Implant Dent Relat Res. 2003;5(1):3-10.
Engstrand P, Grondahl K, Ohrnell LO, Nilsson P, Nannmark U, Branemark PI.
BACKGROUND: The long-term predictability reported with the traditional two-staged
Branemark method has led to developments aimed at simplifying the technique and
reducing healing time. Results from a pilot study using the Branemark Novum concept
are promising, and it has been shown possible to fabricate and deliver an implant-supported
fixed prosthesis to the patient on the day of surgery. PURPOSE: The objective of this
study is to report clinical and radiographic outcomes in a group of patients treated
according to the Branemark Novum concept. MATERIALS AND METHODS: Ninety-five patients
with edentulous mandibles were consecutively included in the study. Three specially
designed fixtures were placed in each patient (285 fixtures in total) using drilling
templates. The fixtures were immediately splinted with a prefabricated substructure,
and fixed prostheses were delivered the same day in 67% of the patients. For the rest,
prosthesis delivery ranged from 1 to 40 days (mean 5.6 d). Clinical and radiographic
examinations were performed after 3 months, 6 months, 1 year, and then annually.
The follow-up time was 1 to 5 years (mean 2.5 yr). RESULTS: The cumulative prosthesis
survival rate was 99%. Eighteen fixtures (6.3%) failed in 13 patients.
Kaplan-Meier survival estimates demonstrated a probability implant survival at
1 year of 95.0% (94 patients), at 3 years of 93.3% (47 patients), and at 5 years
of 93.3% (9 patients). The mean bone loss was 0.73 mm between the examinations at
3 months and 1 year, 0.16 mm during the second year, and 0.13 mm annually during
years 3 to 5. CONCLUSIONS: Comparable results, related to continuous prosthesis stability,
were shown for the Novum approach compared with the traditional two-staged procedure.
Survival of individual fixtures is lower when immediate loading is applied.
Edentulousness and oral rehabilitation: experiences from the patients' perspective.
Eur J Oral Sci. 2002 Dec;110(6):417-24.
Trulsson U, Engstrand P, Berggren U, Nannmark U, Branemark PI.
The psychological effects of tooth loss in the permanent dentition are relatively unknown.
Complete edentulousness is a serious life event in terms of readjustment. The aim of the
study was to describe the process patients with deteriorating dental status had gone through
before treatment with a fixed prosthesis (Branemark System, Novum), and to describe what
living with a fixed prosthesis means to the patients themselves. In-depth interviews were
carried out with 18 patients, and the interviews were transcribed verbatim and analysed in
open, axial and selective coding processes according to Grounded Theory. In the analysis,
four categories were developed and labelled: 'alterations in self-image', 'becoming a
deviating person', 'becoming an uncertain person' and 'becoming the person I once was'.
'Alterations in self-image' was identified as the core category and was related to the
other three categories. The core category describes the changes in self-image starting
with the subjects' increasingly worsened dental status, followed by a period of them
having to live and cope with a denture and, finally, their living with a fixed prosthesis.
The motive power for the decision to undergo treatment with a fixed prosthesis seems to
be a desire to restore dental status and also to recapture attractiveness, self-esteem and a positive self-image.
Remote implant anchorage for the rehabilitation of maxillary defects.
J Prosthet Dent. 2001 Oct;86(4):377-81.
Parel SM, Branemark PI, Ohrnell LO, Svensson B.
The rehabilitation of maxillary defects is a significant challenge in terms of creating
retention and preserving existing dentition in an environment of expanded functional stress.
The advent of osseointegration has enhanced the dental practitioner's capabilities in this
regard with a remarkably improved potential for increasing prosthesis stability and
preserving tissue. For patients with extensive prosthetic cantilevers, however, the
opportunity for implant placement in defect areas is compromised unless remote bone
sites are considered. Implants in the defect buttress zone through the maxillary sinus
in non-defect sites (zygoma implants) can be valuable
in providing a level of functional rehabilitation previously unattainable.
