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  • 1.
    Ahlqvist, Jan, Birger
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Borg, Kennet
    Gunne, Johan
    Nilson, Hans
    Olsson, Morgan
    Åstrand, Per
    Osseointegrated implants in edentulous jaws: a 2-year longitudinal study.1990Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 5, nr 2, s. 155-163Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Osseointegrated implants in 50 edentulous jaws were studied during a 2-year observation period. The implant survival rate was 89% in the maxillae and 97% in the mandibles. The marginal bone loss averaged 1.7 mm in the maxillae and 1.1 mm in the mandibles. Most of this bone loss occurred during the first year. The bone loss was greater in jaws with a preoperatively minor resorption of the alveolar ridge than in those with moderate or advanced resorption. The bone loss was also greater at the medially positioned implants than at those more posterior.

  • 2.
    Bergendal, Birgitta
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Pedodonti.
    Ekman, Agneta
    Nilsson, Peter
    Implant failure in young children with ectodermal dysplasia: a retrospective evaluation of use and outcome of dental implant treatment in children in Sweden2008Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 23, nr 3, s. 520-524Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: This study surveyed dental implant treatment in children up to age 16 years in Sweden between 1985 and 2005, with special reference to young children with ectodermal dysplasia (ED) and anodontia in the lower jaw.

    Materials and Methods: A questionnaire was sent to Swedish specialist clinics in oral and maxillofacial surgery and prosthetic dentistry. Also, the teams who had treated children with ED were asked to submit their records for these children for a discussion on reasons for implant failure.

    Results: Six out of 30 specialist centers (20%) in Sweden had treated 26 children with dental implants between 1985 and 2005. Twenty-one patients had received 33 implants to replace teeth missing from nonsyndromic agenesis or trauma at ages 14 or 15 years; 2 (6.1%) of these implants were lost. Five children with ED received 14 implants at 5 to 12 years of age; 9 (64.3%) of these implants were lost before loading.

    Conclusions: Dental implant placement has been a rarely used treatment modality in Swedish children less than 16 years old in the last 20 years. The failure rate in children treated because of tooth agenesis was only slightly higher than that reported for adult individuals, whereas in young children with ED and anodontia in the mandible, implants seemed to present special challenges, and the failure rate was very high. The small jaw size and peroperative conditions, rather than ED per se, were thought to be the main risk factors. Centralizing implant operations in young children with ED and monitoring outcomes in implant registers are strongly advocated. Int J Oral Maxillofacial Implants 2008;23:520–524

  • 3.
    Hallman, Mats
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Käkkirurgi.
    Sennerby, Lars
    Lundgren, Stefan
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Käkkirurgi.
    A clinical and histologic evaluation of implant integration in the posterior maxilla after sinus floor augmentation with autogenous bone, bovine hydroxyapatite, or a 20:80 mixture.2002Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 17, nr 5, s. 635-643Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: This study was designed to clinically and histologically evaluate the integration of titanium implants in different grafting materials used for maxillary sinus augmentation procedures. MATERIALS AND METHODS: A total of 21 patients and 36 maxillary sinuses were augmented with (1) autogenous particulated bone from the mandibular ramus, (2) bovine hydroxyapatite (BH) with membrane coverage, or (3) an 80/20 mixture of BH and autogenous bone. The grafts were allowed to heal for 6 to 9 months prior to placement of microimplants for histology and standard implants for prosthetic rehabilitation. After another 6 months of healing, when abutments were connected, the microimplants were retrieved for histologic and morphometric analyses. The outcome of the standard implants was clinically evaluated after 1 year of loading. RESULTS: The mean bone-implant contact was 34.6 +/- 9.5%, 54.3 +/- 33.1%, and 31.6 +/- 19.1% for autogenous bone, mixture of 20% autogenous bone/80% BH, and 100% BH, respectively. The corresponding values for the bone area parameter were 37.7 +/- 31.3%, 39.9 +/- 8%, and 41.7 +/- 26.6%. The BH area was found to be 12.3 +/- 8.5% and 11.8 +/- 3.6% for 20% autogenous bone/80% BH and 100% BH, respectively. There were no statistically significant differences for any parameter between any of the groups. After 1 year of loading, 6 of the 33 implants placed in autogenous bone grafts, 2 of the 35 implants placed in the BH/autogenous bone mixture, and 2 of 43 implants placed in BH were lost. There were no statistically significant differences between any of the groups. DISCUSSION: The histomorphometric analysis showed no differences between the 3 groups, indicating that autogenous bone graft can be substituted with bovine hydroxyapatite to 80% or 100% when used for maxillary sinus floor augmentation. The effect of adding autogenous bone remains unclear but may allow for a reduction of the healing time. CONCLUSION: The results from this clinical and histologic study indicate that similar short-term results can be expected when using autogenous bone, BH, or a mixture of them for maxillary sinus floor augmentation and delayed placement of dental implants.

