AimAim of this study was to verify if the type of implant abutment manufacturing, stock or cad‐ca... more AimAim of this study was to verify if the type of implant abutment manufacturing, stock or cad‐cam, could influence the maintenance of stable gingival margins around single restorations in anterior areas.MethodsAfter 16 weeks of healing, implants (Osseospeed, Astra Tech Dental Implant) were positioned. Depending on the different fixture inclination and the thickness of buccal peri‐implant soft tissue, abutment selection resulted in four groups: Group 1 (patients with zirconia ZirDesign® stock abutments), Group 2 (titanium stock TiDesign® abutments), Group 3 (zirconia cad‐cam abutments), and Group 4 (titanium cad‐cam abutments). The following parameters were assessed: buccal gingival margin modification (BGM). The modification of the implant gingival margin was followed at 1 and 2 years of follow‐up. A computerized analysis was performed for measurements. Differences between soft tissue margin at baseline and after 2 years measured the gingival margin recession. A general linear mode...
To determine the dimensions of the soft tissue cuff present at various aspects of teeth and to co... more To determine the dimensions of the soft tissue cuff present at various aspects of teeth and to compare these dimensions to those of the mucosa surrounding single implants. Fifty volunteers were recruited that were ≥25 years of age and exhibited no signs of (i) untreated caries; (ii) loss of periodontal tissue support in the incisor, canine, and premolar regions; (iii) systemic or local disease. Furthermore, among the 50 patients recruited (iV), 27 had one single implant in the maxilla with teeth present mesial and/or distal to the implant. Probing pocket depth (PPD) and transmucosal sounding depth (TS) were assessed by five experienced, carefully calibrated examiners and with the use of a periodontal probe at the proximal (mesial, distal) and flat (facial, buccal and palatal/lingual) surfaces of all teeth/implants. The width of the keratinized mucosa (KM) was also determined. It was demonstrated that (i) PPD and TS were greater at proximal than at flat surfaces at both tooth and implant sites. In addition, both PPD and TS were deeper at implant than at tooth sites. The TS values documented that the cuff of healthy soft tissue that surrounded a tooth varied between 2 mm at flat surfaces and 4 mm at proximal surfaces, while at implant sites, the mucosa at proximal as well as flat surfaces was 1-1.5 mm greater. The probing pocket depth (PPD) and the transmucosal sounding depth (TS) values were greater at proximal than at flat, that is, facial/palatal (lingual) surfaces at tooth sites and frequently also at implant sites. Furthermore, the PPD and the TS dimensions were greater at implant than at adjacent tooth sites.
The aim of this prospective, randomized, controlled multicenter study was to determine the 3-year... more The aim of this prospective, randomized, controlled multicenter study was to determine the 3-year efficacy and stability of the soft and hard tissues at implants with a different geometry that were placed in fresh extraction sockets. Implants with two different configurations, cylindrical (Group A) or conical/cylindrical (Group B) were installed, and healing abutments were attached. Sixteen weeks after implant placement, subjects returned for a re-entry procedure. Prosthetic restorations were delivered 22 weeks after implant placement. Each subject was placed in a 3-year follow-up program, including examinations at yearly visits including various soft tissue and bone level parameters. The percentage of sites that were considered inflamed during the follow-up period was stable and varied between 8.8% and 10.2%. The radiographic examinations documented improved bone levels at the final examination and the mean improvement from baseline (placement of permanent restoration; PR) amounted to 0.17 ± 0.67 mm. More than 70% (54 of 76) of the implants monitored in this study suffered no bone loss during the maintenance period. Moreover, there was an obvious "gain" of interproximal soft tissue volume and at the 3-year examination around 25% of all embrasure gaps were completely filled with "papillae". Both conical/cylindrical and cylindrical implants placed in fresh extraction sockets allowed proper soft and hard tissue healing to occur. At both types of implants, mucosal inflammation was infrequent, marginal bone levels were maintained, and soft tissue volume increased gradually after the placement of the permanent restoration.
Objective: this study was designed to determine the 3-year efficacy and stability of the soft and... more Objective: this study was designed to determine the 3-year efficacy and stability of the soft and hard tissues at implants with a different geometry that were placed in fresh extraction sockets Method: Implants with 2 different configurations, cylindrical (Group A) or tapered (Group B) were installed. Prosthetic restorations were delivered 22 weeks after implant placement. Each patient was placed in a three-year follow-up program, including examinations at yearly visits including various soft tissue and bone level parameters Result: From the 93 randomized subjects (45 in Group A and 48 in Group B ), in Group A, but not in Group B, there was gain of marginal bone between implant placement and the re-entry surgery, 4 months later. During the course of follow-up almost no alteration of the MBL value occurred in Group A. In group-B, however, the MBL measurements indicated that from the PR visit to the ensuing yearly follow-up visits there was a slight gain of crestal bone (0.28 ± 0.81mm...
