Per-Ingvar Brånemark (1929-2014): A Homage to the Father of Osseointegration and Modern Dentistry.

Dr. Professor Per-Ingvar Brånemark (Branemark), a Swedish professor of anatomy, is widely acknowledged as a pioneer in modern implant dentistry. His accidental discovery of the strong bond between titanium and bone, which he named "osseointegration," signifies a revolutionary progression in dentistry. This significant contribution has earned him global recognition among scholars and the general public. His work, which spans across disciplines, has introduced a new era of implant reconstruction and fostered the formulation of principles rooted in bone biology. This interdisciplinary advancement has paved the way for diverse craniofacial and orthopedic applications, including facial prostheses and limb replacements, owing to titanium's biocompatibility within the human body. This article stands as a tribute to Brånemark and his remarkable innovation. Despite not being a dentist, Brånemark, an orthopedic surgeon, has left an enduring legacy in dental implantology that continues to impact the field today and will undoubtedly do so in the future, deserving lasting recognition.

Implante transitório de corpo único com ativação imediata para retenção de prótese total provisória - relato de caso / Single body transient implants immediate activated for provisional prosthesis retention ­ case report

A reabilitação protética ganhou um componente que veio solucionar problemas de pessoas edentadas que até então pareciam sem solução. Trata-se dos implantes osseointegráveis, introduzidos pelo professor Per Ingvar Branemark entre os anos 70 e 80, e que, nos dias de hoje, se tornou na maioria dos casos, a primeira opção para a reabilitação oral. No caso de edentados totais na mandíbula, a prótese total fixa sobre implantes instalados entre os forames mentuais é um tipo de tratamento reabilitador com elevado grau de sucesso. Nos casos onde não é possível a colocação da prótese fixa com carga imediata após a instalação dos implantes, o paciente pode usar uma prótese total provisória, diretamente sobre os implantes permanentes instalados ou retida por implantes transitórios de corpo único, com encaixe tipo bola/o'ring. O presente artigo relata um caso clinico com utilização de implantes transitórios de corpo único para reter prótese total provisória, durante o tempo da osseointegração dos implantes permanentes.

Prosthetic rehabilitation gained a component that solved problems of edentulous people. These are the Osseo integrative implants, introduced by Professor Per Ingvar Branemark between the 1970s and 1980s, and which has become in most cases the first option for oral rehabilitation. In the case of mandible total edentulous, the total fixed prosthesis on implants installed between the mental foramina is a type of rehabilitation treatment with a high degree of success. In cases where it is not possible to place the fixed prosthesis with immediate loading after implant installation, the patient may use a provisional total prosthesis, directly on the permanent implants installed or retained by transient implants of single body, ball-type fitting 'ring. The present article reports a clinical case with the use of single body transient implants to retain temporary total prosthesis during the time of osseointegration of permanent implants.

Evolution of dental implants through the work of per-ingvar branemark: A systematic review.

PURPOSE: This systematic review has been undertaken to highlight the unforgettable contributions of Prof. Brånemark Per-Ingvar (PI). It could be understood that reviewing his work would give an idea of growth of this treatment modality. Materials and Methods: An electronic search on the PubMed/Medline, Ebscohost, and Cochrane database was done using search term "Brånemark PI" to identify his publications. Articles published in English and only related to implants and osseointegration were included. Screening of the titles and abstracts were done according to inclusion criteria and suitable studies were included in the review. RESULTS: The initial literature search resulted in 187 articles, out of which 92 articles were excluded due to not meeting the inclusion criteria and 16 articles excluded due to non-availability of even abstract also. A total of 79 articles were finally included in this review. CONCLUSION: Brånemark PI had a great vision of future; who considered edentulism as equal to amputation and came up with the concept of osseointegrated implants to overcome them. The innovations of Brånemark had assured the world that it is very much possible to provide implant-supported prosthesis in any situations for the rehabilitation of the individuals.

