Ceramic implant abutments for short-span FPDs: a prospective 5-year multicenter study.

PURPOSE: A prospective, randomized, controlled 5-year multicenter study evaluated the long-term clinical function of CerAdapt ceramic abutments compared to titanium abutments on Brånemark implants supporting short-span fixed partial dentures (FPD). MATERIALS AND METHODS: Initially, 105 Brånemark implants were placed in a total of 32 patients at three different clinics; 103 implants remained after initial healing. Fifty-three ceramic and 50 titanium abutments were connected to support 36 FPDs, 19 on ceramic and 17 on titanium abutments. RESULTS: Thirty patients with 29 FPDs were examined after 5 years. There was a cumulative success rate of 97.2% for FPDs (94.7% for ceramic and 100% for titanium abutment-supported FPDs). One of 53 ceramic and none of 50 titanium abutments failed, giving survival rates of 98.1% and 100%, respectively. There was a mean marginal bone loss of 0.3 mm and 0.4 mm, respectively, for ceramic and titanium abutments. Soft tissues around abutments and adjacent teeth appeared healthy, and no significant differences were recorded for mucosal bleeding and plaque between ceramic and titanium abutments. Crown margins at FPD insertion were positioned as follows: 21% submucosally, 33% at the mucosal margin, and 46% supramucosally. Changes in mucosal level were recorded at 12% of the abutments, with 73% of all changes recorded at ceramic abutments. There was a balance between more or less exposed crown margins during the first 2 years, in contrast to the 2- to 5-year period, when all changes meant less exposed margins. CONCLUSION: Safe long-term functional and esthetic results can be achieved with CerAdapt alumina ceramic abutments on Brånemark implants for short-span FPDs.

Mk III: a third generation of the self-tapping Brånemark System implant, including the new Stargrip internal grip design. A 1-year prospective four-center study.

BACKGROUND: Many prospective studies have shown predictable long-term results of the Brånemark System (Nobel Biocare AB, Gothenburg, Sweden) turned-surface implants in totally edentulous, partially edentulous, and single cases. The Mk III self-tapping implant was introduced by Nobel Biocare in 1999 as part of a new implant generation that improved on the Mk II self-tapping implant that had been introduced in 1992. A new implant design should always be evaluated, preferably in prospective multicenter studies. PURPOSE: The aim of the present prospective multicenter study was to evaluate the short-term success rate of the Brånemark Mk III machined- and turned-surface self-tapping implant and to evaluate the clinical handling of the new Stargrip (Nobel Biocare AB) internal grip design. MATERIALS AND METHODS: The open prospective 1-year multicenter study was performed at four clinics. Sixty-four patients (38 females, 26 males) with a mean age of 51 years (range, 16 to 80 years) were included. Seventeen of the patients were totally edentulous, 26 were partially edentulous, and 21 had single-tooth losses. In total, 194 Mk III implants were inserted, 89 in the maxillas and 105 in the mandibles. RESULTS: Fifty-eight patients were observed for 1 year after prosthetic loading. Three of 194 implants were lost, corresponding to a cumulative success rate of 98.4% after 1 year, 100% for maxillary implants and 97.1% for mandibular implants. The implant driver carried the implants reliably in 99.5% of all treated patients. Sixty-two patients received the planned prosthetic reconstruction. All but one prosthetic reconstruction survived after 1 year of loading. The mean marginal bone resorption, analyzed from radiographs of 143 implants, was 1.15 mm (standard deviation [SD], 1.09 mm) from the second-stage surgery to the 1-year follow-up. CONCLUSION: The 1-year success rate of the Mk III implant was high, and the clinical handling of the internal grip design (Stargrip) improved the surgical technique and was well appreciated by both surgeons and assisting staff.

Fixed partial dentures supported by natural teeth and Brånemark system implants: a 3-year report.

PURPOSE: To evaluate fixed partial dentures (FPDs) supported by a combination of natural teeth and implants in a variety of clinical situations. MATERIALS AND METHODS: In 30 patients, 86 teeth and 85 implants were used as supports for 30 FPDs of varying extension (mean = 8.6 units); 23 in the maxilla and 7 in the mandible. The prostheses had a removable section fastened with screws to both the implants and to a section cemented on the supporting teeth, and were thus functioning as rigid, fixed partial dentures. RESULTS: Five implants were lost prior to the placement of prostheses, 2 were lost after loading, giving survival rates of 91.0% in the maxilla and 95.5% in the mandible. Complications were predominantly soft tissue-related and were all amenable to treatments. One patient was lost to follow-up. The remaining 29 FPDs remained stable throughout the 3-year observation period. DISCUSSION: Changes in plaque accumulated, bleeding on probing, pocket depths, and marginal bone level were acceptable. The survival rate of implants was comparable to that of similar studies. Further investigations are needed with regard to design for such FPDs. CONCLUSION: These findings, together with the patient satisfaction experienced, indicated that the combined support of implants and teeth for fixed prostheses may be appropriate treatment for patients.