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Biomedical subjects

K Gotfredsen

Publications and source records attributed to K Gotfredsen.

At least 37 records · Page 2Linked to original sources

Marginal tissue response adjacent to Astra Dental Implants supporting overdentures in the mandible.

The aim of this study was to evaluate the marginal tissue response adjacent to implant supported overdentures. Twenty edentulous patients had 2 Astra Dental Implants placed in the canine region of the lower jaw. New overdentures were retained by individual ball attachments in 11 patients and by a bar attachment in 9 patients. Periodontal registrations were recorded 0 months, 6 months, 12 months and 24 months after the overdentures were inserted. One of the 40 fixtures was lost at the stage of abutment connection. No fixtures were lost during the 2- to 4-year observation period and no fixtures showed any periodontal signs of failure. At the 2-year examination, no pocket depths adjacent to the implants exceeded 4 mm and no bone loss exceeded 3 mm. The mean annual bone loss was less than 0.2 mm during the first 2 years. The preliminary results from this limited study were promising and showed that two osseointegrated Astra Dental Implants could successfully retain an overdenture in the lower jaw. However, long-term observation is needed for a definitive evaluation of this treatment concept.

Aged↗

Periodontal ligament formation around different types of dental titanium implants. I. The self-tapping screw type implant system.

The aim of this study was to determine if a periodontal ligament can form around self-tapping, screw type titanium dental implants. Implants were inserted in contact with the periodontal ligament of root tips retained in the mandibular jaws of 7 monkeys. In each side of the mandible, 1 premolar and 2 molars were removed in such a manner that in approximately half the cases, the root tips were retained. Following healing, the experimental areas were examined on radiographs, and sites were selected for the insertion of the implants, so that every second implant would have a close contact to the retained root tips. Three months after placement of the implants, the animals were sacrificed, and ground sections were produced for histological analysis. The results demonstrated that newly-formed cementum had become deposited on the implant surface in the contact area between the implant and the retained roots, whereas osseointegration was consistently found on the remaining part of the implant surface as well as on the entire surface of the implants placed without contact to the retained root tips. The study has shown that, when placed in contact with periodontal ligament tissue of retained roots, a periodontal ligament can form on self-tapping, screw type titanium dental implants in areas where a void is present between the surrounding bone and the implant at the time of insertion.

Animals↗

Mechanical failure of hydroxyapatite-coated titanium and cobalt-chromium-molybdenum alloy implants. An animal study.

Defects in the hydroxyapatite (HA) ceramic coatings applied to metallic implant systems may occur at the time of insertion or at the time of in vivo loading. However, defects may also occur with time because of interaction with physiological fluids. A canine study was performed to make a histological and biomechanical evaluation of HA-coated titanium and cobalt-chromium-molybdenum alloy implants in a non-weight-bearing model. Twelve cylindrical plugs were inserted into the medial femoral condyle on 6 mongrel dogs. HA-coatings of 80-120 microns thickness were applied to 6 Cr-Co-Mo implants and 6 Ti-6AI-4V implants. The implants were removed together with adjacent bone tissue after 4 weeks. There were no statistically significant differences between the two groups for interface shear strength. No differences were encountered with HA-coating on Cr-Co-Mo or on Ti-6AI-4V, failure consistently being caused by disruption between the metal surface and the HA-coating, which remained fixed to the bone. At histologic evaluation the HA-coated implants exhibited a great amount of direct bone-to-implant contact. In spite of that, this study indicates that HA-coating on smooth metal surfaces might not be suitable for clinical use, because of low bonding strength between metal and coating.

Alloys↗

Histomorphometric and removal torque analysis for TiO2-blasted titanium implants. An experimental study on dogs.

The aim of the present study was to compare the anchorage of TiO2-blasted screw and cylindrical implants with conventionally used machine-produced screw and cylindrical implants inserted immediately in extraction sockets on dogs. 6 adult mongrel dogs had 3rd and 4th mandibular premolars extracted bilaterally and 24 commercial pure titanium implants were placed immediately in extraction sockets and covered with mucoperiosteum. Each dog had inserted 4 implants: 1 screw implant and 1 cylindrical implant blasted with titanium-dioxide-particles; 1 screw implant and 1 cylindrical implant with machine-produced (m.p.) surface (controls). After a healing period of 12 weeks, 16 implants from 4 animals were used for removal torque test, which demonstrated that significantly higher removal torque force was needed to unscrew the implants blasted with titanium-dioxide-particles, than the normal m.p. implants. The medians for the TiO2-blasted screw and cylindrical implants were > 150 Ncm and 105 Ncm, respectively, while the values for the m.p. implants were 60 Ncm and 35 Ncm, respectively. The SEM investigation demonstrated a high irregularity of the TiO2-blasted surface compared to the machined surface. The Ra and Rz values for surface roughness were higher for the TiO2-blasted implants than for the normal m.p. implants. Histomorphometrically, the arithmetic mean of the direct bone-implant contact fraction was 69%. There was no significant difference in direct bone-implant contact length fraction between TiO2-blasted implants and the control implants. The implants blasted with titanium-dioxide-particles in this study showed a better anchorage than implants with a machine-produced surface. The screw implants showed a better anchorage than the cylindrical implants.

