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  • 1.
    Cricchio, Giovanni
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, Oral and Maxillofacial Surgery.
    Sennerby, Lars
    Department of Biomaterials, Institute for Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden .
    Lundgren, Stefan
    Umeå University, Faculty of Medicine, Department of Odontology, Oral and Maxillofacial Surgery.
    Sinus bone formation and implant survival after sinus membrane elevation and implant placement: a 1- to 6-year follow-up study2011In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 22, no 10, p. 1200-1212Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate the long-term clinical and radiographic results of the maxillary sinus membrane elevation technique where implants were inserted in a void space created by the elevation of the sinus membrane without adding any graft material.

    Materials and methods: A total of 84 patients were subjected to 96 membrane elevation procedures and simultaneous placement of 239 implants. Changes of intra-sinus and marginal bone height in relation to the implants were measured in intraoral radiographs taken at insertion, after 6 months of healing, after 6 months of loading and then annually. Computerized tomography was performed pre-surgically and 6 months post-surgically. Resonance Frequency Analyses measurements were performed at the time of implants placement, at abutment connection and after 6 months of loading. The implant follow-up period ranged from a minimum of one to a maximum of 6 years after implants loading.

    Results: All implants were stable after 6 months of healing. A total of three implants were lost during the follow-up period giving a survival rate of 98.7%. Radiography demonstrated on average 5.3±2.1 mm of intra-sinus new bone formation after 6 months of healing. RFA measurements showed adequate primary stability (implant stability quotient 67.4±6.1) and small changes over time.

    Conclusion: Maxillary sinus membrane elevation and simultaneous placement of implants without the use of bone grafts or bone substitutes result in predictable bone formation with a high implant survival rate of 98.7% during a follow-up period of up to 6 years. The intra-sinus bone formation remained stable in the long-term follow-up. It is suggested that the secluded compartment allowed for bone formation according to the principle of guided tissue regeneration. The high implant survival rate of 98.7% indicated that the implants sufficiently supported the fixed bridges throughout the study period. This technique reduces the risks for morbidity related to harvesting of bone grafts and eliminates the costs of grafting materials.

  • 2. De Bruyn, H
    et al.
    Collaert, B
    Lindén, U
    Flygare, L
    A comparative study of the clinical efficacy of Screw Vent implants versus Brånemark fixtures, installed in a periodontal clinic.1992In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 3, no 1, p. 32-41Article in journal (Refereed)
    Abstract [en]

    The clinical success of 85 Screw Vent and 107 Brånemark implants, consecutively installed in a private periodontal clinic under the same conditions and by the same operator, is compared. Mobile implants were removed and considered as failures. Intra-oral radiographs were assessed for the presence of peri-implant radiolucencies and for analysis of bone loss after functional loading. 85 Screw Vent implants were installed in 31 patients. Of 23 implants installed in 9 mandibles, none failed after 16.8 (range 12-25) months of function. Of 62 Screw Vent implants installed in 23 maxillae, 6 failed at abutment connection, 1 failed after 2 months and 2 after 13 months of function. The absolute failure rate after 13.2 (range 6-24) months was 9/62. Mean loss of bone was 1.47 mm (-1.0- +4) after 12 months of functional loading. 107 Brånemark fixtures were installed in 25 patients. Of 51 fixtures inserted in 12 mandibles, none failed; of 56 fixtures installed in 13 maxillae 1 failed before and 2 failed during abutment connection. The absolute failure is 3/56. All remaining fixtures were immobile after loading. 13 fixtures were more than 6 months in function. Only short-term comparison between both systems is possible because the observation time is longer for the Screw Vent implants. In the 1st year, only 1 implant system was available to the periodontist. Short-term comparison reveals 11.3% versus 5.3% of cumulative failure after 6 months for the Screw Vent and Brånemark implants, respectively. The results indicate that clinical efficacy is as effectively obtained with Screw Vent as with Brånemark implants in the mandible. The outcome of treatment with Screw Vent implants in the maxilla seems less predictable.

  • 3.
    Hallman, Mats
    et al.
    Umeå University, Faculty of Medicine, Odontology, Oral and Maxillofacial Surgery.
    Cederlund, Andreas
    Lindskog, Sven
    Lundgren, Stefan
    Umeå University, Faculty of Medicine, Odontology. Umeå University, Faculty of Medicine, Odontology, Oral and Maxillofacial Surgery.
    Sennerby, Lars
    A clinical histologic study of bovine hydroxyapatite in combination with autogenous bone and fibrin glue for maxillary sinus floor augmentation. Results after 6 to 8 months of healing.2001In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 12, no 2, p. 135-143Article in journal (Refereed)
    Abstract [en]