Objective: The aim of the present cross-sectional retrospective study was to determine bone loss ... more Objective: The aim of the present cross-sectional retrospective study was to determine bone loss in a sample of subjects restored with implant-supported prostheses and the prevalence and severity of peri-implantitis in a sub-sample. Material and methods: A total of 139 patients who had attended a follow-up visit in 2007 were considered for inclusion. Subjects with implants that had been in function for less than 3 years or had poor quality radiographs were excluded. The final study population comprised 133 subjects with a total of 407 implants. Radiographic measurements identified subjects who had ! 1 implant site exhibiting marginal bone loss of >0.5 mm; 40 subjects met this criterion and were recalled for a clinical examination. Of the 40 subjects that were recalled for the clinical examination, 30 attended. The following parameters were recorded at mesial, distal, buccal, and lingual/palatal aspects of all implants: oral hygiene standard (plaque), bleeding on probing, probing pocket depth (PPD). The mean interval between the baseline (1-year post-loading) and the follow-up radiographs was 4.8 ± 2.3 years. In the total subject sample (133 subjects and 407 implants), the mean amount of marginal bone loss that had occurred was 0.2 ± 1.2 mm. Ninety-three subjects with 246 implant sites exhibited no bone level alteration (group A), whereas 40 subjects with 161 implant sites (group B) displayed marginal bone loss of >0.5 mm at ! 1 implant (loser site). Sixtyeight implant sites in group B exhibited bone loss of >0.5 mm. However, only 20% of subjects and 11% of sites had lost >1 mm marginal bone, and 8% of subjects and 4% of sites had lost >2 mm bone. The total amount of bone loss that had occurred in group B was (i) 0.88 ± 1.5 mm and (ii)
Objective: To determine if longitudinal bone level change at Astra Techt implants placed in the p... more Objective: To determine if longitudinal bone level change at Astra Techt implants placed in the posterior part of the dentition was influenced by the healing conditions provided following implant placement, i.e., submerged or non-submerged healing. Material and methods: Eighty-four patients and 115 fixed partial dentures (FPDs or cases) entered the study. The cases were randomized into two implant installation groups: initially non-submerged (group A) or initially submerged (group B) implants. Three hundred and twenty-four implants were installed (group A ¼ 153; group B ¼ 171): 145 in the maxilla and 179 in the mandible. Radiographs from the implant sites were obtained at FPD insertion (baseline) and subsequently every 12 months. In the radiographs, the position of the marginal bone at the mesial and distal aspects of the implants was determined and the radiographic (Rx) bone level change over time was calculated. Results: Seven implants failed to integrate (four in group A and three in group B). During the 5 years of monitoring, three implants had to be removed and 35 implants were lost to follow-up. The Rx bone level alteration that occurred during year 1 was 0.02 AE 0.38 mm in group A and 0.17 AE 0.51 mm in group B. During the subsequent 4 years there was some further Rx bone loss in group B (0.02 AE 0.62 mm), while in group A there was some gain of bone (0.07 AE 0.5 mm). Conclusion: The peri-implant bone level change and number of biological complications that took place during the 5 years was small and unrelated to the surgical protocol used for implant placement.
This study was performed to determine whether the distance between an implant and a tooth present... more This study was performed to determine whether the distance between an implant and a tooth present in an inter-proximal unit influenced the amount of marginal bone loss that occurred at the two facing (adjacent) surfaces. One hundred and eighty patients with a total of 278 inter-proximal units were included. Radiographs of implants that also included adjacent (facing) natural tooth/teeth were digitalized, and various linear measurements were performed using a software program. The marginal bone level and the bone level change that had occurred during a mean of 5.8 years were assessed as well as distance between the implant and the adjacent tooth/teeth. The mean amount of additional marginal bone loss that took place during the observation period was about 0.4 mm at both implants and adjacent tooth surfaces. The horizontal distance between an implant and the facing tooth did not influence the amount of marginal bone loss that had occurred. In most inter-proximal units, more advanced b...
Some studies have indicated that marginal bone loss at implants and at teeth are similar, while r... more Some studies have indicated that marginal bone loss at implants and at teeth are similar, while results from other studies showed that implants lost more bone than teeth in the same dentition. To determine the amount of progressive marginal bone loss that had occurred at implants and teeth in the same segment of the dentition following implant placement in partially dentate subjects. A total of 217 patients with a total of 573 implants and 318 teeth present in the same segments of the dentition were included. Radiographs were available from 1 year (baseline) and ≥3 years after loading. The mean bone loss that occurred between the two examinations was at implants 0.42 ± 0.68 mm and at teeth 0.44 ± 0.52 mm. Thirty-eight subjects (18%) had ≥1 implant exhibiting >1 mm bone loss. Bone loss at the 148 implants in this category of patients was 1.30 ± 1.04 mm with a corresponding loss at the 69 teeth of 0.53 ± 0.62 mm. Eighteen subjects (8%) had ≥1 tooth that exhibited >1 mm bone loss...
