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Biomedical subjects

J Gunne

Publications and source records attributed to J Gunne.

At least 19 recordsLinked to original sources
PubMed2004

10-year follow-up of onlay bone grafts and implants in severely resorbed maxillae.

Thirty patients with extremely resorbed maxillae had reconstructive bone grafts from the ala iliaca and endosseous implants in a one-stage procedure. The first ten patients constituted a development group and the following 20 patients a routine group. The marginal bone level and implants success rate was evaluated in a prospective long-term follow-up for a minimum of 10 years (10-13 years). Clinical and radiographic examinations were performed at 6 months and then annually up to 5 years. The final examinations were performed at the 10-year follow-up. The bridges were removed at every clinical examination. Marginal bone loss was seen up to the 3-year examination, where it averaged 4.6 mm in the routine group. Between the 3- and 10-year follow-up no significant change was registered. The initial bone loss was probably due to the design of the 3.6 mm conical unthreaded marginal part of the implant. The implant success rate was 83.1% in the routine group. Failures mostly occurred during the first 2 years (14 out of 20). A substantial amount of bone can be gained in patients with extremely resorbed maxillae, when treated with bone graft according to the procedure described in this study.

Adult↗
PubMed2001

Implant versus tooth-implant supported prostheses in the posterior maxilla: a 2-year report.

When implants are used for restoration of a jaw with a residual dentition, the possibility of combining implants with natural abutments may be considered. In a longitudinal comparative study, 26 patients (15 women & 11 men, age 49-84 years) with residual anterior dentitions were treated with two different designs of fixed partial dentures bilaterally in the posterior maxilla. On one side the reconstruction was supported by implants only, while on the contralateral side an implant and a tooth in combination were used. The patients were followed at intervals of 3, 6, 12 and 24 months after loading of the implants. 95 implants were placed, of which 11 non-loaded. A total of 10 implants failed, 7 prior to loading and three within the first three months of service (88.0+/-SE 6.7% cumulative survival for tested implants after two years' follow-up). There was no difference in failure rate for the implants in the two different prosthesis designs. The total mean loss of marginal bone height close to the implants was within acceptable standards, but was more pronounced at the implants not combined with teeth. The results indicate a correlation between the prosthesis design and the loss of marginal bone.

Aged↗
PubMed1998

A meta-analysis of implants in partial edentulism.

A meta-analytic technique was used to estimate the survival of implants supporting bridges or single crowns in partially edentulous patients. A survey of the literature revealed 66 studies, published between 1986 and 1996. Nine studies on single implants and 10 studies on fixed partial dentures met the inclusion criteria for the meta-analysis. Data from a total of 2686 implants, 570 single crowns (SC) and 2116 in fixed partial dentures (FPD), were analyzed. In order to calculate annual survival rates for individual studies a life-table analysis was conducted. Maximum follow-up time ranged between 1 and 8 years. After 1 year the success rate was calculated to be at least 85.7% for FPD and 97.2% for SC. When the results from the FPD studies were pooled the survival rate was 93.6% after 6-7 years. The corresponding value for SC was 97.5%.

Chi-Square Distribution↗
PubMed1997

Interpositional bone grafting and Le Fort I osteotomy for reconstruction of the atrophic edentulous maxilla. A two-stage technique.

This study presents the results from ten consecutive patients who, because of insufficient bone volume for conventional implant placement in the maxilla, were treated with an interpositional bone graft and Le Fort I osteotomy. The endosteal implants were placed six months after the osteotomy. A total of 60 screw-shaped titanium implants (Brånemark) were placed, of which three failed to integrate during the six-month healing period. No further implants were lost during the follow-up period, ranging from 15 to 39 months after placement of the implants. All patients received fixed bridges and all have continued to function efficiently.

Adult↗
PubMed1997

Bone grafting to the maxillary sinuses, nasal floor and anterior maxilla in the atrophic edentulous maxilla. A two-stage technique.

