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Biomedical subjects

M S Cune

Publications and source records attributed to M S Cune.

49 records · Page 3Linked to original sources
PubMed1996

A clinical retrospective evaluation of FA/HA coated (Biocomp) dental implants. Results after 1 year.

In this retrospective clinical evaluation, the performance of loaded titanium implants with a bilayer bioactive surface coating of the relatively reactive hydroxylapatite (HA, outer layer) and the more stable fluorapatite (FA, inner layer) was evaluated. 98 consecutive patients were included in the study for a total of 354 implants, loaded by overdentures, fixed partial dentures and single tooth replacements. Statistical analyses revealed a cumulative probability of implant survival on a per patient basis of 94.5% (s.e. 2.7%), one year after implant installation. On implants that were lost parts of the bilayer FA/HA coating had vanished as a result of primary or secondary infection and subsequently epithelial down growth. Most complications were associated with implants placed in the maxilla. Periotest values (PTV) were generally high, indicating adequate osseointegration. The PTV's were statistically significantly less favorable in implants placed in the maxilla. The most favorable PTV's and gingival index scores were found around implants servicing overdentures. Marginal bone loss averaged approximately 2mm during the observation period. The amount of marginal bone loss corresponded with the distance from the neck of the implant to the first thread of the implant's cervical screw-section. It is concluded that, during the relatively short observation period, the FA/HA coated implants function adequately. However, in the absence of a direct implant-to-bone contact preceding implant loss, part of the FA/HA coating on the titanium implants generally dissolves.

Adult↗
PubMed1996

Front tooth replacement with Tübingen (Frialit) implants: a radiographical evaluation.

A total of 214 radiographs of 76 Tübingen implants placed in the anterior region of the maxillae of 56 patients were evaluated by two observers. The first radiographs were taken after implant placement (n = 76). The second set of radiographs were taken during months 13-23 (n = 53), the third during the months 24-35 (n = 28), the fourth during months 36-47 (n = 15), the fifth during months 48-59 (n = 18) and the sixth during months 60-72 (n = 20). Only four radiographs were available after longer periods, namely the eight and the ten year of function. The two observers together classified the marginal bone height (mesial and distal) as 0 (no resorption) or 1-5 in steps of 2.5 mm resorption. A score of 1 represents marginal bone resorption less than 2.5 mm, 2 from 2.5 mm to 5 mm, 3 from 5 to 7.5 mm, 4 from 7.5 to 10 mm and 5 more than 10 mm loss of marginal bone height. Thirty-six implants scored marginal bone height of 0 or 1. Twenty-two implants scored not higher than 2. Eight implants scored bone loss up to 3, four up to 4 and one up to 5. Five implants were lost.

Aluminum Oxide↗
PubMed1996

A single dimension statistical evaluation of predictors in implant-overdenture treatment.

This retrospective study aims to identify factors that contribute to either a poor or excellent treatment result in implant-overdenture treatment. A total of 375 implants, in an equal number of patients were included in the study. A clinical examination was performed by 2 observers. Gingival health and oral hygiene were assessed and additional complications were noted, including implant loss. 2 outcome variables, STATUS1 and STATUS2, were constructed that were different with respect to treatment outcome, representing a poor and an excellent result, respectively. Patient variables such as age, gender, medical status and prosthetic history were collected pre-operatively with a questionnaire. Life table analyses were used to test subsets of patient and treatment variables for differences in survival distribution, both for poor or excellent results. With regard to predictors of poor results; implants in the upper jaw were associated with a poorer outcome than those placed in the lower jaw (p = 0.01). When more than 2 implants were placed, the quality of survival was also impaired (p = 0.03). Interestingly, implants in patients with a self-proclaimed history of tooth loss due to periodontitis appear to have a far poorer treatment outcome than implants placed in patients without such a history (p = 0.01). No other variables could be related to a poor result after 3 years. None of the variables could predict an excellent treatment outcome.

Age Factors↗
PubMed1995

Delayed implants in the anterior maxilla with the IMZ-implant system: a radiographical evaluation.

One hundred and seventy-three IMZ-implants in 81 patients, placed in the anterior region of the maxilla, were evaluated radiographically by two observers. Radiographs were evaluated at three intervals, namely at the time of implant placement, the time of prosthetic restoration and at the latest available radiograph, on average 2 1/2 years after implant placement. In this study marginal bone height and the type of radiolucency adjacent to the implant were determined. Both observers were able to classify the marginal bone height (mesial and distal) and the distinctive type of resorptive defects to an acceptable level of agreement, with Cohen's kappa ranging between 0.48 and 0.69. It was found that, at the most recent visit to the clinic, angular-shaped resorptive defects are found mesially and/or distally of the implants at approximately 25% of the implants. At this stage 20.7% of the mesial implant sites and 27.9% of the distal implant sites show marginal bone heights less than three-quarters of the implant length. These findings do not fully underscore and sometimes even contradict the clinical observations which were considered highly satisfactory.

Alveolar Bone Loss↗
PubMed1995

Delayed implants in the anterior maxilla with the IMZ-implant system.

One hundred and seventy-three IMZ two-stage implants have been clinically and radiologically evaluated for a 5 year period. The implants were placed in the anterior region of the maxillae of 81 patients to replace lost incisors, cuspids and bicuspids. The implants were placed 3 months or later after loss of natural anterior teeth when the resorption was already in an advanced stage. The implants used in this study consisted of titanium coated with hydroxylapatite. The prosthetic restorations placed on the implants consisted of fixed or removable partial dentures and single crowns. The cumulative percentage for implant survival after 3 years, with a mean follow-up of 33.5 (s.d. 17.8) months was 96.1%. Although the prosthetic restorations aesthetically often were a compromise they did prove highly satisfactory to both patients and dentists.