Padrão de oclusão em prótese Protocolo de Brånemark: uma revisão de literatura / Standard of occlusion in Brånemark Protocol prothesis: a literature review

O padrão oclusal pode ser considerado um fator crítico para a longevidade dos componentes do sistema estomatognático como também das reabilitações implantossuportadas. Objetivo: revisar a literatura em relação ao padrão de oclusão mais adequado para reabilitar um paciente edêntulo com prótese Protocolo de Brånemark. Revisão de literatura: nesta revisão, os artigos de estudos clínicos retrospectivos (2 artigos) e in silico (2 artigos) foram incluídos. Considerações finais: padrões de oclusão em prótese Protocolo de Brånemark são um tema muito escasso na literatura; o uso de uma oclusão mutuamente protegida com guia lateral em canino favorece a distribuição da tensão sobre os implantes e o osso alveolar; no entanto, a condição do arco antagonista pode influenciar esta escolha. (AU)

The occlusal pattern can be considered a critical factor for the longevity of the components of the stomatognathic system, as well as of the implantsupported rehabilitations. Objective: to review the literature regarding the most appropriate standard of occlusion to rehabilitate a patient edentulous with Brånemark Protocol prothesis. Literature review: in this review, articles from retrospective clinical studies (02 articles) and in silico studies (02 articles) were included. Final considerations: this literature review shows that standard of occlusion in the Brånemark Protocol prosthesis ns are a very scarce subject in the literature, the use of a mutually protected lateral guiding in canine favors the stress distribution on the implants and alveolar bone, however the condition of the arc antagonist may influence this choice. (AU)

Diminuindo tempo e aumentando a qualidade de vida do paciente com o uso de protocolo de carga imediata / By decreasing time and increasing the patient's quality of life with the use of immediate loading protocol

Este artigo consiste na reabilitação protética através do protocolo I de Brånemark em mandíbula submetido a carga imediata. A instalação de implantes imediatos pós-exodontia tem como principais indicações a preservação da arquitetura dos tecidos peri-implantares e a redução de tempo total de tratamento. Após a cirurgia, foram escolhidos o uso de pilares protéticos multi base e, para reabilitação superior, prótese total, visando a melhoria e conforto do paciente portador de próteses totais removíveis convencionais, onde as mesmas prejudicam a função, a estética, saúde psicológica e as relações sociais de seus usuários.

This article consists of prosthetic rehabilitation through the Branemark protocol I, in mandible submitted to immediate loading. The installation of immediate post-exodontic implants has as main indications the preservation of the architecture of the peri-implant tissues and the reduction of total time of treatment, where after the surgery, the use of multi-prosthetic abutments and for superior rehabilitation, prosthesis total. aiming at the improvement and comfort of the patient with conventional removable total dentures, where they impair the function, aesthetics, psychological health and social relations of its users.

Implant-supported rehabilitation after treatment of atrophic mandibular fractures: report of two cases.

OBJECTIVE: The objective of this article is to present options of rehabilitation with dental implants in two cases of severely atrophic mandibles (<10 mm) after rigid internal fixation of fractures. PATIENTS AND METHOD: Two patients who sustained fractures in severely atrophic mandibles with less than 10 mm of bone height were treated by open reduction and internal fixation through a transcervical access. Internal fixation was obtained with 2.4-mm locking reconstruction plates. The first patient presented satisfactory bone height at the area between the mental foramens and after 2 years, received flapless guided implants in the anterior mandible and an immediate protocol prosthesis. The second patient received a tent pole iliac crest autogenous graft after 2 years of fracture treatment and immediate implants. After 5 months, a protocol prosthesis was installed in the second patient. RESULTS: In both cases, the internal fixation followed AO principles for load-bearing osteosynthesis. Both prosthetic devices were Branemark protocol prosthesis. The mandibular reconstruction plates were not removed. Both patients are rehabilitated without complications and satisfied with esthetic and functional results. CONCLUSION: With the current techniques of internal fixation, grafting, and guided implants, the treatment of atrophic mandible fractures can achieve very good results, which were previously not possible.