This study presents the results from 20 consecutive patients treated with an autogenous bone graft from the iliac crest. In ten patients the graft was placed in the maxillary sinuses and the floor of the nose (inlay group). Ten patients, in addition to the inlay graft, had a corticocancellous bone block secured with mini-screws to the anterior maxillary ridge (inlay/onlay group). Endosteal implants (Brånemark) were placed six months after surgery. A total of 136 implants were placed, of which eight failed to integrate during the six-month healing period. A further 15 implants were lost during the follow-up period. For the inlay group the average follow-up period was 22 months and for the inlay/onlay group 19 months. Donor site morbidity was significantly less when iliac bone was harvested with a trephine (inlay group) than in patients treated with our routine procedure for bone harvesting (inlay/onlay group). Surgical technique, donor site morbidity, implant survival and patient acceptance are presented.

Adult↗
PubMed1995

Vertical load distribution on a three-unit prosthesis supported by a natural tooth and a single Brånemark implant. An in vivo study.

In vivo bite forces, implant axial forces and bending moments were measured on 5 patients with fixed posterior prostheses supported by a natural tooth and a single Brånemark implant. The results demonstrate that the vertical loads applied to the prostheses are shared between the tooth and the implant. The maximum bending moment transferred to the implant (10-15 N.cm) was well below the acceptable load limits for the mechanical components (50-60 N.cm), even at bite forces exceeding 100 N. The main reason for this load sharing seems to be the inherent bending flexibility of the implant screw joint, which matches the axial flexibility of the periodontal ligament of the tooth.

Aged↗
PubMed1995

Bridges supported by free-standing implants versus bridges supported by tooth and implant. A five-year prospective study.

The clinical question at issue, whether it is possible to combine implants and natural teeth via fixed bridges, is of current interest. The treatment of the subjects of this prospective study was performed between June 1984 and December 1986. This article presents the 5-year results of the study. The consecutive patient material comprised 23 patients with Applegate Kennedy Class I residual dentition in the mandible and a complete maxillary denture. All 23 patients were provided with implants ad modum Brånemark in each mandibular quadrant. One side was randomized to rehabilitation with fixed bridge between the distal tooth of the residual dentition and an implant; the other side received a free-standang bridge on 2 implants. The fixture survival rate was 88%. No difference was found between the two sides. Bridge stability was 89% for the implant bridges and 91% for the combination bridges. The change in marginal bone level at the implants was small during the 5-year follow up period (on average 0.1-0.3 mm) and with no difference between the two sides. In conclusion, it was not possible to demonstrate any higher risk of implant or prosthetic failure for tooth-implant fixed bridges compared with implant-supported bridges.

Alveolar Bone Loss↗
PubMed1993

Bone grafts and Brånemark implants in the treatment of the severely resorbed maxilla: a 2-year longitudinal study.

A combination of horseshoe-shaped iliac bone grafts and Brånemark implants was used in 30 patients with severely resorbed maxillary alveolar ridges. All patients were followed clinically for 2 years and evaluated with regard to prosthesis stability, fixture survival, wound healing complications, and soft tissue conditions. Surgery was performed by the same oral surgeons using identical procedures, and the prosthetic treatment was performed by the same prosthodontist. The development group included the first 10 patients and the routine group included the following 20. Fixture survival in the development group was 54.4%, whereas 88.3% of the fixtures in the routine group have survived after 2 years. The average fixture survival in the study was 77.4%. Three patients in the development group lost all fixtures, primarily the result of trauma to the grafted region. With respect to the difficult situation many of these patients experienced, the survival rate should be considered most acceptable.

Adult↗
PubMed1992

Implants in partially edentulous patients. A longitudinal study of bridges supported by both implants and natural teeth.

The aim of the study was to compare the outcome of bridges supported by implants with bridges supported by a combination of implants and natural teeth abutments. The study comprised 23 patients with Applegate Kennedy Class I dentition in the mandible and a full upper denture. Implants ad modum Brånemark were inserted in the posterior areas of both mandibular quadrants. On one side, a bridge supported by 2 implants was constructed (Type I) and on the other side, a bridge supported by 1 tooth (mostly the canine or first premolar) and 1 implant was made (Type II). A total of 46 bridges were made and during the 3-year follow-up period, 4 Type I and 2 Type II bridges were lost. 8 out of 69 implants were lost during the 3-year follow-up, resulting in an implant survival rate of 88.4%. Marginal bone loss, one of several parameters, was evaluated on standardized intraoral radiographs. This was performed during the 1st and 2nd year of function and the total mean bone loss from loading was 0.46 mm and 0.56 mm, respectively. The bone loss during the 2nd year of function was significantly less, adjacent to implants supporting Type II bridges, than adjacent to implants supporting Type I bridges. Summarily, no disadvantages of combining of teeth and implants in the same bridge were found in this study. On the contrary, the slightly lower marginal bone loss adjacent to implants in Type II bridges may indicate that the bone reactions could be more favorable when bridges are connected to both implants and teeth.

