The Experts below are selected from a list of 309 Experts worldwide ranked by ideXlab platform
Lars Sennerby - One of the best experts on this subject based on the ideXlab platform.
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particulate vs block bone grafts three dimensional changes in graft volume after reconstruction of the atrophic Maxilla a 2 year radiographic follow up
Journal of Cranio-maxillofacial Surgery, 2012Co-Authors: Ami Dasmah, Lars Sennerby, Andreas Thor, Annika Ekestubbe, Lars RasmussonAbstract:Abstract Background Extensive alveolar bone resorption in the Maxilla limits the possibility of successful placement and osseointegration of endosseous implants for future prosthetic rehabilitation. Autogenous bone from the iliac crest may be used as lateral onlays in the atrophic Maxilla, both as block and particulate bone. To our knowledge, there is no three-dimensional 2-year follow-up study measuring the volumetric reduction of the augmented areas comparing particulate and block bone grafts. Purpose The aim of this study was to conduct a radiographic 2-year follow-up study, using computed tomographic (CT) images in order to evaluate and compare the extent of bone graft resorption in the frontal Maxillae augmented by particulate (test) and block bone (control). Material and methods Eleven patients treated with iliac bone grafts and oral implants in the Maxilla were followed with CT examinations directly post grafting and after 2 years. Result The volumetric changes after 6 months were extensive. Additionally, the changes in particulate bone tended to be larger after 2 years compared to block bone, using this protocol. However, the difference was not statistically significant. Conclusion The present follow-up study showed that there is radiographically complete integration and embedding of implants installed in grafted bone despite extensive initial graft resorption. There was no significant difference in the amount of volumetric reduction between particulate bone and block bone grafts.
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a clinical and histological case series study on calcium sulfate for Maxillary sinus floor augmentation and delayed placement of dental implants
Clinical Implant Dentistry and Related Research, 2012Co-Authors: Ami Dasmah, Lars Sennerby, Mats Hallma, Lars RasmussoAbstract: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®, Rome, Italy) was used as graft material in the Maxillary sinus and was covered by BioGide® (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.
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five year results from a randomized controlled trial on early and delayed loading of implants supporting full arch prosthesis in the edentulous Maxilla
Clinical Oral Implants Research, 2008Co-Authors: Kerstin Fischer, Torsten Stenberg, Mans Hedin, Lars SennerbyAbstract:Objectives: The overall aim was to compare the clinical outcomes of early and delayed implant loading in the totally edentulous Maxilla during 5 years of function. Materials and methods: Twenty-four patients with edentulous Maxillae were randomized in two groups and subjected to early (test, n=16) or delayed (control, n=8) loading. A total of 142 implants were placed and 139 implants (Straumann AG) were loaded with full-arch bridges and followed for 5 years. Results: All patients received and maintained a fixed bridge throughout the study period. Five (5.3%) test implants in three patients and two (4.3%) control implants in two patients were lost during the 5 years (NS). There were no differences in implant stability as measured with resonance frequency analysis at 5 years. More bone loss occurred at test than at control implants, −0.8 mm (SD 1.2) vs. −0.3 mm (SD 1.1), respectively. However, test implants showed a more coronal marginal bone level than control implants after 5 years, 2.9 mm (SD 1.1) vs. 3.7 mm (SD 1.2) from the implant shoulder, respectively. No control implants and four (4.4%) test implants in three (18.8%) patients showed >3 mm bone loss after 5 years. Two of the latter implants in one patient also showed increased probing depths, bleeding at probing and plaque accumulation. Tooth fracture was the most common prosthetic complication. The use of lingual gold onlay effectively reduced the number of resin-related complications as opposed to a resilient mouth guard. Conclusions: The present randomized controlled trial showed no important differences between early and delayed loading of implants in the edentulous Maxilla after 5 years of function. A favourable long-term marginal bone response to the sandblasted large-grit acid-etched (SLA) surface was observed. Technical complications were mainly resin-related which could be avoided by the use of a lingual gold onlay. It is concluded that early loading of SLA-surface implants for support of full-arch bridges represents a viable therapy for the totally edentulous Maxilla.