  • 4.
    Jungner, Måns
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Käkkirurgi. Department of Oral and Maxillofacial Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Legrell, Per Erik
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral diagnostisk radiologi.
    Lundgren, Stefan
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Käkkirurgi.
    Follow-up study of implants with turned or oxidized surfaces placed after sinus augmentation2014Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 29, nr 6, s. 1380-1387Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To compare long-term survival and clinical outcomes of endosseous implants with different surface characteristics in patients with sinus elevation procedures, autologous bone grafting, and delayed implant placement. Materials and Methods: Implant survival, peri-implant soft tissue conditions, marginal bone level, intrasinus apical bone level, and sinus health were studied in patients subjected to autologous bone graft and delayed placement of implants with turned or oxidized surfaces. After a minimum of 5 years of functional loading, all patients were clinically examined regarding gingival pocket depth (PD) and bleeding on probing (BoP). The marginal bone level (MBL) was measured in intraoral radiographs. Cone beam computed tomography was used to evaluate the apical bone level (ABL) of the implants and intrasinus conditions. Results: Twenty-eight patients received sinus elevation and a total of 92 dental implants. Thirteen patients received 47 implants with a turned surface, and 15 patients received 45 implants with an oxidized surface. Mean follow-up was 10 years (range, 5 to 19 years). No significant difference was found between the two implant surfaces in terms of PD, BoP, MBL, or ABL. Four patients (14%) exhibited radiographic signs of sinus pathology, with opacification, polyplike structures, and thickening of the sinus membrane. Radiographic signs of sinus pathology were not correlated to implant survival or to the investigated parameters. Conclusion: Grafting of the maxillary sinus floor with intraorally harvested bone and delayed placement of either turned or oxidized implants results in equally high long-term survival rates, stable marginal and apical bone levels, and good peri-implant soft tissue health.

  • 5. Kahnberg, K E
    et al.
    Nyström, Elisabeth
    Umeå universitet, Medicinsk fakultet, Odontologi, Käkkirurgi.
    Bartholdsson, L
    Combined use of bone grafts and Brånemark fixtures in the treatment of severely resorbed maxillae.1989Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 4, nr 4, s. 297-304Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Bone grafts from the hip in combination with Brånemark self-tapping fixtures have been used to rehabilitate patients with extremely resorbed maxillae. Experiences and results from the first ten consecutive cases have been analyzed to form the basis for further use of the method. Eight of 57 fixtures placed have been lost to date. Surgical complications, including exposure of the bone transplant, have occurred in three patients. The method should be used with caution, and cases should be meticulously chosen to exclude those who do not have proper motivation to endure the long-lasting and demanding surgical and prosthetic procedures required. The combined use of implants and transplants should not be used routinely until a long-term evaluation of the method and results has been made.