    Biopsies were taken from 16 out of 20 consecutive referral patients 6 to 8 months after maxillary sinus floor augmentation with a mixture of bovine hydroxyapatite (BH), autogenous bone particles and fibrin glue. Four days prior to biopsy retrieval the patients were given a single dose of tetracycline to label bone forming sites. Fluorescence microscopy of 100 microm thick sections revealed active bone formation in conjunction with the BH particles in 14 of 15 specimens analysed. Light microscopy and morphometry of ground sections from 16 patients showed various amounts of mineralised bone tissue in all except one specimen. In the latter case, the BH particles were encapsulated by a dense fibrous connective tissue. Sections from the augmented areas were occupied by non-mineralized tissue (54.1+12.6%), lamellar bone (21.2+24.5%), BH particles (14.5+10.3%) and woven bone (10.2+13.4%). The non-mineralized tissue seen in bone forming areas consisted of a loose connective tissue, rich of vessels and cells, and in the periphery of a more dense fibrous connective tissue. Woven bone with large and scattered osteocyte lacunae was bridging between the BH particles and the lamellar trabecular bone. There were no signs of resorption of the BH particles. The lamellar bone appeared to have originated from the recipient site and was seldom in contact with the BH particles. It is concluded that the tested implant material has bone conducting properties. The bone associated with the BH particles after 6 to 8 months of healing was mainly woven.

  • 4.
    Jungner, Måns
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Lundqvist, Peter
    Umeå University, Faculty of Medicine, Department of Odontology.
    Lundgren, Stefan
    Umeå University, Faculty of Medicine, Department of Odontology.
    Oxidized titanium implants (Nobel Biocares TiUnite) compared with turned titanium implants (Nobel Biocares mark III) with respect to implant failure in a group of consecutive patients treated with early functional loading and two-stage protocol2005In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 16, no 3, p. 308-312Article in journal (Refereed)
  • 5. Karlsson, Karolina
    et al.
    Derks, Jan
    Håkansson, Jan
    Wennström, Jan L.
    Molin Thorén, Margareta
    Umeå University, Faculty of Medicine, Department of Odontology.
    Petzold, Max
    Berglundh, Tord
    Technical complications following implant-supported restorative therapy performed in Sweden2018In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 29, no 6, p. 603-611Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to evaluate the occurrence and consequences of technical complications in implant-supported restorative therapy.

    Material & Methods: The occurrence and consequences of technical complications in implant-supported restorative therapy over a mean follow-up period of 5.3years were assessed based on documentation in files from 2,666 patients. Risk indicators were identified by the use of survival models, considering repeated events. Results were expressed as hazard ratios (HR) including 95% confidence intervals.

    Results: Technical complications occurred in 24.8% of the patients. Chipping and loss of retention were the most common, affecting 11.0% and 7.9% of supraconstructions, respectively, while implant-related complications (e.g., implant fracture) were rare. More than 50% of the affected patients experienced technical complications more than once and almost all reported complications led to interventions by a dental professional. The extent of the supraconstruction was the strongest risk indicator for both chipping (HR<0.2) and loss of retention (HR>3).

    Conclusion: Over a 5-year period, technical complications in implant-supported restorative therapy occurred frequently and their management required professional intervention.

  • 6. Lindgren, Christer
    et al.
    Hallman, Mats
    Umeå University, Faculty of Medicine, Department of Odontology, Oral and Maxillofacial Surgery. Department of Oral and Maxillofacial Surgery, County Hospital, Gävle, Sweden; Centre for Research and Development, Uppsala University/Gävleborg County Council, Sweden.
    Sennerby, Lars
    Sammons, Rachel
    Back-scattered electron imaging and elemental analysis of retrieved bone tissue following sinus augmentation with deproteinized bovine bone or biphasic calcium phosphate2010In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 21, no 9, p. 924-930Article in journal (Refereed)
    Abstract [en]

    Objectives: To compare resorption of a synthetic biphasic calcium phosphate (BCP) bone–graft substitute with deproteinized bovine bone (DBB) used for human maxillary sinus augmentation.

    Materials and methods: Eleven patients underwent bilateral maxillary sinus floor augmentation with DBB in one side and a BCP (40%β-tricalcium phosphate (β-TCP) and 60% hydroxyapatite) in the contralateral side. Simultaneously, with the augmentation on each side a microimplant was placed vertically from the top of the alveolar crest penetrating the residual bone and the grafting material. Eight months after initial surgery the microimplants were retrieved with a surrounding bone core. The composition of residual graft material and surrounding bone was analysed by scanning electron microscopy and energy dispersive X-ray spectroscopy.

