Autotransplantation of teeth in 215 patients. A follow-up study.

OBJECTIVE: To evaluate the success rate of autotransplantation of teeth in consecutive patients and to analyze factors affecting the outcome. MATERIALS AND METHODS: The subjects consisted of 215 consecutive patients (101 women and 114 men; aged 9.1-56.4 years, median age 15.2 years [P(10) = 11.4, P(90) = 19.7]) who had undergone transplantation of a total of 269 teeth, all by the same surgeon. In patients with multiple transplants, only the first transplant was included, to ensure that all transplanted teeth were independent units. The transplants were recorded as unsuccessful if the tooth had been extracted or was surviving but with root resorption or ankylosis. The interval between transplantation and final follow-up was a median 4.8 years (P(10) = 2.0, P(90) = 5.5) for successful transplants and a median of 2.4 years (P(10) = 0.4, P(90) = 7.7) for unsuccessful transplants. RESULTS: One-hundred seventy-five (81%) of the transplantations were recorded as successful and 40 (19%) as unsuccessful. Twenty-five teeth had been extracted and 15 had survived but did not fulfill the criteria for success. CONCLUSIONS: The success rate of 215 consecutively transplanted teeth was 81%. The highest success rate was for transplantation of premolars to the maxillary incisor region (100%). Complications at surgery such as difficult extraction, deviant root anatomy, or damaged root periodontium affected the outcome. During growth, a successful transplant preserves alveolar bone.

A three-year follow-up report of a comparative study of ITI Dental Implants and Brånemark System implants in the treatment of the partially edentulous maxilla.

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 Brånemark 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 Brånemark 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 Brånemark implants or ITI implants; 77 ITI implants and 73 Brånemark implants were inserted. After 6 months abutment connections were made to both ITI and Brånemark 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 Brånemark implants and two ITI implants were lost. The Brånemark 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 Brånemark 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 Brånemark 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 Brånemark 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.

Nonsubmerged and submerged implants in the treatment of the partially edentulous maxilla.

BACKGROUND: Dental implants vary in design and surfaces. In addition, different surgical techniques have been used for implant insertion. The ITI Dental Implant System (Straumann AG, Waldenburg, Switzerland) has always required a one-stage technique, whereas the Brånemark System (Nobel Biocare AB, Gothenburg, Sweden) requires a two-stage technique. PURPOSE: The aim of this study is to compare the outcome of fixed partial bridges in the maxilla supported by both ITI and Brånemark implants in a split-mouth design. MATERIALS AND METHODS: Twenty-eight patients with a residual anterior dentition in the maxilla were included in this split-mouth study. The Brånemark implants were used on one side and the ITI implants on the other side of the residual dentition according to a randomization procedure. A blocking size of four was used, giving equal probability of placing ITI or Brånemark implants in the right or left side of the jaw. The surgical and prosthetic procedures followed the guidelines given by the manufacturers. The prosthetic treatment with the two-implant systems was performed at the same time, and for that reason the healing period was 6 months for both systems. The observation period for all patients was 1 year after loading. RESULTS: Two Brånemark implants (in one patient) were lost before loading, and one ITI implant was lost 1 year after loading. There was no significant difference in survival rate. Radiographic examination of the bone level was performed at the time of delivery of the bridge and after 1 year. The mean marginal bone level at baseline was situated 1.9 mm from the reference point for the Brånemark implants and 1.5 mm for the ITI implants. With regard to the insertion depth used, these bone levels indicate that bone loss had taken place before baseline. However, between baseline and the 1-year examination, there was no significant change of the marginal bone (0.2 +/- 0.08 mm at the Brånemark implants and 0.1 +/- 0.11 mm at the ITI implants). The difference between results with the two implants was not statistically significant. Crater-form bone destructions were seen at some ITI implants, indicating periimplantitis. However, at only two implants were there clinical signs of periimplantitis. CONCLUSIONS: No significant difference in survival rate or in marginal bone change could be demonstrated between the two systems. At some ITI implants (18%), crater-form bone loss was observed.