  • 6. Lindgren, Christer
    et al.
    Mordenfeld, Arne
    Johansson, Carina B.
    Hallman, Mats
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Käkkirurgi.
    A 3-Year Clinical Follow-up of Implants Placed in Two Different Biomaterials Used for Sinus Augmentation2012Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 27, nr 5, s. 1151-1162Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The aims of the present study were to compare a novel biphasic calcium phosphate (BCP) with deproteinized bovine bone (DBB) for maxillary sinus floor augmentation in a split-mouth design and to perform a clinical follow-up of dental implants placed in the augmented sinuses. Materials and Methods: Partially or completely edentulous patients requiring bilateral sinus augmentation were included in the study. The patients were randomized for augmentation with BCP (test) and DBB (control) in the contralateral side. Eight months after grafting, dental implants were placed. After 3 years of graft healing, core biopsy specimens were obtained from the grafted areas for histologic and histomorphometric analyses. After 3 years of functional implant loading, implant survival/success rates and clinical indices were assessed and radiographic examination and resonance frequency analysis were performed. Results: Nine completely edentulous patients and two partially edentulous patients (mean age, 67 years) who required bilateral sinus augmentation were included in the study, and 62 implants were placed. The mean values for the area of newly formed bone in the retrieved specimens were 29% +/- 14.3% and 32% +/- 18.0% for BCP and DBB, respectively; the percentage of graft particles in contact with bone was 38% +/- 10.9% in the BCP group and 44% +/- 12.1% in the DBB group (no statistical significant differences between groups). The mean values for the area of BCP particles and DBB particles were 20% +/- 7.5% and 24% +/- 13.5%, respectively (difference not significant). One dental implant was lost from each group, resulting in an overall implant survival rate of 96.8% after 3 years of loading. Conclusion: After 3 years, a similar amount of newly formed bone was present regardless of the biomaterial used. The choice of biomaterial did not seem to influence implant survival rates. INT J ORAL MAXILLOFAC IMPLANTS 2012;27:1151-1162

  • 7. Lindgren, Christer
    et al.
    Sennerby, Lars
    Mordenfeld, Arne
    Hallman, Mats
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Käkkirurgi. Department of oral and maxillofacial surgery, Gävle County Hospital, Gävle, Sweden; Center for research and development, Uppsala University/Gävleborg County Council, Sweden.
    Clinical histology of microimplants placed in two different biomaterials2009Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 24, nr 6, s. 1093-1100Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: This randomized, controlled study was designed to compare bone formation around microimplants with a sandblasted, acid-etched surface placed at the time of maxillary sinus floor augmentation with a synthetic biphasic calcium phosphate (BCP) or deproteinized bovine bone (DBB).

    Materials and Methods: Nine completely edentulous patients and two partially edentulous patients (six women, five men) with a mean age of 67 years (range, 50 to 79 years) requiring bilateral sinus augmentation were included in the study. The patients were randomized for augmentation with BCP (test) in one side and DBB (control) in the contralateral side. At the time of augmentation, one microimplant on each side was placed vertically from the top of the alveolar crest, penetrating the residual bone and the grafting material. After 8 months of graft healing, at the time of ordinary implant placement, all 22 microimplants were retrieved with a surrounding bone core for histologic analyses.

    Results: The bone-to-implant contact in the BCP group was 64.6% +/- 9.0%, versus 55.0% +/- 16.0% for the DBB group. The difference was not significant. The corresponding values for the area of newly formed bone in the biopsies were 41.1% +/- 9.8% and 41.6% +/- 14.0% for BCP and DBB, respectively. There were significantly more DBB particles in contact with newly formed bone than BCP particles (87.9 +/- 18.2% versus 53.9 +/- 26.1%; Wilcoxon rank sum test; P = .007).

    Conclusion: In this randomized, controlled clinical trial, new bone formation and bone-to-implant contact around microimplants with a sandblasted, acid-etched surface was found to be equivalent between sinuses augmented with BCP or DBB. Significantly more DBB particles than BCP particles were in contact with newly formed bone, but the clinical relevance of this has yet to be established.