A 7-year prospective radiographic evaluation of marginal bone level around two different implant systems: a randomized clinical trial.

OBJECTIVE: The aim of this study was to evaluate the change in marginal bone level radiographically around two different implant systems after 7 years of use. MATERIAL AND METHODS: Twenty fully edentulous patients were included in the study and randomly assigned to two treatment groups of machined surface implants (Brånemark, n = 40) and rough-surface implants (Xive, n = 40). The implants were early loaded with individual bar-retained overdentures. All patients were treated by the same surgeon and the same prosthodontist. Clinical and radiographic examinations were conducted at the time of implant loading (baseline) and annually for up to 7 years of use. Measurements to the nearest 0.1 mm were taken at the mesial and distal site, and the average values were calculated for each implant. A three-level mixed-effect analysis of covariance (ANOVA) was used to test the significance of the mean marginal bone change in the two implant groups. RESULTS: The study population consisted of 15 women (75%) and five men (25%) with an average age of 61.6 years. A total of 79 of 80 implants integrated successfully. n = 1 Brånemark implant failed after 3 weeks. There was a significant difference (P < 0.001) between the two implant systems at the baseline measurements (0.14 mm Brånemark vs. 0.39 mm Xive) and a highly significant difference for the annual bone loss (0.07 mm [Brånemark] vs. 0.18 mm [Xive], P < 0.001). CONCLUSION: Both the implant systems are clinically satisfying. Nevertheless, the Brånemark group showed a better radiological performance than the Xive group.

Brånemark Novum® immediate loading rehabilitation of edentulous mandibles: 11-year retrospective study.

OBJECTIVES: Short-term results indicated that the Brånemark Novum® protocol (Nobel Biocare AB, Goteborg, Sweden) allowed successful rehabilitation of mandibular edentulism with immediately loaded implants. Yet, long-term studies are lacking. The aim of the present retrospective study was to report the 11-year outcomes for patients treated according to this protocol. MATERIAL AND METHODS: Four patients treated according to the Brånemark Novum protocol (Nobel Biocare AB) were followed-up to evaluate implant and prosthesis cumulative survival rate (CSR), implant stability (RFA), marginal bone loss by periapical radiographs, probing depth (PD), and possible complications. Clinical and radiographic parameters were evaluated immediately after completion of the treatment and 1, 5, and 11 years after loading. RESULTS: The 11-year implant and prosthesis CSRs were 100%. Implant stability (RFA values) remained stable over the 11-year follow-up. Small bone resorption was found next to distal implants (median 1 mm) after 11 years, while central implants showed greater bone resorption (median 4.5 mm). The PD (mean 3.75 mm at 11 years) grew together with marginal bone loss. One implant complication was detected on a central implant (crater-form bone destruction), and 10 prosthetic complications (fractures of resin or teeth), 80% of which registered on the same parafunctional patient. CONCLUSIONS: The 11-year results demonstrated that the Brånemark Novum protocol (Nobel Biocare AB) is a predictable technique with favorable long-term outcomes. This was a rigid protocol, which could be applied only in patients with specific anatomical characteristics of the lower jaw, but it had the merit of indicating the key factors for full-arch immediate loading rehabilitations.

Rendimiento masticatorio en pacientes rehabilitados con prótesis total removible v/s prótesis Ad-Modum Branemark / Masticatory performance in patients rehabilitated by means of removable complete dentures vs. Ad-Modum Branemark prostheses