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early loading of Maxillary fixed cross arch dental prostheses supported by six or eight oxidized titanium implants results after 1 year of loading case series
Clinical Implant Dentistry and Related Research, 2003Co-Authors: Morgan Olsson, Goran Urde, Jan B Andersen, Lars SennerbyAbstract:Background: Recent reports have demonstrated that immediate/early loading of dental implants is a clinically feasible concept with results similar to those for two-stage procedures, at least in good bone qualities. However, documentation of the outcome of immediate/early loading in the totally edentulous Maxilla is scarce. Purpose: The present investigation was undertaken to evaluate the outcome over 1 year of oxidized titanium implants when loaded with a fixed full-arch bridge in the Maxilla 1 to 9 days after implant placement. Materials and Methods: Ten patients with totally edentulous Maxillas were treated with 61 oxidized titanium implants, and a provisional fixed bridge was delivered after 1 to 9 days (mean 2.5 d). Nine patients had six implants and one patient had eight implants supporting the bridge. The provisional bridge was replaced with a permanent bridge after 2 to 7 months (mean 4.1 mo) of loading. Resonance frequency analysis (RFA) for implant stability measurements was made at implant placement in eight patients and in conjunction with permanent bridge connection in five patients. The patients were followed up for 1 year with clinical and radiographic examinations. Results: Four implants (6.6%) were lost in one patient after 10 weeks of loading owing to an infection. All other implants were clinically stable with a mean marginal bone loss of 1.3 ± 0.6 mm after 1 year of loading. RFA showed a mean primary stability of 60.1 ± 3.6 ISQ (implant stability quotient), which increased to 62.8 ± 1.6 ISQ after, on average, 4 months. Conclusions: The results from this limited study on 10 cases indicate that early loading protocols can be applied for cross-arch dental bridges supported by six to eight implants in the Maxilla. However, more clinical trials are needed to establish the long-term predictability of the treatment.
Paulo Malo - One of the best experts on this subject based on the ideXlab platform.
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immediate full arch rehabilitation of the severely atrophic Maxilla supported by zygomatic implants a prospective clinical study with minimum follow up of 6 years
International Journal of Oral and Maxillofacial Surgery, 2017Co-Authors: E L Agliardi, D Romeo, S Panigatti, M De Araujo Nobre, Paulo MaloAbstract:The aim of this study was to evaluate the outcomes of immediate full-arch prostheses supported by zygomatic implants alone or in combination with standard fixtures after a minimum of 6 years of loading. From October 2008 to April 2010, 15 patients with severely atrophic Maxillae were treated using four zygomatic implants or two zygomatic implants in conjunction with two conventional fixtures. All subjects received a fixed screw-retained prosthesis within 3hours of surgery, while the final restoration was delivered after 6 months. Follow-up examinations were scheduled to evaluate zygomatic implant survival, conventional dental implant success, prosthetic success, plaque and bleeding scores, marginal bone loss for conventional dental implants, and patient satisfaction. Forty-two zygomatic fixtures and 18 standard implants were placed. Patients were followed up for a minimum of 79 months (range 79-97 months, average 90.61 months). No implant was lost, leading to implant and prosthetic survival rates of 100%. Bone loss for conventional implants averaged 1.39±0.10mm after 6 years of function, leading to a 100% implant success rate. High levels of patient satisfaction were recorded. These medium-term results indicate that immediate full-arch rehabilitation supported by zygomatic implants could be considered a viable treatment modality for the severely atrophic Maxilla.