Objective: this study was designed to determine the 3-year efficacy and stability of the soft and... more Objective: this study was designed to determine the 3-year efficacy and stability of the soft and hard tissues at implants with a different geometry that were placed in fresh extraction sockets Method: Implants with 2 different configurations, cylindrical (Group A) or tapered (Group B) were installed. Prosthetic restorations were delivered 22 weeks after implant placement. Each patient was placed in a three-year follow-up program, including examinations at yearly visits including various soft tissue and bone level parameters Result: From the 93 randomized subjects (45 in Group A and 48 in Group B ), in Group A, but not in Group B, there was gain of marginal bone between implant placement and the re-entry surgery, 4 months later. During the course of follow-up almost no alteration of the MBL value occurred in Group A. In group-B, however, the MBL measurements indicated that from the PR visit to the ensuing yearly follow-up visits there was a slight gain of crestal bone (0.28 ± 0.81mm...
Aim of this study was to verify if the type of implant abutment manufacturing, stock or cad-cam, ... more Aim of this study was to verify if the type of implant abutment manufacturing, stock or cad-cam, could influence the maintenance of stable gingival margins around single restorations in anterior areas. After 16 weeks of healing, implants (Osseospeed, Astra Tech Dental Implant) were positioned. Depending on the different fixture inclination and the thickness of buccal peri-implant soft tissue, abutment selection resulted in four groups: Group 1 (patients with zirconia ZirDesign(®) stock abutments), Group 2 (titanium stock TiDesign(®) abutments), Group 3 (zirconia cad-cam abutments), and Group 4 (titanium cad-cam abutments). The following parameters were assessed: buccal gingival margin modification (BGM). The modification of the implant gingival margin was followed at 1 and 2 years of follow-up. A computerized analysis was performed for measurements. Differences between soft tissue margin at baseline and after 2 years measured the gingival margin recession. A general linear model was used to evaluate each group in relation to gingival recession after two years. Tukey's post hoc test was used to compare the mean REC indexes of each group of abutments. Seventy-two healthy patients (39 males and 33 females; mean age of 46 years) scheduled for single gap rehabilitation in anterior areas were enrolled. A 100% of implant survival rate was observed after 24 months of function. One failure occurred due to fracture of a Zirconia cad-cam abutment. Moreover, two abutment screw unscrewing were observed. Both for zirconia and titanium stock abutments (Group 1 and 2), the mean recession of implant buccal soft tissue was of 0.3 mm (SD of 0.3 and 0.4 mm, respectively). Soft tissue mean recession of zirconia and titanium cad-cam abutments (Group 3 and 4) was of 0.1 and -0.3 mm, respectively (SD of 0.3 and 0.4 mm, respectively). REC values of cad-cam titanium abutments (Group 4) were significantly lower than that of Group 1 (-0.57 mm), Group 2 (-0.61 mm), and Group 3 (-0.40 mm), respectively (Table ). In the anterior area, the use of cad-cam abutments is related to a better soft tissue stability. Such a relationship is significant if cad-cam titanium abutments are compared to both titanium and zirconia stock abutments.
The International Journal of Periodontics and Restorative Dentistry, 2013
This report presents early clinical experiences with the treatment of a consecutive cohort of 89 ... more This report presents early clinical experiences with the treatment of a consecutive cohort of 89 patients who received 125 prostheses supported by 205 milled abutments. Abutments were fabricated using unique computer-aided design software to deliver both titanium and zirconia abutments based on idealized values for tooth dimensions and emergence profiles as well as on a scan of the proposed definitive prosthesis. (Int J
Objective: To determine the dimensions of the soft tissue cuff present at various aspects of teet... more Objective: To determine the dimensions of the soft tissue cuff present at various aspects of teeth and to compare these dimensions to those of the mucosa surrounding single implants.
Background: Early implant failures may document that the bone tissue or the wound-healing process... more Background: Early implant failures may document that the bone tissue or the wound-healing process following installation surgery was compromised. Subjects who have lost teeth for periodontal reasons exhibit more earlier implant failures than subjects who had experienced tooth loss for other reasons.
The aim of the present study was to examine tissue integration of implants placed (i) in subjects... more The aim of the present study was to examine tissue integration of implants placed (i) in subjects who had lost teeth because of advanced periodontal disease or for other reasons, (ii) in the posterior maxilla exhibiting varying amounts of mineralized bone.