Alveolar Bone Loss↗
PubMed1991

Mechanical aspects of a Brånemark implant connected to a natural tooth: an in vitro study.

Mechanical in vitro tests of the Brånemark implant disclose that the screw joint which attaches the prosthetic gold cylinder and the transmucosal abutment to the fixture forms a flexible system. This inherent flexibility seems to match well the vertical mobility of a supporting tooth connected to the implant. Calculations of vertical load distribution based on measured flexibility data demonstrate that the forces are shared almost equally between tooth and implant even without taking the flexibility of the surrounding bone or the prosthesis into account. The therapy of a single Brånemark implant connected to a natural tooth should be considered without any additional element of a flexible nature. Mechanical tests and theoretical considerations, however, indicate that the transverse mobility of the connected tooth should be limited and that the attachment of the prosthesis to the tooth should be of a rigid design to avoid gold-screw loosening.

Dental Abutments↗
PubMed1991

Combination of natural teeth and osseointegrated implants as prosthesis abutments: a 2-year longitudinal study.

Twenty-three patients with Kennedy Class I mandibular dentition were supplied with prostheses in the posterior parts of the mandible. On one side they were given a prosthesis supported by two implants (prosthesis Type I) and on the other side they received a prosthesis supported by one implant and one natural tooth (prosthesis Type II). Sixty-nine fixtures were inserted and 46 prostheses constructed. Eight of the fixtures were lost during the observation period. The failure rate of the implants was about the same in the two types of prostheses; five fixtures belonged to prostheses Type I (10.9%) and two fixtures belonged to prostheses Type II (8.7%), while one fixture was lost prior to loading. From a theoretical point of view, the combination of a tooth and an osseointegrated implant should encounter problems with regard to the difference in bone anchorage and there should be a risk of biomechanical complications. However, the results of this study did not indicate any disadvantages in connecting teeth and implants in the same restoration.

Adult↗
PubMed1990

Osseointegrated implants in edentulous jaws: a 2-year longitudinal study.

Osseointegrated implants in 50 edentulous jaws were studied during a 2-year observation period. The implant survival rate was 89% in the maxillae and 97% in the mandibles. The marginal bone loss averaged 1.7 mm in the maxillae and 1.1 mm in the mandibles. Most of this bone loss occurred during the first year. The bone loss was greater in jaws with a preoperatively minor resorption of the alveolar ridge than in those with moderate or advanced resorption. The bone loss was also greater at the medially positioned implants than at those more posterior.

Adult↗
PubMed1990

Impression technique for RPDs. A comparison between two methods.

The purposes of this study were threefold, 1) to develop a method for comparing various impression techniques and materials, 2) to compare the extension of impressions with ZOE-paste and silicone, and 3) to evaluate the precision for each method. A special device was constructed in order to secure an identical position of the impression trays. The results indicated that ZOE-paste impression in a border moulded tray produced more extended impressions lingually but buccally there were no difference between the chosen materials/method. No differences in precision of the two methods could be measured.

Dental Impression Materials↗
PubMed1989

Opinions and wearing habits among patients new to removable partial dentures. An interview study.

Thirty-five patients treated at the Department of Prosthetic Dentistry, University of Umeå, who had received removable partial dentures (RPD) during the period July 1st 1981 to December 31st 1982, were interviewed regarding the use and experiences of their dentures. None of the patients had previously used an RPD. The treatment had been carried out by dentists and dental students. At the time of the interview, 1-2 1/2 years after receiving the prosthesis, 34 subjects (97%) declared that they used their RPDs during various parts of the day.

Adult↗
PubMed1985

Masticatory ability in patients with removable dentures. A clinical study of masticatory efficiency, subjective experience of masticatory performance and dietary intake.