Propósito: el propósito de este estudio fue evaluar y comparar el rendimiento masticatorio de pacientes desdentados totales rehabilitados mediante (prótesistipo Ad-Modum y/o prótesis removibles convencional. Método: Se evaluaron24 pacientes divididos en 3 grupos de ocho pacientes. Grupo Ipacientes rehabilitados con prótesis Ad-Modum bimaxilar, Grupo IIpacientes rehabilitados con prótesis Ad-Modum inferior y prótesis total removible superior, Grupo III pacientes rehabilitados con prótesis total removible bimaxilar. Se solicitó a cadapaciente realizar 20 golpes masticatorios a una pastilla de silicona previamente estandarizada, a la muestra obtenida se le realizó tamizado múltiple y los resultados fueron procesados con la fórmula de obtención de rendimiento masticatorio propuesta por el protocolo de Edlund y Lamm en 1980. Resultados: Lospromedios de rendimiento masticatorio fueron: Grupo I(15,6 por ciento±3,4), Grupo II (4,3 por ciento±4,6), Grupo III (0,3 por ciento±0,7). Mediante test de Tukey se demostró que existendiferencias significativas entre el grupo I y II, pero no entre los Grupos II yIII. Conclusiones: El tratamiento con prótesis Ad-Modum bimaxilar logró elmejor rendimiento masticatorio entre los 3 tratamientos rehabilitadores evaluados, el tratamiento con prótesis total removible superior y Ad-Modum inferior fue más exitoso en términos de rendimiento masticatorio que el grupo rehabilitado con prótesis total removible bimaxilar. Los tratamientos con prótesis removible total convencional, no otorgan al paciente una óptima función masticatoria(AU)

Rendimiento masticatorio en pacientes rehabilitados con prótesis total removible v/s prótesis Ad-Modum Branemark / Masticatory performance in patients rehabilitated by means of removable complete dentures vs. Ad-Modum Branemark prostheses

Propósito: el propósito de este estudio fue evaluar y comparar el rendimiento masticatorio de pacientes desdentados totales rehabilitados mediante (prótesistipo Ad-Modum y/o prótesis removibles convencional. Método: Se evaluaron24 pacientes divididos en 3 grupos de ocho pacientes. Grupo Ipacientes rehabilitados con prótesis Ad-Modum bimaxilar, Grupo IIpacientes rehabilitados con prótesis Ad-Modum inferior y prótesis total removible superior, Grupo III pacientes rehabilitados con prótesis total removible bimaxilar. Se solicitó a cadapaciente realizar 20 golpes masticatorios a una pastilla de silicona previamente estandarizada, a la muestra obtenida se le realizó tamizado múltiple y los resultados fueron procesados con la fórmula de obtención de rendimiento masticatorio propuesta por el protocolo de Edlund y Lamm en 1980. Resultados: Lospromedios de rendimiento masticatorio fueron: Grupo I(15,6 por ciento±3,4), Grupo II (4,3 por ciento±4,6), Grupo III (0,3 por ciento±0,7). Mediante test de Tukey se demostró que existendiferencias significativas entre el grupo I y II, pero no entre los Grupos II yIII. Conclusiones: El tratamiento con prótesis Ad-Modum bimaxilar logró elmejor rendimiento masticatorio entre los 3 tratamientos rehabilitadores evaluados, el tratamiento con prótesis total removible superior y Ad-Modum inferior fue más exitoso en términos de rendimiento masticatorio que el grupo rehabilitado con prótesis total removible bimaxilar. Los tratamientos con prótesis removible total convencional, no otorgan al paciente una óptima función masticatoria

Removal of fractured implants and immediate reimplantation:Report of a case / 实用口腔医学杂志

Fracture of multiple implants is rare.This report describes 1 case with the fracture of multiple implants related to occlusal over-load,bruxism,periodontitis and other factors in the posterior position.The fractured implants were removed and immediate reimplantation was performed.The panoramic film showed that the implants were integrated successfully 12 months after prosthesis.

Long-term evaluation of Astra Tech and Brånemark implants in patients treated with full-arch bridges. Results after 12-15 years.