The aim of the present cross-sectional retrospective study was to determine bone loss in a sample... more The aim of the present cross-sectional retrospective study was to determine bone loss in a sample of subjects restored with implant-supported prostheses and the prevalence and severity of peri-implantitis in a sub-sample. A total of 139 patients who had attended a follow-up visit in 2007 were considered for inclusion. Subjects with implants that had been in function for less than 3 years or had poor quality radiographs were excluded. The final study population comprised 133 subjects with a total of 407 implants. Radiographic measurements identified subjects who had ≥1 implant site exhibiting marginal bone loss of >0.5 mm; 40 subjects met this criterion and were recalled for a clinical examination. Of the 40 subjects that were recalled for the clinical examination, 30 attended. The following parameters were recorded at mesial, distal, buccal, and lingual/palatal aspects of all implants: oral hygiene standard (plaque), bleeding on probing, probing pocket depth (PPD). The mean interval between the baseline (1-year post-loading) and the follow-up radiographs was 4.8 ± 2.3 years. In the total subject sample (133 subjects and 407 implants), the mean amount of marginal bone loss that had occurred was 0.2 ± 1.2 mm. Ninety-three subjects with 246 implant sites exhibited no bone level alteration (group A), whereas 40 subjects with 161 implant sites (group B) displayed marginal bone loss of >0.5 mm at ≥1 implant (loser site). Sixty-eight implant sites in group B exhibited bone loss of >0.5 mm. However, only 20% of subjects and 11% of sites had lost >1 mm marginal bone, and 8% of subjects and 4% of sites had lost >2 mm bone. The total amount of bone loss that had occurred in group B was (i) 0.88 ± 1.5 mm and (ii) among the loser sites 2.1 ± 1.4 mm. Thirty subjects from group B were exposed to a clinical examination; out of 37 sites with bone loss >0.5 mm in this subgroup, 29 sites had a PPD value of ≥4 mm. Marginal bone loss (>0.5 mm) at implants was observed in 30% of subjects and 16% of implant sites. More advanced loss of marginal bone occurred in much fewer subjects and sites. Sites with marginal bone loss was in the sub-sample characterized by bleeding on probing, but only occasionally with deep (≥6 mm) pockets.
The primary objective of this study was to determine the association between the size of the void... more The primary objective of this study was to determine the association between the size of the void established by using two different implant configurations and the amount of buccal/palatal bone loss that occurred during 16 weeks of healing following their installation into extraction sockets.
Aim: To identify factors that may influence ridge alterations occurring at the buccal aspect of t... more Aim: To identify factors that may influence ridge alterations occurring at the buccal aspect of the extraction site following immediate implant placement. Material and methods: In 93 subjects, single-tooth implants were placed immediately into extraction sockets in the maxilla (tooth locations 15-25). A series of measurements describing the extraction site were made immediately after implant installation and at reentry, 16 weeks later. The implant sites were stratified according to four factors: (i) implant location (anterior/posterior), (ii) cause of tooth extraction (periodontitis/non-periodontitis), (iii) thickness of the buccal bone walls ( 1/41 mm) and (iv) the dimension of the horizontal buccal gap ( 1/41 mm).
Aim: To use multilevel, multivariate models to analyze factors that may affect bone alterations d... more Aim: To use multilevel, multivariate models to analyze factors that may affect bone alterations during healing after an implant immediately placed into an extraction socket. Material and methods: Data included in the current analysis were obtained from a clinical trial in which a series of measurements were performed to characterize the extraction site immediately after implant installation and at re-entry 4 months later. A regression multilevel, multivariate model was built to analyze factors affecting the following variables: (i) the distance between the implant surface and the outer bony crest (S-OC), (ii) the horizontal residual gap (S-IC), (iii) the vertical residual gap (R-D) and (iv) the vertical position of the bone crest opposite the implant (R-C). Results: It was demonstrated that (i) the S-OC change was significantly affected by the thickness of the bone crest; (ii) the size of the residual gap was dependent of the size of the initial gap and the thickness of the bone crest; and (iii) the reduction of the buccal vertical gap was dependent on the age of the subject. Moreover, the position of the implant opposite the alveolar crest of the buccal ridge and its bucco-lingual implant position influenced the amount of buccal crest resorption. Conclusions: Clinicians must consider the thickness of the buccal bony wall in the extraction site and the vertical as well as the horizontal positioning of the implant in the socket, because these factors will influence hard tissue changes during healing.
The objective of this prospective study was to determine the prevalence and incidence of marginal... more The objective of this prospective study was to determine the prevalence and incidence of marginal bone loss and, in addition, peri-implantitis in subjects and implant sites after 10 years in function. One hundred and thirty-three subjects with a total of 407 implants that had been in function for about 5 years attended a follow-up visit in 2007 (visit 2; V2). 100 of the 133 subjects returned for a new clinical and radiographic examination in 2012 (visit 3; V3). The clinical examination included assessment of "bleeding on probing" (BoP+) and "probing pocket depth." Subjects with implant sites that in the radiograph exhibited crater-shaped marginal bone loss of >0.5 mm were identified as losers. During the interval between V2 and V3 (about 5 years), 13 implants in 7 subjects exhibited progressive bone loss and were removed. The overall amount of crestal bone loss that had occurred at the remaining implants between visit 1 (V1; ≥1 year of loading) and V3 (10 years) was small (0.36 ± 1.4 mm). The bone-level reduction was twice as great between V2 and V3 as between V1 and V2. Forty subjects and 75 (26%) implant sites exhibited marginal bone loss of >0.5 mm between V1 and V3. In the interval between V2 and V3, 37 new implant sites lost significant amounts of bone. During the entire 10-year period (V1-V3), 12% of patients and 5% of implants displayed signs of peri-implantitis (bone loss >0.5 mm, BoP+, PPD ≥6 mm), while in the V2-V3 interval, the corresponding numbers were 10% (patients) and 4% (implant sites). Sites with marginal bone loss of ≥1 mm were not common among implant patients. Peri-implantitis occurred in about 10% of patients and 4% of implant sites.
