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A clinical and radiological long-term follow-up study of narrow diameter implants in the aesthetic area
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.ORCID iD: 0000-0003-4944-8626
Uppsala & Västerås Käkkirurgiska Ctr, Vaksalagatan 8, S-75320 Uppsala, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.ORCID iD: 0000-0001-9590-2039
2018 (English)In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 20, no 4, p. 598-605Article in journal (Refereed) Published
Abstract [en]

Purpose

To study long-term function of narrow diameter implants (NDI:s) and if reduced implant-tooth distance negatively impacts adjacent teeth.

Materials and Methods

A clinical and radiological follow-up of NDI:s replacing maxillary laterals and mandibular incisors was performed. Subjects that received 3.0-3.3 mm-diameter single implants from 3 units in Uppsala and Vasteras, Sweden, between 2002 and 2011 were offered to participate in this retrospective study.

Results

Twenty-seven patients (30 implants) underwent clinical and CBCT examination, mean follow-up time was 63.3 months. On average, the implant-tooth distance was 1.6 mm at the cervical region and 17 implants were placed 1 mm or less to the adjacent root. Additionally, 2 patients (3 implants) underwent clinical examination (I). Twenty-seven patients (36 implants) declined the examination but agreed to an interview (II). At the time of the follow-up, all implants had good function, and implant survival of group I and II together was 97.2%. In both groups, the 2 main patient concerns were discoloration and regression of the buccal gingiva.

Conclusion

Survival of implants is in accordance to standard diameter studies and although most implants were placed very close to the adjacent teeth, no pathologies could be linked to this except aesthetic concerns.

Place, publisher, year, edition, pages
WILEY , 2018. Vol. 20, no 4, p. 598-605
Keywords [en]
cbct imaging, implant survival, long-term survival, narrow implants
National Category
Dentistry
Identifiers
URN: urn:nbn:se:uu:diva-363062DOI: 10.1111/cid.12627ISI: 000440988300022PubMedID: 29920935OAI: oai:DiVA.org:uu-363062DiVA, id: diva2:1256810
Available from: 2018-10-18 Created: 2018-10-18 Last updated: 2018-10-28Bibliographically approved
In thesis
1. Clinical and experimental studies of bone substitutes and dental implants in compromised bone sites
Open this publication in new window or tab >>Clinical and experimental studies of bone substitutes and dental implants in compromised bone sites
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: With an ageing population, an increase of more challenging implant treatments is expected. In this thesis, we evaluate the outcome of two faster implant protocols, in patients with compromised alveolar bone. We examine the bone integrating abilities of two new synthetic bone substitute materials and in another paper, we discuss the effects of nonsteroidal anti-inflammatory drugs (NSAID) on bone healing.

Aim: In paper I we investigate implant survival and effect of reduced implant-tooth distance. In paper II we evaluate the long-term implant survival and function of immediately loaded implants. In paper III & IV, we analyse if added NSAID reduce postoperative pain and if it has a reduced effect on new bone formation in a rabbit sinus lift model. We also investigate if a ceramic compound (CPC, granules) and hydrogel (HABP.CaP) result in a similar or larger bone amount, in comparison with bovine bone mineral. In Paper V we assess new bone formation adjacent to a hollow CPC implant.

Material & Methods: Paper I present a clinical and radiological follow-up, performed on subjects that previously received 3.0-3.3 mm diameter implants in the aesthetic area. In paper II, clinical and radiographic examinations were performed on subjects that had received six implants each with immediate loading in the maxilla 8-11-year ago. For paper III-IV, pain was assessed by clinical examination and scoring of facial expressions from photos. Histomorphometry and histology evaluations were performed. In paper V, a critical radius defect was created and either replaced by particulate autologous bone (AB) or a CPC implant. Qualitative and quantitative radiographic and histology evaluations were performed. 

Results: In paper I, an implant survival of 97.2% up to 124 months was shown with a tooth-implant distance in many cases of  <1.5 mm. Discoloration and recession of the buccal gingiva was the most frequent patient concern. In paper II a cumulative implant survival rate was 81.9 % at the final follow-up. In paper III and IV it was shown that NSAID had no effect on pain relief or bone formation. No difference was shown between CPC and control, but both showed larger bone amount and BIC than HABP.CaP. In paper V new bone was seen in sites throughout the entire CPC implant.

Conclusion: Satisfactory long-term dental implant results can be obtained without bone augmentation in most patients with atrophic alveolar bone, but there is still a minority in this group that may benefit of bone enhancement prior to implant treatment. To avoid the negative effects of autologous bone grafting, synthetic materials as the presented CPC, have shown promising results as a solution or alternative to existing bone substitutes in animal models.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2018. p. 82
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1515
Keywords
clinical follow-up, calcium phosphates, rabbit model, sinus lift, radius model, in vivo, bisphosphonates, narrow diameter implants, dental implants
National Category
Medical and Health Sciences
Research subject
Oral and Maxillofacial Surgery
Identifiers
urn:nbn:se:uu:diva-364437 (URN)978-91-513-0501-1 (ISBN)
Public defence
2018-12-14, Skoogsalen, Ing. 78/79, Akademiska sjukhuset, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2018-11-23 Created: 2018-10-28 Last updated: 2018-11-30

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Trbakovic, AmelaThor, Andreas

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