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  • 1.
    Aludden, Hanna
    et al.
    Aalborg Univ Hosp, Dept Oral & Maxillofacial Surg, 18-22 Hobrovej, DK-9000 Aalborg, Denmark.
    Mordenfeld, Arne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Publ Hlth Serv, Dept Oral & Maxillofacial Surg, Gavle, Sweden.
    Hallman, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Publ Hlth Serv, Dept Oral & Maxillofacial Surg, Gavle, Sweden.
    Christensen, Ann-Eva
    Aalborg Univ Hosp, Unit Epidemiol & Biostatist, Aalborg, Denmark.
    Starch-Jensen, Thomas
    Aalborg Univ Hosp, Dept Oral & Maxillofacial Surg, 18-22 Hobrovej, DK-9000 Aalborg, Denmark.
    Osteotome-Mediated Sinus Floor Elevation With or Without a Grafting Material: A Systematic Review and Meta-analysis of Long-term Studies (>= 5-Years)2018In: Implant Dentistry, ISSN 1056-6163, E-ISSN 1538-2982, Vol. 27, no 4, p. 488-497Article, review/survey (Refereed)
    Abstract [en]

    Objective: To test the hypothesis of no difference in the long-term treatment outcome after osteotome-mediated sinus floor elevation with or without a grafting material. Materials and Methods: A MEDLINE/PubMed, Cochrane Library, and EMBASE search in combination with a hand-search of relevant journals was conducted, including human studies published in English from January 1, 1986 to December 1, 2017. Results: One comparative and 7 noncomparative studies fulfilled the inclusion criteria. Survival of suprastructures had never been compared within the same study. Meta-analysis demonstrated an overall estimated patient-based implant survival of 94%. Gain in vertical alveolar bone height was similar with the 2 treatment modalities. Noncomparative studies demonstrated high long-term survival rate of suprastructures and implants with the 2 treatment modalities, as well as limited periimplant marginal bone loss. Conclusion: High long-term implant survival was demonstrated after osteotome-mediated sinus floor elevation with or without a grafting material. However, long-term randomized controlled trials comparing the 2 treatment modalities are sparse. Hence, conclusions drawn from this systematic review should be interpreted with caution.

  • 2. Astrand, Per
    et al.
    Engquist, Bo
    Anzén, Bengt
    Bergendal, Tom
    Hallman, Mats
    Uppsala University, Interfaculty Units, Centrum för klinisk forskning, Gävleborg.
    Karlsson, Ulf
    Kvint, Sven
    Lysell, Leif
    Rundcranz, Torgil
    A three-year follow-up report of a comparative study of ITI Dental Implants and Bråemark System implants in the treatment of the partially edentulous maxilla.2004In: Clin Implant Dent Relat Res, ISSN 1523-0899, Vol. 6, no 3, p. 130-41Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Many longitudinal studies of different implant systems have been published but few controlled randomized investigations have been reported. A 1-year report of a comparative study of ITI Dental Implant System implants (Straumann AG, Waldenburg, Switzerland) and Branemark System implants (Nobel Biocare AB, Gothenburg, Sweden) has been published by the present authors. This paper is a 3-year follow-up of that randomized study. PURPOSE: The aim of the study was to compare the outcome of fixed partial prostheses supported by ITI or Branemark implants. The outcome was evaluated primarily in terms of survival rates and changes in marginal bone level. MATERIAL AND METHODS: The study group comprised 28 patients with anterior residual dentition in the maxilla. The patients were provided with two to four implants on each side of the dentition and were randomly allocated to Branemark implants or ITI implants; 77 ITI implants and 73 Branemark implants were inserted. After 6 months abutment connections were made to both ITI and Branemark implants. All patients were provided with fixed partial prostheses of gold-ceramic. The patients were followed up annually with clinical and radiographic examinations for 3 years RESULTS: Two Branemark implants and two ITI implants were lost. The Branemark implants were lost before loading whereas the ITI implants were lost because of periimplantitis. The survival rate for both groups was 97.3%. The mean marginal bone level of the Branemark implants was situated 1.8 mm from the reference point at both the baseline and the 3-year examinations. The corresponding values for the ITI implants were 1.4 mm at baseline and 1.3 mm after 3 years. There was no significant difference between the implant systems with regard to bone level or bone level change. A steady state of the marginal bone level was calculated to have been reached after 3 years for 95.5% of the Branemark implants and 87.1% of the ITI implants. Periimplantitis (infection including pus and bone loss) was observed with seven ITI implants but with none of the Branemark implants. This difference was statistically significant. CONCLUSIONS: No statistically significant differences were found between the implants studied, except for the frequency of periimplantitis, which was higher for the ITI implants. The survival rates were high, and the marginal bone loss was small for both systems.