AimAim of this study was to verify if the type of implant abutment manufacturing, stock or cad‐ca... more AimAim of this study was to verify if the type of implant abutment manufacturing, stock or cad‐cam, could influence the maintenance of stable gingival margins around single restorations in anterior areas.MethodsAfter 16 weeks of healing, implants (Osseospeed, Astra Tech Dental Implant) were positioned. Depending on the different fixture inclination and the thickness of buccal peri‐implant soft tissue, abutment selection resulted in four groups: Group 1 (patients with zirconia ZirDesign® stock abutments), Group 2 (titanium stock TiDesign® abutments), Group 3 (zirconia cad‐cam abutments), and Group 4 (titanium cad‐cam abutments). The following parameters were assessed: buccal gingival margin modification (BGM). The modification of the implant gingival margin was followed at 1 and 2 years of follow‐up. A computerized analysis was performed for measurements. Differences between soft tissue margin at baseline and after 2 years measured the gingival margin recession. A general linear mode...
To determine the dimensions of the soft tissue cuff present at various aspects of teeth and to co... more To determine the dimensions of the soft tissue cuff present at various aspects of teeth and to compare these dimensions to those of the mucosa surrounding single implants. Fifty volunteers were recruited that were ≥25 years of age and exhibited no signs of (i) untreated caries; (ii) loss of periodontal tissue support in the incisor, canine, and premolar regions; (iii) systemic or local disease. Furthermore, among the 50 patients recruited (iV), 27 had one single implant in the maxilla with teeth present mesial and/or distal to the implant. Probing pocket depth (PPD) and transmucosal sounding depth (TS) were assessed by five experienced, carefully calibrated examiners and with the use of a periodontal probe at the proximal (mesial, distal) and flat (facial, buccal and palatal/lingual) surfaces of all teeth/implants. The width of the keratinized mucosa (KM) was also determined. It was demonstrated that (i) PPD and TS were greater at proximal than at flat surfaces at both tooth and implant sites. In addition, both PPD and TS were deeper at implant than at tooth sites. The TS values documented that the cuff of healthy soft tissue that surrounded a tooth varied between 2 mm at flat surfaces and 4 mm at proximal surfaces, while at implant sites, the mucosa at proximal as well as flat surfaces was 1-1.5 mm greater. The probing pocket depth (PPD) and the transmucosal sounding depth (TS) values were greater at proximal than at flat, that is, facial/palatal (lingual) surfaces at tooth sites and frequently also at implant sites. Furthermore, the PPD and the TS dimensions were greater at implant than at adjacent tooth sites.
The aim of this prospective, randomized, controlled multicenter study was to determine the 3-year... more The aim of this prospective, randomized, controlled multicenter study was to determine the 3-year efficacy and stability of the soft and hard tissues at implants with a different geometry that were placed in fresh extraction sockets. Implants with two different configurations, cylindrical (Group A) or conical/cylindrical (Group B) were installed, and healing abutments were attached. Sixteen weeks after implant placement, subjects returned for a re-entry procedure. Prosthetic restorations were delivered 22 weeks after implant placement. Each subject was placed in a 3-year follow-up program, including examinations at yearly visits including various soft tissue and bone level parameters. The percentage of sites that were considered inflamed during the follow-up period was stable and varied between 8.8% and 10.2%. The radiographic examinations documented improved bone levels at the final examination and the mean improvement from baseline (placement of permanent restoration; PR) amounted to 0.17 ± 0.67 mm. More than 70% (54 of 76) of the implants monitored in this study suffered no bone loss during the maintenance period. Moreover, there was an obvious "gain" of interproximal soft tissue volume and at the 3-year examination around 25% of all embrasure gaps were completely filled with "papillae". Both conical/cylindrical and cylindrical implants placed in fresh extraction sockets allowed proper soft and hard tissue healing to occur. At both types of implants, mucosal inflammation was infrequent, marginal bone levels were maintained, and soft tissue volume increased gradually after the placement of the permanent restoration.
Objective: this study was designed to determine the 3-year efficacy and stability of the soft and... more Objective: this study was designed to determine the 3-year efficacy and stability of the soft and hard tissues at implants with a different geometry that were placed in fresh extraction sockets Method: Implants with 2 different configurations, cylindrical (Group A) or tapered (Group B) were installed. Prosthetic restorations were delivered 22 weeks after implant placement. Each patient was placed in a three-year follow-up program, including examinations at yearly visits including various soft tissue and bone level parameters Result: From the 93 randomized subjects (45 in Group A and 48 in Group B ), in Group A, but not in Group B, there was gain of marginal bone between implant placement and the re-entry surgery, 4 months later. During the course of follow-up almost no alteration of the MBL value occurred in Group A. In group-B, however, the MBL measurements indicated that from the PR visit to the ensuing yearly follow-up visits there was a slight gain of crestal bone (0.28 ± 0.81mm...