Animals↗

A method for histological preparation of undecalcified bone sections containing acrylic bone cement.

An improved and time reducing method is presented for the histological evaluation of bone containing polymethylmethacrylate (PMMA) bone cement. The undecalcified bone was embedded in epoxy resin and section of 50-100 microns thickness were produced using a commercially available cutting grinding system. The sections were stained with Stevenel's blue and van Gieson picrofuchsin or a modified hematoxylineosin. PMMA bone cement was not dissolved and remained enabling examination in situ of an intact cement bone interface and tissue reaction without decalcification.

Animals↗

Histologic analysis of a retrieved hydroxyapatite-coated femoral prosthesis.

A hydroxyapatite-coated hip hemi-prosthesis was retrieved from a 98-year-old osteoporotic woman 12 weeks after implantation. Histologic analysis revealed bone and fibrous tissue almost evenly distributed around the surface of the implant circumference. Quantitative histologic analysis showed that 48% of the hydroxyapatite surface was covered by bone. Fibrous tissue covered 30% of the prosthetic surface, and 20% of the surface had no tissue coverage. Scanning electron microscopy showed direct contact without any clear boundary between the newly formed bone and the hydroxyapatite ceramic.

Aged↗

Bone growth into a revised porous-coated patellar implant.

A noncemented and clinically stable porous-coated patellar component (PCA) was removed from a patient after 11 months because of infection. It was sectioned and examined histologically in undecalcified, thin-ground sections. The bone ingrowth into the porous space was measured at eight levels. Each histologic section was quantified by a conventional point-counting method using a square grid. There was inhomogeneous, but extensive, bone ingrowth, often extending to the core of the patellar component, with direct contact between bone and porous coating without any interstitial fibrous membrane.

Adult↗

ITI implants with overdentures: a prevention of bone loss in edentulous mandibles?

Changes in the bone mineral content (BMC) of edentulous mandibles with osseointegrated ITI implants supporting overdentures were measured in vivo by dual-photon absorptiometry. The BMC measurements were performed 3 weeks postoperatively and at the 2-year follow-up visit. Measurements were made in the ITI site (anteriorly), the premolar region just behind the fixtures, and the standard site of the mandible for obtaining reference values of the age-related MBC loss. The increased function of the mandible after this treatment seems to cause a load-related bone formation that minimizes, or in some cases may counteract, the physiologic age-related BMC loss leading to osteoporosis.

Absorptiometry, Photon↗

A method for preparing and staining histological sections containing titanium implants for light microscopy.

An improved method for preparing and staining ground tissue-implant sections for light microscopy is presented. Undecalcified tissue blocks with titanium implants were dehydrated in an ascending series of ethanol and stained in toto with basic fuchsin. Specimens were infiltrated and embedded in methyl methacrylate and sections were prepared using a cutting-grinding-system. The polished surface was counterstained with light green or anilin blue. Light polymerizing resin was used as slide mounting medium and for mounting the coverglass. The sections obtained were 10-15 microns thick with tissue architecture which clearly differentiated structures at the tissue-implant interface. The method was very useful for computer assisted morphometric analysis.

Animals↗

[The reactions of patients to mandibular osseointegrated dental prosthesis/implants].

A removable denture as rehabilitation for complete edentulousness is not always sufficient treatment. Some patients cannot achieve acceptable function with this treatment and psychosocial problems sometimes arise. In recent years an alternative treatment has been available for these patients, viz. treatment with overdentures supported by oral implants. An interview has been made with the first 10 patients. The treatment was 3 to 5 ITI-implants in the mandible between the mental foramina. A barconstruction stabilized the implants and barclips were placed in the denture. There was a very positively reaction to the treatment. The patients have an improvement in oral function and retention of the denture. Also the psychosocial sequelae from which some of them previously suffered were reduced or removed.