  • 8.
    Nyström, Elisabeth
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Käkkirurgi.
    Kahnberg, Karl-Erik
    Albrektsson, Tomas
    Treatment of the severely resorbed maxillae with bone graft and titanium implants: histologic review of autopsy specimens.1993Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 8, nr 2, s. 167-172Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    One of a series of patients with extremely resorbed maxillae treated with bone grafts from the hip in combination with Brånemark self-tapping fixtures died in a car accident 4 months after implant surgery. Autopsy specimens from this patient were analyzed to evaluate the amount and extent of "osseointegration" after 4 months of healing. Histologic examination revealed that minimal bone was in direct contact with the titanium and the general pattern was that of soft tissue screw anchorage. There were no signs of sequestering of the transplanted bone. The connection between the nasal cavity and the sinus mucosa with respect to the transplants seemed to be without adverse reactions. The superior part of the transplant did show signs of newly formed bone. The grafted specimens showed indications of delayed bone response compared to the nongrafted situation. All implants were clinically stable as studied postmortem.

  • 9.
    Nyström, Elisabeth
    et al.
    Umeå universitet, Medicinsk fakultet, Odontologi, Käkkirurgi.
    Kahnberg, Karl-Erik
    Gunne, Johan
    Umeå universitet, Medicinsk fakultet, Odontologi, Protetik.
    Bone grafts and Brånemark implants in the treatment of the severely resorbed maxilla: a 2-year longitudinal study.1993Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 8, nr 1, s. 45-53Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A combination of horseshoe-shaped iliac bone grafts and Brånemark implants was used in 30 patients with severely resorbed maxillary alveolar ridges. All patients were followed clinically for 2 years and evaluated with regard to prosthesis stability, fixture survival, wound healing complications, and soft tissue conditions. Surgery was performed by the same oral surgeons using identical procedures, and the prosthetic treatment was performed by the same prosthodontist. The development group included the first 10 patients and the routine group included the following 20. Fixture survival in the development group was 54.4%, whereas 88.3% of the fixtures in the routine group have survived after 2 years. The average fixture survival in the study was 77.4%. Three patients in the development group lost all fixtures, primarily the result of trauma to the grafted region. With respect to the difficult situation many of these patients experienced, the survival rate should be considered most acceptable.

  • 10.
    Sjöström, Mats
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Käkkirurgi.
    Lundgren, Stefan
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Käkkirurgi.
    Sennerby, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Käkkirurgi.
    A histomorphometric comparison of the bone graft-titanium interface between interpositional and onlay/inlay bone grafting techniques.2006Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 21, nr 1, s. 52-62Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: To analyze the bone graft-implant interface of titanium microimplants (MIs) placed at the time of bone grafting or after a healing period of 6 months and retrieved after another 6 to 14 months of healing. Integration of MIs placed in interpositional bone grafts (IBGs) in conjunction with a Le Fort I osteotomy was compared with the integration of those placed in onlay/inlay bone grafts (OBGs). MATERIALS AND METHODS: The severely atrophied edentulous maxillae of 23 patients (14 women, 9 men) were restored with autogenous bone grafts (either IBG [n=8] or OBG [n=15]) and titanium implants. Six-month periods were allowed between grafting, implant placement, and abutment connection. The bone-implant interface was studied histologically with the use of unloaded titanium MIs. RESULTS: Sixty-eight MIs were either (1) placed simultaneously with grafting and retrieved after 6, 12, or 14 months or (2) placed after 6 months of healing and retrieved after another 6 to 8 months. Histomorphometry indicated equal degrees of osseointegration for the 2 intraoral reconstruction techniques when looking at bone-implant contact, bone area in threads, and newly formed bone (NFB) (Student t test for unpaired observations). There was a significant difference between simultaneous and delayed implant placement with respect to BIC and NFB (Student t test for paired observations). Three additional MIs placed in the nongrafted residual alveolar ridge and retrieved after 6 months showed significantly more bone in threads and NFB (Student t test for paired observations; P = .003 and P = .009, respectively) compared to MIs placed at graft placement (6 months' healing). DISCUSSION: Timing of implant placement appeared more important than healing time or surgical technique. The delayed approach resulted in better implant integration, probably because of the initial revascularization of the graft. CONCLUSIONS: Implant integration was similar in the IBG and OBG groups. Placement of MIs after an initial healing period of 6 months resulted in better integration than placement simultaneously with grafting.

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