Objective: The aim of the present cross-sectional retrospective study was to determine bone loss ... more Objective: The aim of the present cross-sectional retrospective study was to determine bone loss in a sample of subjects restored with implant-supported prostheses and the prevalence and severity of peri-implantitis in a sub-sample. Material and methods: A total of 139 patients who had attended a follow-up visit in 2007 were considered for inclusion. Subjects with implants that had been in function for less than 3 years or had poor quality radiographs were excluded. The final study population comprised 133 subjects with a total of 407 implants. Radiographic measurements identified subjects who had ! 1 implant site exhibiting marginal bone loss of >0.5 mm; 40 subjects met this criterion and were recalled for a clinical examination. Of the 40 subjects that were recalled for the clinical examination, 30 attended. The following parameters were recorded at mesial, distal, buccal, and lingual/palatal aspects of all implants: oral hygiene standard (plaque), bleeding on probing, probing pocket depth (PPD). The mean interval between the baseline (1-year post-loading) and the follow-up radiographs was 4.8 ± 2.3 years. In the total subject sample (133 subjects and 407 implants), the mean amount of marginal bone loss that had occurred was 0.2 ± 1.2 mm. Ninety-three subjects with 246 implant sites exhibited no bone level alteration (group A), whereas 40 subjects with 161 implant sites (group B) displayed marginal bone loss of >0.5 mm at ! 1 implant (loser site). Sixtyeight implant sites in group B exhibited bone loss of >0.5 mm. However, only 20% of subjects and 11% of sites had lost >1 mm marginal bone, and 8% of subjects and 4% of sites had lost >2 mm bone. The total amount of bone loss that had occurred in group B was (i) 0.88 ± 1.5 mm and (ii)
Objective: To determine if longitudinal bone level change at Astra Techt implants placed in the p... more Objective: To determine if longitudinal bone level change at Astra Techt implants placed in the posterior part of the dentition was influenced by the healing conditions provided following implant placement, i.e., submerged or non-submerged healing. Material and methods: Eighty-four patients and 115 fixed partial dentures (FPDs or cases) entered the study. The cases were randomized into two implant installation groups: initially non-submerged (group A) or initially submerged (group B) implants. Three hundred and twenty-four implants were installed (group A ¼ 153; group B ¼ 171): 145 in the maxilla and 179 in the mandible. Radiographs from the implant sites were obtained at FPD insertion (baseline) and subsequently every 12 months. In the radiographs, the position of the marginal bone at the mesial and distal aspects of the implants was determined and the radiographic (Rx) bone level change over time was calculated. Results: Seven implants failed to integrate (four in group A and three in group B). During the 5 years of monitoring, three implants had to be removed and 35 implants were lost to follow-up. The Rx bone level alteration that occurred during year 1 was 0.02 AE 0.38 mm in group A and 0.17 AE 0.51 mm in group B. During the subsequent 4 years there was some further Rx bone loss in group B (0.02 AE 0.62 mm), while in group A there was some gain of bone (0.07 AE 0.5 mm). Conclusion: The peri-implant bone level change and number of biological complications that took place during the 5 years was small and unrelated to the surgical protocol used for implant placement.
This study was performed to determine whether the distance between an implant and a tooth present... more This study was performed to determine whether the distance between an implant and a tooth present in an inter-proximal unit influenced the amount of marginal bone loss that occurred at the two facing (adjacent) surfaces. One hundred and eighty patients with a total of 278 inter-proximal units were included. Radiographs of implants that also included adjacent (facing) natural tooth/teeth were digitalized, and various linear measurements were performed using a software program. The marginal bone level and the bone level change that had occurred during a mean of 5.8 years were assessed as well as distance between the implant and the adjacent tooth/teeth. The mean amount of additional marginal bone loss that took place during the observation period was about 0.4 mm at both implants and adjacent tooth surfaces. The horizontal distance between an implant and the facing tooth did not influence the amount of marginal bone loss that had occurred. In most inter-proximal units, more advanced b...
Some studies have indicated that marginal bone loss at implants and at teeth are similar, while r... more Some studies have indicated that marginal bone loss at implants and at teeth are similar, while results from other studies showed that implants lost more bone than teeth in the same dentition. To determine the amount of progressive marginal bone loss that had occurred at implants and teeth in the same segment of the dentition following implant placement in partially dentate subjects. A total of 217 patients with a total of 573 implants and 318 teeth present in the same segments of the dentition were included. Radiographs were available from 1 year (baseline) and ≥3 years after loading. The mean bone loss that occurred between the two examinations was at implants 0.42 ± 0.68 mm and at teeth 0.44 ± 0.52 mm. Thirty-eight subjects (18%) had ≥1 implant exhibiting >1 mm bone loss. Bone loss at the 148 implants in this category of patients was 1.30 ± 1.04 mm with a corresponding loss at the 69 teeth of 0.53 ± 0.62 mm. Eighteen subjects (8%) had ≥1 tooth that exhibited >1 mm bone loss...