Attitude to Health↗

Histological and histomorphometrical evaluation of tissue reactions adjacent to endosteal implants in monkeys.

A qualitative and quantitative histological study of the initial healing response adjacent to 24 submerged and non-submerged implants placed in the lower jaws of 6 monkeys is presented. The histomorphometric analysis showed no significant differences in mineralized bone-implant contact length between submerged and non-loaded non-submerged titanium implants. The infrabony defects around some of the implants on the radiographs were significantly correlated to the histological measurements. Qualitatively, a greater number of gingival inflammation cells and a longer junctional epithelium were seen adjacent to non-submerged implants without oral hygiene than were seen adjacent to non-submerged implants with oral hygiene in the initial healing period.

Animals↗

Guided tissue regeneration ensures osseointegration of dental implants placed into extraction sockets. An experimental study in monkeys.

The aim of the present study was to explore the possibility of achieving osseointegration of dental titanium implants, inserted into alveoli immediately after tooth extraction, by covering the recipient site with a teflon membrane. In each of 7 monkeys, mucoperiosteal flaps were raised on the buccal and palatal aspects of the maxillary molars in both sides of the jaw. The second molars were then extracted and self tapping titanium implants of the screw type (Astra Dental Implants) were inserted into the sockets of the largest roots. In the coronal portion of the sockets, a void was always present between the implant and the socket walls. In one side of the jaw, a membrane (Gore-Tex Augmentation Material) was adjusted to cover the implant. The implant in the other side of the jaw served as control and was only covered by the tissue flaps. Microscopic analysis after 3 months of healing revealed that soft tissue was facing the coronal portion of the implants to a varying degree in the control side, while osseointegration was consistently observed to the top of the membrane-covered implants which remained submerged throughout the experimental period. The results suggest that the membrane technique can secure complete osseointegration of implants inserted immediately into extraction sockets.

Alveolar Process↗

Effect of membranes and porous hydroxyapatite on healing in bone defects around titanium dental implants. An experimental study in monkeys.

The purpose of the present study was to examine the effect of treating bony craters around titanium dental implant with polytetrafluoroethylene membranes (PTFE), with and without grafting of hydroxyapatite (HA), and with HA alone. 4 standardized bone defects were prepared in the alveolar ridge of edentulous areas in each of 7 monkeys. A titanium implant was then placed centrally in each defect, and in each monkey, the defects were treated with 1 of the following 4 treatment modalities: (1) coverage with PTFE membrane; (2) grafting of HA and covering with a PTFE membrane; (3) HA grafting; (4) no treatment. Following a healing period of 12 weeks, all animals were sacrificed and mesio-distal ground sections of the treated areas were prepared. The histological analysis showed that all bone defects around the implants treated with PTFE membranes and 5 of the defects treated with HA and PTFE membranes were completely filled with new bone. The defects treated with HA alone and thecontrol defects with no treatment only demonstrated new bone formation in the bottom of the defects. The results suggest that bone defects around titanium implants can be treated wuccessfully with PTFE membranes.

Alveolar Bone Loss↗

Implant-supported mandibular overdentures retained with ball or bar attachments: a randomized prospective 5-year study.

PURPOSE: The aim of the present study was to evaluate the periimplant conditions and the maintenance requirements for implant-supported overdentures in the mandible retained with ball or bar attachments during a 5-year period. MATERIALS AND METHODS: Twenty-six completely edentulous patients had two Astra Tech dental implants placed in the anterior part of the mandible. The denture attachment system for the patients was chosen randomly by drawing lots. Eleven patients drew the bar attachment system and fifteen patients drew the ball attachment system. Plaque Index, Gingival Index, and probing pocket depth were assessed around each implant. Periotest values were recorded, and periodically identical intraoral radiographs were obtained with a specially designed film-holding device. RESULTS: No implants were lost from baseline to the 5-year registration. The periimplant conditions were very healthy after 5 years. No significant differences of the periimplant variables were recorded between the bar and the ball groups. During the first year of function, significantly more complications/repairs were registered in the bar group than in the ball group. In the following years, no significant differences were registered. The mean frequency of complications/repairs per patient per year was 1.0 in the bar group and 0.6 in the ball group during the 5-year observation period. CONCLUSION: Two implants with ball or bar attachment supported an overdenture in the mandible for 5 years with a 100% survival rate. No differences in marginal bone loss or health of the periimplant mucosa were observed between bar and ball attachment, but the frequency of technical complications/repairs per patient was higher around bar than ball attachments.

Aged↗