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a new approach to rehabilitate the severely atrophic Maxilla using extraMaxillary anchored implants in immediate function a pilot study
Journal of Prosthetic Dentistry, 2008Co-Authors: Paulo Malo, Miguel De Araujo Nobre, Isabel LopesAbstract:Statement of problem There is a need to simplify implant treatment for complete arch rehabilitation of severely atrophic Maxillae, as well as a desire to eliminate grafting and provide quality rehabilitation in terms of esthetics, function, and comfort for the patient. Purpose The purpose of this study was to report on the initial results of rehabilitation of complete edentulous atrophied Maxillae using a new surgical approach and a newly designed extra long implant, placed externally to the Maxillary bone (implant only accommodated in the Maxillary bone) and anchored in the zygomatic bone. Material and methods The pilot study included 29 patients (21 women and 8 men), with an age range of 32-75 years (mean=52.4 years), followed between 6 and 18 months, with a mean follow-up time of 1 year. The patients presenting severe atrophy in the Maxillae (Cawood and Howell classification C-VI and D-V or D-VI) were rehabilitated either by using 1, 2, or 4 extra long implants (30 to 50 mm in length; Nobel Biocare AB) placed in the zygomatic bone in conjunction with standard implants (24 patients): or 4 extra long implants (5 patients), all placed in immediate function. The criteria used to evaluate implant outcome were: implants function as support for reconstruction; implants stable when individually and manually tested; no signs of infection observed; and good esthetic outcome of the rehabilitation. To evaluate the secondary objective of assessing the stability and health of the soft tissue covering the implants, the mucosal seal efficacy evaluation index (MSEE) was used. This index was modified from the probing depth for standard implants and performed with a 0.25-N calibrated plastic periodontal probe measuring the depth (mm) of the space between the implant and the mucosa. Data were analyzed with descriptive and inferential analyses. Results The cumulative implant survival rate and prosthetic survival rate at 1 year were 98.5% and 100%, respectively. The mean and median values of the MSEE at 2 months (2.9 mm, 3 mm), 4 months (2.5 mm, 2.8 mm), 6 months (2.9 mm, 2.8 mm), and 1 year (2.8 mm, 2.5 mm) are comparable to the values of probing depths assessed for standard implants. Conclusions The results indicate that, within the limitations of this preliminary study, the rehabilitation of Maxillae with severe atrophy can be performed using extra long implants placed external to the Maxilla and anchored only in the zygomatic bone, and placed in immediate function. (J Prosthet Dent 2008;100:354-366)
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all on 4 immediate function concept with branemark system implants for completely edentulous Maxillae a 1 year retrospective clinical study
Clinical Implant Dentistry and Related Research, 2005Co-Authors: Paulo Malo, Bo Rangert, Miguel De Araujo NobreAbstract:ABSTRACT Background: Immediate implant function has become an accepted treatment modality for fixed restorations in totally edentulous mandibles, whereas experience from immediate function in the edentulous Maxilla is limited. Purpose: The purpose of this study was to evaluate a protocol for immediate function (within 3 hours) of four implants (All-on-4, Nobel Biocare AB, Goteborg, Sweden) supporting a fixed prosthesis in the completely edentulous Maxilla. Materials and Methods: This retrospective clinical study included 32 patients with 128 immediately loaded implants (Branemark System® TiUnite™, Nobel Biocare AB) supporting fixed complete-arch Maxillary all-acrylic prostheses. A specially designed surgical guide was used to facilitate implant positioning and tilting of the posterior implants to achieve good bone anchorage and large interimplant distance for good prosthetic support. Follow-up examinations were performed at 6 and 12 months. Radiographic assessment of the marginal bone level was performed after 1 year in function. Results: Three immediately loaded implants were lost in three patients, giving a 1-year cumulative survival rate of 97.6%. The marginal bone level was, on average, 0.9 mm (SD 1.0 mm) from the implant/abutment junction after 1 year. Conclusion: The high cumulative implant survival rate indicates that the immediate function concept for completely edentulous Maxillae may be a viable concept.
Massimiliano Tomatis - One of the best experts on this subject based on the ideXlab platform.
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simplified treatment of the atrophic posterior Maxilla via immediate early function and tilted implants a prospective 1 year clinical study
Clinical Implant Dentistry and Related Research, 2005Co-Authors: Roberto Calandriello, Massimiliano TomatisAbstract:ABSTRACT Background: Posterior Maxillae are often difficult to treat owing to the sinus antrum. Placing implants in remaining bone regions in the atrophic Maxilla, without performing sinus grafting, is a challenge. Immediate function adds to this challenge. Purpose: The purpose of this study was to suggest and evaluate a simplified treatment concept for the rehabilitation of the atrophic Maxilla using tilted implants subjected to immediate/early function. Materials and Methods: Eighteen patients were included in the study. Sixty implants were placed to support 19 fixed partial or full-arch prostheses. Immediate/early function was applied. The patients were followed for a minimum of 1 year after prosthesis connection. Stability measurements and radiographic evaluation of the change of the marginal bone level were performed. Results: One axial and one tilted implant failed in one patient, giving a cumulative survival rate of 96.7%. No failure of provisional prostheses occurred. The mean marginal bone resorption recorded after 1 year was low (0.82 mm for axial implants and 0.34 mm for tilted implants). Conclusion: The results of the present study suggest that tilted implants placed in immediate function may be a viable treatment approach for the rehabilitation of the atrophied Maxilla. Simplified treatment procedures, reduced surgical invasion, shorter treatment time, and reduced costs constitute some of the benefits for the patient and the clinician.