Objective: this study was designed to determine the 3-year efficacy and stability of the soft and... more Objective: this study was designed to determine the 3-year efficacy and stability of the soft and hard tissues at implants with a different geometry that were placed in fresh extraction sockets Method: Implants with 2 different configurations, cylindrical (Group A) or tapered (Group B) were installed. Prosthetic restorations were delivered 22 weeks after implant placement. Each patient was placed in a three-year follow-up program, including examinations at yearly visits including various soft tissue and bone level parameters Result: From the 93 randomized subjects (45 in Group A and 48 in Group B ), in Group A, but not in Group B, there was gain of marginal bone between implant placement and the re-entry surgery, 4 months later. During the course of follow-up almost no alteration of the MBL value occurred in Group A. In group-B, however, the MBL measurements indicated that from the PR visit to the ensuing yearly follow-up visits there was a slight gain of crestal bone (0.28 ± 0.81mm...
Aim of this study was to verify if the type of implant abutment manufacturing, stock or cad-cam, ... more Aim of this study was to verify if the type of implant abutment manufacturing, stock or cad-cam, could influence the maintenance of stable gingival margins around single restorations in anterior areas. After 16 weeks of healing, implants (Osseospeed, Astra Tech Dental Implant) were positioned. Depending on the different fixture inclination and the thickness of buccal peri-implant soft tissue, abutment selection resulted in four groups: Group 1 (patients with zirconia ZirDesign(®) stock abutments), Group 2 (titanium stock TiDesign(®) abutments), Group 3 (zirconia cad-cam abutments), and Group 4 (titanium cad-cam abutments). The following parameters were assessed: buccal gingival margin modification (BGM). The modification of the implant gingival margin was followed at 1 and 2 years of follow-up. A computerized analysis was performed for measurements. Differences between soft tissue margin at baseline and after 2 years measured the gingival margin recession. A general linear model was used to evaluate each group in relation to gingival recession after two years. Tukey's post hoc test was used to compare the mean REC indexes of each group of abutments. Seventy-two healthy patients (39 males and 33 females; mean age of 46 years) scheduled for single gap rehabilitation in anterior areas were enrolled. A 100% of implant survival rate was observed after 24 months of function. One failure occurred due to fracture of a Zirconia cad-cam abutment. Moreover, two abutment screw unscrewing were observed. Both for zirconia and titanium stock abutments (Group 1 and 2), the mean recession of implant buccal soft tissue was of 0.3 mm (SD of 0.3 and 0.4 mm, respectively). Soft tissue mean recession of zirconia and titanium cad-cam abutments (Group 3 and 4) was of 0.1 and -0.3 mm, respectively (SD of 0.3 and 0.4 mm, respectively). REC values of cad-cam titanium abutments (Group 4) were significantly lower than that of Group 1 (-0.57 mm), Group 2 (-0.61 mm), and Group 3 (-0.40 mm), respectively (Table ). In the anterior area, the use of cad-cam abutments is related to a better soft tissue stability. Such a relationship is significant if cad-cam titanium abutments are compared to both titanium and zirconia stock abutments.
The International Journal of Periodontics and Restorative Dentistry, 2013
This report presents early clinical experiences with the treatment of a consecutive cohort of 89 ... more This report presents early clinical experiences with the treatment of a consecutive cohort of 89 patients who received 125 prostheses supported by 205 milled abutments. Abutments were fabricated using unique computer-aided design software to deliver both titanium and zirconia abutments based on idealized values for tooth dimensions and emergence profiles as well as on a scan of the proposed definitive prosthesis. (Int J
Objective: To determine the dimensions of the soft tissue cuff present at various aspects of teet... more Objective: To determine the dimensions of the soft tissue cuff present at various aspects of teeth and to compare these dimensions to those of the mucosa surrounding single implants.
Background: Early implant failures may document that the bone tissue or the wound-healing process... more Background: Early implant failures may document that the bone tissue or the wound-healing process following installation surgery was compromised. Subjects who have lost teeth for periodontal reasons exhibit more earlier implant failures than subjects who had experienced tooth loss for other reasons.
The aim of the present study was to examine tissue integration of implants placed (i) in subjects... more The aim of the present study was to examine tissue integration of implants placed (i) in subjects who had lost teeth because of advanced periodontal disease or for other reasons, (ii) in the posterior maxilla exhibiting varying amounts of mineralized bone.