AIM: To study the long-term outcome of implant survival rate, soft and hard tissue conditions and prosthetic status in a group of individuals treated with either Astra Tech TiOblast or Brånemark turned implants supporting a full-arch bridge. MATERIAL AND METHODS: Edentulous patients treated with either Astra Tech TiOblast surface or Brånemark turned implants were recalled for examination after 12-15 years. Out of initially 66 patients 46 were available for examination. Intra-oral radiographs were taken for bone level assessments. Clinical prosthetic conditions, number of surviving implants, implant stability, plaque scores, probing pocket depths, bleeding and pus after probing were recorded. Analyses of bone level changes during the total observation period were performed. RESULTS: Three patients in the Astra Tech group lost totally eight implants and five patients in the Brånemark group lost 10 implants during the total observation period. No statistically significant difference in implant loss or bone level change was found. Sixteen per cent of Astra Tech and 29% of Brånemark patients showed at least one implant with ≥2 mm bone loss after the first year in function. The corresponding prevalence on implant level was 6% and 5% respectively. No significant differences were found between the other examined variables. Two patients showed prosthetic complications of the supra construction in need of repair. Seven bridges had minor ceramic chippings. CONCLUSION: Treatment with Astra Tech TiOblast implants and Brånemark turned implants supporting full-arch bridges showed generally good clinical results with low numbers of implants with marginal bone loss indicative of peri-implantitis. No significant differences were found between the implant systems after 12-15 years in function.

Análise clínica retrospectiva (4 - 6 anos) dos implantes P-I Brånemark Philosophy / Multicenter, clinical retrospective analysis (4-6 year-follow-up) of P-I Brånemark Philosophy dental implants

Este trabalho teve como objetivo avaliar retrospectivamente a taxa de sobrevivência longitudinal de um novo conceito de implantes, tendo como objetivo adicional medir o remodelamento ósseo peri-implantar após o primeiro ano de carregamento protético e ao final do acompanhamento. Entre janeiro de 2002 e janeiro de 2005, seis centros clínicos selecionaram 412 pacientes (248 homens, 164 mulheres) que receberam os implantes P-I Brånemark Philosophy. O protocolo de preparação cirúrgica foi o preconizado por Brånemark especialmente para estes implantes. Os implantes foram instalados com torque de aproximadamente 45 Ncm. Coroas unitárias (SC), próteses parciais fixas (FPDs) e próteses totais (CD) foram confeccionadas imediatamente ou entre 45-128 dias. O remodelamento ósseo foi avaliado radiograficamente em relação às faces mesiais e distais dos implantes utilizando-se um software. O período de observação foi de 48 a 72 meses. Dos 1.161 implantes examinados inicialmente, 39 falharam (3,36%). No total, 528 implantes foram instalados em mandíbula e 633 em maxila. A taxa de sobrevivência dos implantes foi de 96,64% (mandíbula = 97,2%; maxila = 96,2%). Não houve diferenças estatisticamente significativas entre as taxas de sobrevivência dos implantes com carregamento imediato ou tardio. Cento e trinta e cinco implantes foram instalados utilizando-se a técnica de reconstrução com enxertos. A remodelagem óssea cortical no primeiro ano após o carregamento e último período de acompanhamento foi de 1,63 mm e 2,18 mm, respectivamente. O estudo concluiu que o novo conceito de implantes funcionais desenvolvidos e patenteados pelo professor Per-Ingvar Brånemark fornecem resultados longitudinais de sobrevivência muito bons, compatíveis com a literatura atual, possibilitando a aplicação clínica com segurança.

To perform a long-term retrospective analysis of a new implant concept, with the aim to measure periimplant bone remodeling 1 year after loading and at the final follow-up period. Between January 2002 and January 2005, six private centers selected 412 patients (248 men, 164 women) who received P-I Brånemark Philosophy dental implants. The surgical protocol was performed according to protocols established by Brånemark, especially for these implants. All implants were inserted approximately at 45Ncm torque. Single crowns (SC), fixed partial prostheses (FPDs) and complete dentures (CD) were inserted soon after or between 45-128 days after surgery. Bone remodeling was measured at mesial and distal aspects with adequate computer software. The observation period was between 48-72 months. Of the 1,161 inserted implants, 39 were lost (3.36%). Overall, 528 implants were placed in the mandibular and 633 in the maxillary arches. The survival rate was of 96.64% (mandible = 97.2%; maxilla = 96.2%). No significant differences on SR were verified between immediate and delayed loading. One-hundred and thirty-five implants were installed along with bone grafts. Bone remodeling at first year after loading and in the last follow-up were 1.68mm and 2.18mm, respectively. This new implant concept developed and patented by Prof. Brånemark provided good long-term survival results similar to the published literature e and can be safely used into clinical practice.