    Results: Residual graft material of both types was present as 10–500 μm particles in direct contact with, or completely surrounded by, newly formed bone; smaller particles were also present in non-mineralized tissue. In the case of BCP the bone–graft substitute interface showed evidence of superficial disintegration of particles into individual grains. Median Ca/P ratios (at.%), determined from >200 discreet sites within residual graft particles and adjacent bone, were: DBB: 1.61 (confidence interval [CI] 1.59–1.64); BCP: 1.5 (CI 1.45–1.52); DBB-augmented bone: 1.62 (CI 1.59–1.66); BCP-augmented bone: 1.52 (CI 1.47–1.55); P=0.028 for DBB vs. BCP and DBB- vs. BCP-augmented bone. The reduction in Ca/P ratio for BCP over the healing period is consistent with the dissolution of β-TCP and reprecipitation on the surface of calcium-deficient hydroxyapatite.

    Conclusion: The β-TCP component of BCP may be gradually substituted by calcium-deficient hydroxyapatite over the healing period. This process and superficial degranulation of BCP particles may influence the progress of resorption and healing.

  • 7. Lindh, T
    et al.
    Gunne, J
    Tillberg, A
    Molin, M
    Umeå University, Faculty of Medicine, Odontology, Prosthetic Dentistry.
    A meta-analysis of implants in partial edentulism.1998In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 9, no 2, p. 80-90Article in journal (Refereed)
    Abstract [en]

    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%.

  • 8. Lindh, Tomas
    et al.
    Bäck, Tomas
    Nyström, Elisabeth
    Umeå University, Faculty of Medicine, Odontology, Oral and Maxillofacial Surgery.
    Gunne, Johan
    Umeå University, Faculty of Medicine, Odontology, Prosthetic Dentistry.
    Implant versus tooth-implant supported prostheses in the posterior maxilla: a 2-year report.2001In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 12, no 5, p. 441-449Article in journal (Refereed)
    Abstract [en]

    When implants are used for restoration of a jaw with a residual dentition, the possibility of combining implants with natural abutments may be considered. In a longitudinal comparative study, 26 patients (15 women & 11 men, age 49-84 years) with residual anterior dentitions were treated with two different designs of fixed partial dentures bilaterally in the posterior maxilla. On one side the reconstruction was supported by implants only, while on the contralateral side an implant and a tooth in combination were used. The patients were followed at intervals of 3, 6, 12 and 24 months after loading of the implants. 95 implants were placed, of which 11 non-loaded. A total of 10 implants failed, 7 prior to loading and three within the first three months of service (88.0+/-SE 6.7% cumulative survival for tested implants after two years' follow-up). There was no difference in failure rate for the implants in the two different prosthesis designs. The total mean loss of marginal bone height close to the implants was within acceptable standards, but was more pronounced at the implants not combined with teeth. The results indicate a correlation between the prosthesis design and the loss of marginal bone.

  • 9.
    Mladenovic, Zivko
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Sahlin-Platt, Annika
    Umeå University, Faculty of Medicine, Department of Odontology, Ortodontics.
    Andersson, Britta
    Department of Medicine Solna, Karolinska Institutet, S-171 76 Stockholm,Sweden.
    Johansson, Anders
    Umeå University, Faculty of Medicine, Department of Odontology, Molecular Periodontology.
    Björn, Erik
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Ransjö, Maria
    Umeå University, Faculty of Medicine, Department of Odontology.
    In vitro study of the biological interface of Bio-Oss: implications of the experimental setup2013In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 24, no 3, p. 329-335Article in journal (Refereed)
    Abstract [en]

    Objectives To systematically investigate the biological interface of Bio-Oss by analysing dissolution–precipitation behaviour and osteogenic responses using in vitro experimental systems.

    Material and methods Different concentrations (1–100 mg/ml) of Bio-Oss were incubated in cell culture medium for 24 h before elemental concentrations for calcium, phosphorus and silicon in the medium were analysed with inductive coupled plasma-optical emission spectroscopy. Radioactive calcium-45 isotope labelling technique was used to study possible precipitation of calcium on the Bio-Oss particle. Biological interface of Bio-Oss was studied in osteogenic experiments using mineralization medium and three different sources of cells (primary mouse bone marrow stromal cells, primary rat calvarial cells and MC3T3-E1 mouse pre-osteoblast cell line). Cells were fixed and stained with Toulidine blue, von Kossa or Alizarin Red staining for confirmation of extracellular matrix mineralization.

    Results Elemental analysis of the cell culture medium demonstrated a significant decrease of calcium and phosphorus and a dose-dependent release of silicon to the medium after incubation with Bio-Oss. A significant decrease of calcium and phosphorus in the medium occurred even at low concentrations of Bio-Oss. Uptake of calcium on the Bio-Oss particle was confirmed with radioactive calcium-45 isotope labelling technique. In osteogenic experiments with Bio-Oss (<1 mg/ml), matrix mineralization around the Bio-Oss particles were demonstrated in all three cell types with von Kossa and Alizarin Red staining.

    Conclusion Dissolution–precipitation reactions occur at the surface of Bio-Oss, and osteogenic responses are seen at the biological interface. The concentration of Bio-Oss is a key factor for the experimental in vitro results, and may also have implications for the clinic.

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