Five-year prospective study of prosthodontic and surgical single-tooth implant treatment in general practices and at a specialist clinic.
Int J Prosthodont. 1998 Jul-Aug;11(4):351-5.
Andersson B, Odman P, Lindvall AM, Branemark PI.
PURPOSE: The aim of this 5-year prospective study was to compare the results of
single-tooth implant treatments planned and performed at four general practitioners'
offices with the results from a specialist clinic. MATERIALS AND METHODS: The group
comprised 38 patients. Nineteen patients, with 19 implants/crowns, were planned and
treated by four general practitioners, and the outcome was compared to a matched group
of patients from a specialist clinic. RESULTS: Three patients did not complete the study.
None of the implants failed; one crown failed. This was a very positive result, as the
single failure, a crown at the specialist clinic, was caused by an extraordinary trauma
and was not related to a common cause such as bite forces or fatigue. No significant
differences were observed between the groups when the radiographic findings were compared.
Some minor differences, for bleeding and the position of the mucosal level around implants
and adjacent teeth, were observed between the two groups. CONCLUSION:
The small discrepancies that were observed between treatment performed by the four
general practitioners at their own offices and treatment performed at the specialist
clinic were not regarded to be of any clinical importance. This indicates that complete
single-tooth implant treatment may be performed for many patients by general
practitioners who have received adequate training, allowing the possibility
of referring complicated treatments to specialists and other treatments to general practitioners.
Cemented single crowns on osseointegrated implants after 5 years: results from a prospective study on CeraOne.
Int J Prosthodont. 1998 May-Jun;11(3):212-8.
Andersson B, Odman P, Lindvall AM, Branemark PI.
PURPOSE: The aim of this prospective study was to present the results after 5 years of
loading of 65 CeraOne (Nobel Biocare) crowns. MATERIALS AND METHODS: Sixty-two implants
in the maxilla and 3 implants in the mandible were placed in 57 patients.
Sixty-two all-ceramic and three metal-ceramic crowns were cemented. The group comprised
the first patients treated with the CeraOne prosthodontic concept. RESULTS: Eight patients
did not complete the study. Only one implant failed, giving a cumulative success rate for
implants of 98.5%. The failed implant was replaced: a crown was cemented and then followed
for 5 years without any complications. Four crowns were recorded as failures, giving a
cumulative success rate for crowns of 93.7%. It should be observed that this result was
very positive, as all crown failures were related to extraordinary causes and not one was
a result of common bite forces or fatigue. The initial bone loss was in accordance with
other studies on Branemark implants, and a stable situation was recorded after 2 years for
the supporting bone around implants and adjacent teeth when the conical implants were
excluded. Soft tissues around implants and adjacent teeth appeared healthy, and the
cementation and the placement of the abutment shoulder in the peri-implant sulcus did
not cause any recession of the peri-implant mucosa. CONCLUSION: CeraOne experienced
virtually no complications and proved to be a highly predictable and safe prosthodontic
concept. CeraOne also eliminated problems with abutment screw loosening and
created a platform for good esthetic results and satisfied patients.
Titanium implants and onlay bone graft to the atrophic edentulous maxilla: a 3-year longitudinal study.
Int J Oral Maxillofac Surg. 1996 Feb;25(1):25-9.
Astrand P, Nord PG, Branemark PI.
Treatment of the atrophic maxilla using an onlay bone-grafting technique in combination
with simultaneous insertion of endosteal implants (Branemark System) was performed in 17
patients. They were followed during a 3-year period. At the end of this period, 14 patients
had stable bridges in use and one patient had an overdenture. Two patients had had to
return to conventional dentures due to implant losses. The survival rate of the implants
after 3 years use was 75%. It is concluded that, in spite of the implant losses,
onlay bone grafting to the
maxilla is a valuable method in cases of severe maxillary atrophy.
|
|
|