Adolescent↗
PubMed1995

Characteristics of 5410 edentulous implant candidates and the treatment they receive.

Since 1989 implant dentistry in the Netherlands is a National Dental Insurance (NDI) benefit, thus reducing out-of-pocket expenditures for implant candidates considerably. A nationwide investigation was set up in order to evaluate quantitative, qualitative and financial effects of this new provision. The patient and treatment characteristics of 5410 edentulous implant candidates are discussed. Intensive monitoring of the usage of these new regulations facilitates health care policy making, including future planning. Over a 3 1/2 yr period, two out of every thousand totally edentulous NDI patients were treated in combination with dental implants. This number is being considered small, bearing in mind the number of edentulous patients in the Netherlands and the proportion of dissatisfied denture wearers. Demographic data, prosthetic and pre-prosthetic surgical history reveal that these patients, mostly female and middle-aged, experience severe denture-related problems. In the majority of cases the implants are placed by an oral surgeon and the suprastructure is made by a general dentist or at a centre for special dental care. The treatment itself mostly consists of an implant retained overdenture on two or four permucosal implants and a bar-construction.

Adolescent↗
PubMed1995

[Implant-retained overdentures. Part 1. Clinical findings from an evaluation study].

A total of 429 patients who had received implant overdenture treatment, were clinically investigated by two dentists. Implant survival was high, especially for implants placed in the mandible. Results for the maxilla appeared far less promising. Complications that were observed predominantly concerned inflammation of the peri-implant tissues and poor oral hygiene. No statistically significant correlation could be found between patient and treatment characteristics at baseline and the clinical treatment outcome.

Dental Health Surveys↗
PubMed1994

Treatment outcome with implant-retained overdentures: Part I--Clinical findings and predictability of clinical treatment outcome.

This nationwide study was conducted to clinically evaluate treatment with implant-retained overdentures when applied on a large scale and to determine to what degree treatment results could be predicted from patient and treatment characteristics at baseline. A total of 429 patients who had received implant overdenture treatment were clinically investigated by two dentists. Implant survival was high, especially for implants placed in the mandible. Results for the maxilla appeared far less promising. Complications that were observed predominantly concerned inflammation of the peri-implant tissues and poor oral hygiene. The quality of the overdentures, as assessed on three conventional prosthetic parameters, was generally good. Nevertheless, overdentures on oral implants appear to require considerable maintenance. No statistically significant correlation could be found between patient and treatment characteristics at baseline and the clinical treatment outcome. So, although treatment outcome with implant-retained overdentures appeared favorable, clinical results were not individually predictable.

Dental Health Surveys↗
PubMed1994

Treatment outcome with implant-retained overdentures: Part II--Patient satisfaction and predictability of subjective treatment outcome.

The purpose of this study was to determine the effects of implant-overdenture treatment (IOT) on patients' complaints about dentures and the degree to which subjective treatment outcome could be predicted from baseline patient and treatment characteristics. Four groups of patients were distinguished: one pretreatment group, two posttreatment groups (1 year after treatment) and one reference group of denture wearers, who had not applied for any kind of treatment. They finished a questionnaire with 20 statements on denture complaints. Four scales concerning denture complaints could be distinguished and named after their underlying variables. Differences between the groups were analyzed. IOT treatment was shown to be very effective on a wide range of denture complaints. Little change was seen in patient satisfaction with regard to maxillary dentures when measured on the scales, although many patients wanted improvement in retention and stability for the maxillary denture after IOT treatment in the mandible. Sixteen percent of the denture wearers who had not applied for IOT expressed complaints regarding their mandibular dentures that matched or were more severe than those of the patients that had applied for IOT, before the actual start of treatment. Although generally the subjective treatment outcome of IOT was favorable, it could not be individually predicted from baseline patient and treatment characteristics.

Analysis of Variance↗
PubMed1994

[Implants in combination with an overdenture. Indications for the number of implants needed].

Considerations regarding the choice of the number of implants to be placed in combination with an implant-retained overdenture are discussed. Primarily, the characteristics of the chosen retention mechanism should be considered, as well as the magnitude and direction of forces on the implant-bone interface delivered through the suprastructure and implant, and the expected effects on the antagonist denture and/or jaw.

Bone Resorption↗
PubMed1994

[Dental implants under overlay dentures: an assessment].

In the treatment of edentulous patients endosseous implants play an increasingly important role. This paper discusses treatment and treatment results from a nationwide study among 429 edentulous patients who received implant-retained complete overdentures. In this particular treatment concept the denture derives retention and support from the implants that are placed in the edentulous part of the jaw. In terms of implant survival and patient satisfaction treatment results can be considered satisfactory, especially for the mandible. Of those patients who had an implant supported denture in the mandible, 95% considered the new mandibular denture to function better than the previously constructed denture. The chance on implant survival, three years postoperatively, is approximately 97%. It is concluded that oral rehabilitation in the mandible by means of endosseous implants in combination with a complete overdenture is a reliable and effective treatment alternative.

Aged↗
PubMedDate not supplied

Immediate labial contour restoration for improved esthetics: a radiographic study on bone splitting in anterior single-tooth replacement.

A bone-splitting technique used for anterior single-tooth replacement was evaluated in 54 patients and 68 sites. The cumulative rate of implant survival was 93.7% (SE 4.6%) after more than 4 years. The decrease in marginal bone height ranged from 0.8 to 1.3 mm. Some reaction of the bone levels around the adjacent teeth should be anticipated (0.3 to 0.5 mm). It was concluded that the bone-splitting procedure is a safe and predictable technique when performed carefully on selected patients and with the proper instrumentation. The procedure seeks to reconstruct the labial contour of the alveolar process, which is a prerequisite for optimal and lasting implant esthetics.

Adult↗