Análise das características atuais de dentes artificiais empregados em prótese do tipo Overdenture e protocolo sobre implantes / Analysis of the current characteristics of artificial teeth employed in prosthesis of the type Overdenture and records on implants

O sucesso das próteses implanto-suportadas (overdenture e protocolo Brånemark) tem ganho significante popularidade como opção do tratamento, devido ao desconforto gerado pela falta de retenção e estabilidade das próteses convencionais. Além do conforto, estes pacientes buscam função e a estética nos dentes artificiais que mais se aproximam dos seus dentes naturais. Através de uma técnica, do conhecimento básico, métodos, bom senso e limitações, o cirurgião-dentista foi instruído nos cursos de graduação e pós-graduação a fazer uma escolha dos dentes artificiais. Baseado na expectativa dos estudantes e profissionais, este estudo fez uma busca de revisão de literatura, buscando uma resposta quanto à seleção de dentes artificiais baseadas pelas cartas moldes (espaço ocupado pelos dentes posteriores) de diversas marcas existentes no mercado, comparando estes achados, ao apresentarem as sugestões sobre a largura, forma, tamanho dos dentes e a fidelidade contida nas cartas moldes. A comparação foi realizada através da montagem dos dentes artificiais em articuladores não ajustáveis, considerando que as informações apresentadas pelos fabricantes são imprecisas, que podem comprometer o resultado estético e funcional da confecção da prótese implanto suportada (overdenture e protocolo Brånemark).

The success on implant-supported prostheses overdenture and Brånemark protocols have won a lot of preference as a treatment option, because the discomfort initiated by a lack of retention and stability of conventional lower dentures. Besides comfort, these patients look for esthetics and function on their teeth, as much as possible as their own natural. Through many ways as basic knowledge, methods, techniques, good sense and limitations, the dentists were instructed at graduate and post-graduate schools to learn how to selection artificial teeth. Based on students and professional expectations, this work consisted in a literature review looking for an answer about artificial teeth selection based at “chart molds” (on the available space on posterior teeth) from different brands around the world. Comparing these findings, we presented suggestions about teeth width, shape, size and accuracy included at “chart molds.” A comparison was performed through mounting of artificial teeth at non adjustable articulators, considering the inexact manufacturers information’s, that can compromise teeth selection and so, the esthetic and functional result for implant-supported prostheses overdenture and Brånemarck protocols construction.

12 a 15 anos de avaliação longitudinal do sistema de implantes Branemark e próteses unitárias cimentadas / A 12 to 15 years longitudinal study of the Branemark system and cemented single prosthesis

Este estudo mostra o acompanhamento clínico e radiográfico de 12 a 15 anos de 58 implantes unitários do sistema Branemark de plataforma regular (3,75 ou 4mm de diâmetro), instalados em pacientes dos gêneros masculino e feminino, em áreas de incisivos, caninos, pré-molares e molares e restaurados com pilares de titânio CeraOne e coroas AllCeram ou metalocerâmicas. Os resultados revelam elevado percentual de sucesso para os implantes (98,3%) e para as próteses cimentadas sobre os pilares CeraOne (96,5%). Poucos problemas foram encontrados, como: 3 casos de afrouxamento de parafuso do pilar CeraOne, 1 caso de fratura de implante por hábitos parafuncionais, 2 casos de fratura da coroa de porcelana e 1 caso envolvendo formação de fístula. Dentro das limitações deste estudo, pode-se concluir que: com este sistema de implantes é possível obter bons resultados funcionais e estéticos, a médio e longo prazo, desde que os protocolos cientificamente estabelecidos sejam observados.