  • 3. Dasmah, Amir
    et al.
    Hallman, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg.
    Sennerby, Lars
    Rasmusson, Lars
    A Clinical and Histological Case Series Study on Calcium Sulfate for Maxillary Sinus Floor Augmentation and Delayed Placement of Dental Implants2012In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 14, no 2, p. 259-265Article in journal (Refereed)
    Abstract [en]

    Background: Maxillary sinus floor augmentation is a procedure that is indicated in cases when the volume of the posterior maxillary bone is inadequate. The goal of this treatment is to obtain sufficient amount of bone tissue in order to gain osseointegration of endosseous implants. Purpose: The purpose of this study was to conduct a clinical and histological analysis of calcium sulfate (CaS) as bone graft substitute in sinus floor augmentation.

    Material and Methods: Ten patients with edentulous maxillas were included in this study. They had moderate to severe atrophy of the posterior maxilla. Surgiplaster (Classimplant(R), Rome, Italy) was used as graft material in the maxillary sinus and was covered by BioGide(R) (Geistlish Pharmaceutical, Wolhusen, Switzerland). After 4 months of graft healing, 40 dental implants were placed and a biopsy for histomorphometry was taken at these occasions. The specimens were viewed by light microscope, and the extent of bone regeneration and remaining graft material was evaluated. Radiographs were taken at the time of sinus augmentation and after 4 months of graft healing.

    Results: At the time of abutment surgery, one implant was considered as a failure and was consequently removed, giving a survival rate of 97.5% after 1 year of loading. Radiographs showed a mean of 26.5% shrinkage of the augmented area. A significant resorption of CaS was noted with a mean value of 8.8% of remaining graft material after 4 months of healing. The biopsies also revealed new bone formation with a mean value of 21.2% of the total biopsy area. Histology showed signs of an acellular substitution of CaS with bone-like tissue.

    Conclusion: The results of this study show that new bone regeneration occurs in the maxillary sinus after augmentation with CaS. This enabled successful placement, integration, and loading of dental implants in the posterior maxilla, as only 1 of 40 implants was lost during 1 year of follow-up.

  • 4.
    Hallman, Mats
    et al.
    Uppsala University, Interfaculty Units, Centrum för klinisk forskning, Gävleborg.
    Nordin, Thomas
    Sinus floor augmentation with bovine hydroxyapatite mixed with fibrin glue and later placement of nonsubmerged implants: a retrospective study in 50 patients.2004In: Int J Oral Maxillofac Implants, ISSN 0882-2786, Vol. 19, no 2, p. 222-7Article in journal (Refereed)
  • 5.
    Hallman, Mats
    et al.
    Uppsala University, Interfaculty Units, Centrum för klinisk forskning, Gävleborg.
    Zetterqvist, Lars
    A 5-year prospective follow-up study of implant-supported fixed prostheses in patients subjected to maxillary sinus floor augmentation with an 80:20 mixture of bovine hydroxyapatite and autogenous bone.2004In: Clin Implant Dent Relat Res, ISSN 1523-0899, Vol. 6, no 2, p. 82-9Article in journal (Refereed)
  • 6.
    Mordenfeld, Arne
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Gavle Cty Hosp, Dept Oral & Maxillofacial Surg, Gavle, Sweden..
    Lindgren, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Gavle Cty Hosp, Dept Oral & Maxillofacial Surg, Gavle, Sweden..
    Hallman, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Gavle Cty Hosp, Dept Oral & Maxillofacial Surg, Gavle, Sweden.;Umea Univ, Dept Oral & Maxillofacial Surg, Umea, Sweden..
    Sinus Floor Augmentation Using Straumann (R) BoneCeramic (TM) and Bio-Oss (R) in a Split Mouth Design and Later Placement of Implants: A 5-Year Report from a Longitudinal Study2016In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 18, no 5, p. 926-936Article in journal (Refereed)
    Abstract [en]