One of the functions of the masticatory system is to grind the food, salivate and prepare it for swallowing. Individuals who have lost many teeth or wear removable dentures, both complete and partial, find it more difficult to grind food i.e. they suffer from impaired masticatory efficiency (ME). Some of these subjects have to avoid food-stuffs which are hard and difficult to chew. This could influence the social well-being and may eventually lead to an increased risk of malnutrition. Many different methods have been used to evaluate ME. In most of them the degree to which the masticated food or test material was broken down was measured by fractionating the particles in a sieve system. However, one of the purposes of chewing the food is to enlarge the surface area to be exposed to the digestive juices. A few authors have applied this idea and have calculated ME using the summarized area of the masticated test material. This is physiologically a more correct method. ME was investigated in 19 complete denture wearers who were fitted with new dentures. The subjects were tested twice with the old dentures and 5 times with the new ones. The last test took place about 18 months after insertion of the new dentures. The test material was gelatin hardened with formalin. The breakdown of test material was calculated by fractionating it in a sieve system. ME was also evaluated in two other groups, 43 complete denture wearers, who were in need of new dentures, and 19 subjects who were in need of RPDs in the lower jaw. In these two studies ME was evaluated in two ways. Firstly the summarized area of masticated gelatin particles was calculated and used as a measure of ME. Secondly almonds were used as test material and the breakdown was calculated by fractionating in a sieve system. The subjects were tested on three occasions, before prosthetic treatment and about one and four months after insertion of the dentures. On the first and last occasions the subjective experience of masticatory performance was assessed as well as the dietary intake. The results revealed no systematic change in ME when the 19 subjects were fitted with new complete dentures and when the breakdown of the test material was evaluated by fractionating it in a sieve system.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMedDate not supplied

Survival of the Brånemark implant in partially edentulous jaws: a 10-year prospective multicenter study.

A total of 127 partially edentulous patients, treated according to the Brånemark protocol, was followed for 10 years after completion of prosthetic treatment. The patients ranged in age from 18 to 70 years, and 57% were female. Four hundred sixty-one implants were placed in 56 maxillae and 71 mandibles. In 125 patients, 163 fixed partial prostheses were attached to the implants; a majority of the prostheses (83%) were located in posterior regions. At the end of the 10-year period, 73% of the implants could be traced either as failed or in function, providing cumulative implant survival rates of 90.2% and 93.7% for the maxilla and mandible, respectively. Of the original fixed prostheses, 63% (cumulatively 86.5%) were still in use, whereas the level of continuous cumulative prosthesis function, including primary and remade restorations, was 94.3% at the end of the evaluation period. Marginal bone resorption at the implants was low (mean = 0.7 mm), and mucosal health was good. No severe complications apart from the above-mentioned implant and prosthetic failures were reported. The Brånemark Implant System is a safe and predictable method for restoring partially edentulous patients, as demonstrated by this 10-year follow-up investigation.

Adolescent↗
PubMedDate not supplied

Tooth-implant and implant supported fixed partial dentures: a 10-year report.

PURPOSE: The use of implants for prosthetic rehabilitation of partially edentulous patients is increasing. However, the possibilities of placing implants in the posterior part of the mandible are often limited. The purpose of this longitudinal study with 10 years of follow-up was to evaluate the use of short implants supporting fixed partial dentures (FPD) in the posterior part of the mandible, and to compare implant supported FPDs to tooth-implant supported FPDs. MATERIALS AND METHODS: The patient material comprised 23 patients with residual mandibular anterior teeth, and each patient received FPDs unilaterally. On one side the FPD was supported by two implants, and on the other side by one implant and one tooth, thus permitting intraindividual comparison. The distribution of the two types of FPDs in each jaw was randomized. Implant success rates, marginal bone changes, and mechanical complications were studied. RESULTS: The tooth-implant connection did not demonstrate any negative influences on the overall success rates for the 10-year period, nor were the shorter implants found to be less favorable. CONCLUSION: It is suggested that a prosthetic construction supported by both a tooth and an implant may be recommended as a predictable and reliable treatment alternative in the posterior mandible.

Alveolar Bone Loss↗