This study shows a 12 to 15 year clinical and radiographic follow-up on 58 Branemark system single implants using regular platform (3.75 or 4mm of diameter), installed in male and female patients, in incisor, canine, pre-molar and molar area, and restored with CeraOne abutments and AllCeram or metalceramic crowns. The results revealed a high success rate for implants (98.3%) as well as for the prosthesis cemented over the CeraOne abutments (96.5%). Very few problems were encountered as: 3 unscrewing cases of CeraOne abutment, 1 case of implant fracture in patient with parafunctional habits, 2 cases of porcelain crown fracture and 1 case involving fistula formation. Among the Iimitations of this study, it can be concluded that with this implant system it is possible to obtain good functional and aesthetic results mid and long term as Iong as scientifically established protocols are followed.

A 10-year retrospective clinical study of Branemark implants / 대한치과보철학회지

STATEMENT OF PROBLEMS: There are few studies which reported the survival rates of the specific dental implant systems in the Korean population with the follow-up periods longer than 5 years. PURPOSE: This retrospective clinical study was aimed to evaluate cumulative survival rate (CSR) of Branemark implants followed for 10 years and to determine risk factors for implant failure. MATERIAL AND METHODS: A total of 271 Bra.nemark implants in 83 patients were investigated with several identified risk factors. Life table analysis was undertaken to examine the CSR. Cox regression method was conducted to assess the association between potential risk factors and overall CSR. RESULTS: Thirty implants failed. The 10-year implant CSR was 82.5%. Cox regression analysis demonstrated a significant predictive association between overall CSR and implant length (P<.05). CONCLUSION: An acceptable long-term result of Branemark implant was achieved and implant length showed a significant association with the CSR.

Effect of cleansing me thods on the bone re sorption due to repeated dis/re-connection of implant abutment / 대한치주과학회지

BACKGROUND: Repeated dis/re-connection of implant abutment caused bone loss around implant fixtures due to the new formation of biologic width of the mucosal-implant barrier. The aim of this clinical study was to evaluate whether the repeated dis/re-connection of implant abutment cause bone loss clinically and the effect of cleansing methods on a bone loss during the early healing period. METHODS: A total 50 implants were installed in 20 patients and repeated dis/re-connection of abutment was performed at the time of surgery and once per week for 12 weeks. 0.9% normal saline solution as group1 and 0.1% chlorhexidine solution as group 2 was used to clean abutments. All patients had radiographs taken at the placement of implant and 4, 8, and 12 weeks postoperatively. The data for bone loss around implant were analyzed. RESULTS: The marginal bone loss at 12 weeks were 1.28+/-0.51mm, 1.32+/-0.57mm in the mesial and distal sides in group1, 1.94+/-0.75mm, 1.81+/-0.84mm in group 2, respectively. In view of marginal bone loss, there was not a significant statistical difference between groups. CONCLUSIONS: Repeated dis/re-connection of implant abutment may not cause marginal bone loss around implant fixture although limited samples and short-term observation period. In spite of more bone loss in group 2, there was no statistical significant difference between groups. In context of those results, the clinical significance of the repeated dis/re-connection of implant abutment and the cleansing method of abutments is debatable when it comes to marginal bone loss during early healing period.