    Background: Straumann (R) BoneCeramic (TM) is a synthetic biphasic calcium phosphate (BCP) aimed for sinus floor augmentation. Long-term follow-up of implants placed in BCP after sinus augmentation is still missing. Purpose: The primary aim of the study was to compare survival rates and marginal bone loss of Straumann SLActive implants placed in either BCP (test) or Bio-Oss (R) (DBB) (control) after sinus floor augmentation. The secondary aim was to calculate graft sinus height at different time points. Materials and Methods: Bilateral sinus floor augmentation was performed in a split mouth model. Eleven patients (mean age 67 years) received 100% BCP on one side and 100% DBB on the contralateral side. After 8 months of graft healing, 62 Straumann SLActive implants were placed. After 5 years of functional loading (6 years after augmentation) of implants, marginal bone levels and grafted sinus height were measured, and implant survival and success rates were calculated. Results: After 5 years of loading, all prosthetic constructions were in function although two implants were lost in each grafting material. The overall implant survival rate was 93.5% (91.7% for BCP, 91.3% for DBB, and 100% for residual bone). The success rates were 83.3% and 91.3% for BCP and DBB, respectively. There was no statistically significant difference in mean marginal bone level after 5 years between BCP (1.4 +/- 1.2 mm) and DBB (1.0 +/- 0.7 mm). Graft height reduction (GHR) after 6 years was limited to 6.6% for BCP and 5.8% for DBB. Conclusion: In this limited RCT study, the choice of biomaterial used for sinus floor augmentation did not seem to have any impact on survival rates and marginal bone level of the placed implants after 5 years of functional loading and GHR was minimal.

  • 7. Nordin, Thomas
    et al.
    Nilsson, Roland
    Frykholm, Anders
    Hallman, Mats
    Uppsala University, Interfaculty Units, Centrum för klinisk forskning, Gävleborg.
    A 3-arm study of early loading of rough-surfaced implants in the completely edentulous maxilla and in the edentulous posterior maxilla and mandible: results after 1 year of loading.2004In: Int J Oral Maxillofac Implants, ISSN 0882-2786, Vol. 19, no 6, p. 880-6Article in journal (Refereed)
  • 8.
    Starch-Jensen, T.
    et al.
    Aalborg Univ Hosp, Dept Oral & Maxillofacial Surg, 18-22 Hobrovej, DK-9000 Aalborg, Denmark..
    Aludden, H.
    Aalborg Univ Hosp, Dept Oral & Maxillofacial Surg, 18-22 Hobrovej, DK-9000 Aalborg, Denmark..
    Hallman, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Publ Hlth Serv, Dept Oral & Maxillofacial Surg, Gavle, Sweden..
    Dahlin, C.
    Univ Gothenburg, Sahlgrenska Acad, Inst Surg Sci, BIOMATCELL VINN Excellence Ctr,Dept Biomat, Gothenburg, Sweden.;NU Hospital Org, Dept Oral & Maxillofacial Surg, Trollhattan, Sweden..
    Christensen, A. -E
    Aalborg Univ Hosp, Unit Epidemiol & Biostat, Aalborg, Denmark.
    Mordenfeld, Arne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Publ Hlth Serv, Dept Oral & Maxillofacial Surg, Gavle, Sweden..
    A systematic review and meta-analysis of long-term studies (five or more years) assessing maxillary sinus floor augmentation2018In: International Journal of Oral and Maxillofacial Surgery, ISSN 0901-5027, E-ISSN 1399-0020, Vol. 47, no 1, p. 103-116Article, review/survey (Refereed)
    Abstract [en]

    The objective was to test the hypothesis of no difference in long-term (>= 5 years) implant treatment outcomes after maxillary sinus floor augmentation (MSFA) with autogenous bone graft compared to a mixture of autogenous bone graft and bone substitutes or bone substitutes alone. A MEDLINE (PubMed), Embase, and Cochrane Library search in combination with a hand-search of relevant journals was conducted. Human studies published in English between January 1, 1990 and October 1, 2016 were included. Nine studies fulfilled the inclusion criteria. The survival of suprastructures has never been compared within the same study. The 5-year implant survival after MSFA with autogenous bone graft was 97%, compared to 95% for Bio-Oss; the reduction in vertical height of the augmented sinus was equivalent with the two treatment modalities. Non comparative studies demonstrated high survival rates for suprastructures and implants regardless of the grafting material used. Meta-analysis revealed an overall estimated patient-based implant survival of 95% (confidence interval 0.92-0.96). High implant stability quotient values, high patient satisfaction, and limited peri-implant marginal bone loss were revealed in non-comparative studies. No long-term randomized controlled trial comparing the different treatment modalities was identified. Hence, the conclusions drawn from the results of this systematic review should be interpreted with caution.

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