The aim of the present cross-sectional retrospective study was to determine bone loss in a sample... more The aim of the present cross-sectional retrospective study was to determine bone loss in a sample of subjects restored with implant-supported prostheses and the prevalence and severity of peri-implantitis in a sub-sample. A total of 139 patients who had attended a follow-up visit in 2007 were considered for inclusion. Subjects with implants that had been in function for less than 3 years or had poor quality radiographs were excluded. The final study population comprised 133 subjects with a total of 407 implants. Radiographic measurements identified subjects who had ≥1 implant site exhibiting marginal bone loss of >0.5 mm; 40 subjects met this criterion and were recalled for a clinical examination. Of the 40 subjects that were recalled for the clinical examination, 30 attended. The following parameters were recorded at mesial, distal, buccal, and lingual/palatal aspects of all implants: oral hygiene standard (plaque), bleeding on probing, probing pocket depth (PPD). The mean interval between the baseline (1-year post-loading) and the follow-up radiographs was 4.8 ± 2.3 years. In the total subject sample (133 subjects and 407 implants), the mean amount of marginal bone loss that had occurred was 0.2 ± 1.2 mm. Ninety-three subjects with 246 implant sites exhibited no bone level alteration (group A), whereas 40 subjects with 161 implant sites (group B) displayed marginal bone loss of >0.5 mm at ≥1 implant (loser site). Sixty-eight implant sites in group B exhibited bone loss of >0.5 mm. However, only 20% of subjects and 11% of sites had lost >1 mm marginal bone, and 8% of subjects and 4% of sites had lost >2 mm bone. The total amount of bone loss that had occurred in group B was (i) 0.88 ± 1.5 mm and (ii) among the loser sites 2.1 ± 1.4 mm. Thirty subjects from group B were exposed to a clinical examination; out of 37 sites with bone loss >0.5 mm in this subgroup, 29 sites had a PPD value of ≥4 mm. Marginal bone loss (>0.5 mm) at implants was observed in 30% of subjects and 16% of implant sites. More advanced loss of marginal bone occurred in much fewer subjects and sites. Sites with marginal bone loss was in the sub-sample characterized by bleeding on probing, but only occasionally with deep (≥6 mm) pockets.
The primary objective of this study was to determine the association between the size of the void... more The primary objective of this study was to determine the association between the size of the void established by using two different implant configurations and the amount of buccal/palatal bone loss that occurred during 16 weeks of healing following their installation into extraction sockets.
Aim: To identify factors that may influence ridge alterations occurring at the buccal aspect of t... more Aim: To identify factors that may influence ridge alterations occurring at the buccal aspect of the extraction site following immediate implant placement. Material and methods: In 93 subjects, single-tooth implants were placed immediately into extraction sockets in the maxilla (tooth locations 15-25). A series of measurements describing the extraction site were made immediately after implant installation and at reentry, 16 weeks later. The implant sites were stratified according to four factors: (i) implant location (anterior/posterior), (ii) cause of tooth extraction (periodontitis/non-periodontitis), (iii) thickness of the buccal bone walls ( 1/41 mm) and (iv) the dimension of the horizontal buccal gap ( 1/41 mm).
Aim: To use multilevel, multivariate models to analyze factors that may affect bone alterations d... more Aim: To use multilevel, multivariate models to analyze factors that may affect bone alterations during healing after an implant immediately placed into an extraction socket. Material and methods: Data included in the current analysis were obtained from a clinical trial in which a series of measurements were performed to characterize the extraction site immediately after implant installation and at re-entry 4 months later. A regression multilevel, multivariate model was built to analyze factors affecting the following variables: (i) the distance between the implant surface and the outer bony crest (S-OC), (ii) the horizontal residual gap (S-IC), (iii) the vertical residual gap (R-D) and (iv) the vertical position of the bone crest opposite the implant (R-C). Results: It was demonstrated that (i) the S-OC change was significantly affected by the thickness of the bone crest; (ii) the size of the residual gap was dependent of the size of the initial gap and the thickness of the bone crest; and (iii) the reduction of the buccal vertical gap was dependent on the age of the subject. Moreover, the position of the implant opposite the alveolar crest of the buccal ridge and its bucco-lingual implant position influenced the amount of buccal crest resorption. Conclusions: Clinicians must consider the thickness of the buccal bony wall in the extraction site and the vertical as well as the horizontal positioning of the implant in the socket, because these factors will influence hard tissue changes during healing.
The objective of this prospective study was to determine the prevalence and incidence of marginal... more The objective of this prospective study was to determine the prevalence and incidence of marginal bone loss and, in addition, peri-implantitis in subjects and implant sites after 10 years in function. One hundred and thirty-three subjects with a total of 407 implants that had been in function for about 5 years attended a follow-up visit in 2007 (visit 2; V2). 100 of the 133 subjects returned for a new clinical and radiographic examination in 2012 (visit 3; V3). The clinical examination included assessment of "bleeding on probing" (BoP+) and "probing pocket depth." Subjects with implant sites that in the radiograph exhibited crater-shaped marginal bone loss of >0.5 mm were identified as losers. During the interval between V2 and V3 (about 5 years), 13 implants in 7 subjects exhibited progressive bone loss and were removed. The overall amount of crestal bone loss that had occurred at the remaining implants between visit 1 (V1; ≥1 year of loading) and V3 (10 years) was small (0.36 ± 1.4 mm). The bone-level reduction was twice as great between V2 and V3 as between V1 and V2. Forty subjects and 75 (26%) implant sites exhibited marginal bone loss of >0.5 mm between V1 and V3. In the interval between V2 and V3, 37 new implant sites lost significant amounts of bone. During the entire 10-year period (V1-V3), 12% of patients and 5% of implants displayed signs of peri-implantitis (bone loss >0.5 mm, BoP+, PPD ≥6 mm), while in the V2-V3 interval, the corresponding numbers were 10% (patients) and 4% (implant sites). Sites with marginal bone loss of ≥1 mm were not common among implant patients. Peri-implantitis occurred in about 10% of patients and 4% of implant sites.
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