A Retrospective study on Branemark TiUnite(R) implant for mandibular posterior single tooth replacement / 대한치주과학회지

The purpose of this study was to evaluate 6 years cumulative survival rate (CSR, %) of mandibular posterior single tooth implants replaced with Branemark TiUnite(R) implant system. The findings from this study were as followed ; 1. The 112 (111 persons) single implants that were placed in the mandibular posterior region were successful except 4 cases and showed 96.42% CSR. 2. The 55 (55 persons) single implants that were placed in the mandibular first molar region were successful except 2 cases and showed 96.36% survival rate. And, among the 57 (56 persons) single implants replacing the mandibular second molar, 2 failed showing 96.49% survival rate. There was no significant statistical difference. 3. Among the total 112 implants, 5.0mm wide diameter implants were placed in 96 cases(85.7%) showing 96.9% survival rate. 4.0mm standard diameter implants were placed in 16 cases showing 93.8% survival rate. There was no significant statistical difference. 4. Long implants above 10.0mm length were placed 103 cases(91.0%) and showed 96.1% survival rate. Short implants within 8.5mm length were placed 9 cases and showed 100% survival rate. There was no significant statistical difference. 5. 37 implants placed in typeI,II bone quality were showed higher survival rate(100%) than that of 52 implants placed in typeIII, IV bone quality(92.3%). But, there was no significant statistical difference. In conclusion, Branemark TiUnite(R) implant showed successful results when replacing manbibular single molar.

Comparison of Complications in Direct and Indirect Osseointegration of Prosthetic Auricular Reconstruction

Osseointegrated prosthetic auricular reconstruction can be classified as either direct or indirect. In the Branemark system of direct osseointegration, implants are placed into the mastoid process of the temporal bone. In the Epitec system of indirect osseointegration, implants are inserted into a three-dimensional carrier plate that is fixed to the mastoid by means of screws. We experienced forty-four cases using the indirect system and seventeen cases using the direct system. We compared with two systems by complications, such as skin reaction, implant loosening, implant loss. There were no specific differences in the skin reaction around the implants and abutments in relation to age or system used. The degree of skin reaction was different according to the conditions around the implant: in cases of virgin microtia, a skin flap was used to cover the implant, in contrast to grafted skin coverage for failed autogenous reconstruction. In both systems, the skin reaction was more severe and frequent in skin flap than in grafted skin. Loosening of the implant was more frequent in the direct system; however, accidental detachment of the implant from the abutment was more frequent in the indirect system. To reduce complications of skin reaction in osseointegrated prosthetic auricular reconstruction, it is important for soft tissue around implant to immobilize. Therefore, grafted skin is better than skin flap as soft tissue around implant. And immobilization of soft tissue around implant by wound dressing is major facter.

Radiographic evaluation of the proximal bone level between two implants: A 3-year comparative study between Branemark and ITI implants in the mandibular posterior region / 대한치과보철학회지

STATEMENT OF PROBLEM: Branemark or ITI are two currently most widely used implant systems but with contrasting design, surgical and restoration methods. PURPOSE: The purpose of this study was to compare changes and its statistical significance in bone height and shape which may rise due to the differences between two implant systems. Also to analyse the effect of inter-implant distance on annual bone height changes. MATERIAL & METHOD: Those patients who were treated with two or more of either Branemark or ITI implants at posterior mandibular area at Yonsei University Dental Hospital, Implant Clinic were selected. At annual examination appointments, standardised radiographs using parallel technique were taken. Marginal bone and inter-implant crestal bone changes were measured and following results were obtained. RESULTS: 1) When ITI and Branemark system were compared, both annual marginal and inter-implant crestal bone height changes in ITI system in the first two years were smaller than Branemark and they were statistically significant. On the third year, however, there was no statistical difference between two implant systems on their annual bone level changes (p>0.05). 2) The Marginal and inter-implant crestal bone changes were compared when inter-implant distance was less than 4mm. Statistically significant bone level changes were noted on the first year only for ITI implants but in the first and second year for Branemark implants (p>0.05). 3) When comparing angulation changes between marginal bone and implant fixture, ITI system had smaller angulation changes but the annual changes were not statistically significant (p>0.05). CONCLUSION: Within the limitation of this study, it could be concluded that Branemark implant systems had more changes in marginal and inter-implant crestal bone level in the first and second year after loading with statistical significance. Further studies are recommended to see the effects of these bone loss during the first and second year after loading on the long term prognosis of Branemark Implants.