Reinhilde Jacobs - One of the best experts on this subject based on the ideXlab platform.
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Peri-implant bone changes following tooth extraction, immediate placement and loading of implants in the edentulous Maxilla
Clinical Oral Investigations, 2012Co-Authors: Lieven Barbier, Johan Abeloos, Calix Clercq, Reinhilde JacobsAbstract:The aim of this study was to clinically and radiographically evaluate peri-implant bone level changes after rehabilitation of a fully edentulous Maxilla by placement of six implants in either fresh extraction sites or healed edentulous ridges up till 18 months after implant placement. Twenty patients with a terminal dentition in the Maxillae (11 men, 9 women) received a total of 120 OsseoSpeed® implants; 118 implants could be loaded immediately of which 59 were placed in extraction sockets and 59 were placed in healed sites. Within 24 h after surgery, all patients received a chairside-assembled, fibre-reinforced temporary fixed prosthetic reconstruction in occlusion. Six months post-surgery, final screw-retained CoCr (15) or Ti (5) computer numerical control-milled and acrylic-veneered frameworks were placed directly at implant level without interposing abutments. Intraoral radiographs were taken 6 and 18 months after implant placement. Implant survival rate was 100%. Mean marginal bone level was located on average −0.35 mm below the reference point (standard deviation 0.29, range −1.20 to +0.02 mm) 18 months after loading. Whether implants were placed in healed bone sites or fresh extraction sockets did not significantly affect the bone level changes. Furthermore, the use of either CoCr or Ti at the implant level did not significantly affect marginal bone loss. Within the limits of this prospective clinical trial, results seem to indicate that immediate placement and occlusal loading of five to six implants in the edentulous Maxilla can be carried out successfully. Whether or not those implants are placed in fresh extraction sockets does not seem to alter the outcome. The present data show a successful 1-year outcome of a treatment protocol involving tooth extraction immediately combined with implant placement and loading.
R Weinstein - One of the best experts on this subject based on the ideXlab platform.
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immediate occlusal loading and tilted implants for the rehabilitation of the atrophic edentulous Maxilla 1 year interim results of a multicenter prospective study
Clinical Oral Implants Research, 2008Co-Authors: Tiziano Testori, Massimo Del Fabbro, Matteo Capelli, Francesco Zuffetti, Luca Francetti, R WeinsteinAbstract:Objectives: The aims of this prospective study were to assess the treatment outcome of immediately loaded full-arch fixed bridges anchored to both tilted and axially placed implants for the rehabilitation of fully edentulous Maxillae and to compare the outcome of axial vs. tilted implants. Material and methods: Forty-one patients with edentulous Maxillae were included in the study. Each patient received a full-arch fixed bridge supported by four axial implants and two distal tilted implants. Loading was applied within 48h from surgery. Patients were scheduled for follow-up at 6 months, 1 year and annually up to 5 years. Radiographic evaluation of marginal bone-level change was performed at 1 year. Results: One patient died 4 months after surgery. Thirty patients were followed for a minimum of 1 year (range 3‐42 months, mean 22.1 months). Three failures were recorded at 1-year follow-up (two axial implants and one tilted). Two more implants (one tilted and one axially placed) were lost within 18 months of loading. The 1-year implant survival rate was 98.8% for both axial and tilted implants. Prosthesis success rate was 100% at 1 year. Marginal bone loss around axial and tilted implants at 12-month evaluation was similar, being, respectively, 0.9 � 0.4 (standard deviation) mm and 0.8 � 0.5mm. Conclusions: The present preliminary data suggest that immediate loading associated with tilted implants could be considered to be a viable treatment modality for the atrophic Maxilla and that there does not seem to be a different clinical outcome between tilted and axial implants.
