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Biomedical subjects

R Adell

Publications and source records attributed to R Adell.

36 records · Page 2Linked to original sources
PubMed1986

Marginal tissue reactions at osseointegrated titanium fixtures (I). A 3-year longitudinal prospective study.

16 consecutive totally edentulous patients were provided with 95 osseointegrated titanium fixtures in 7 upper and 9 lower jaws. Facultatively removable bridges were later connected to abutments, attached to the fixtures. The marginal soft and hard tissue reactions were investigated at a baseline examination and after 6, 12, 21, 30 and 39 months by standardized clinical and radiographical methods. At the last examination, microbiological samples and gingival biopsies were also analysed. The % ratios of abutments without plaque, 70-75%, and without any gingivitis, 80-85%, were almost constant throughout the study. The mean probing depth was 2.9 mm at the final examination. About 75% of all probing depths were 3 mm or less and none exceeded 5 mm. The bridge-gingiva distances increased during the investigation. Attached gingiva surrounded 65% of the buccal and lingual abutment surfaces. Only 0.9 mm marginal bone was lost as a mean during the first year and not more than 0.05 mm annually for the next 2 years. After 6 months, no significant changes in marginal bone levels occurred. The perifixtural bone gradually became more radiopaque, especially marginally in upper jaws, indicating a successive load-related remodelling. The microbiotia comprised coccoid cells and non-motile rods to 93% in 32 samples. Healthy tissues were present in 35% of the 14 soft tissue biopsies. In a further 29%, only a slight inflammation was observed. No constant correlations could be established for any of the investigation parameters used. It is concluded that the marginal soft tissue reactions were mild and not significant for a progressive periodontitis. Mobility tests of separate fixtures combined with quantitative and qualitative standardized radiological examinations of the surrounding bone appear to provide a truer comprehension of longitudinal events at osseointegrated implants than conventional clinical soft tissue observations. The prognosis for the osseointegrated implants appears excellent, especially with regard to the microbiotia, the small marginal bone height changes, and the radiological indications of remodelling in the perifixtural bone.

Adult↗
PubMed1986

Marginal tissue reactions at osseointegrated titanium fixtures. (II) A cross-sectional retrospective study.

20 totally edentulous patients, provided with 24 facultatively removable fixed bridges (13 upper and 11 lower jaws) were recalled. The material consisted of 125 osseointegrated titanium fixtures with a mean observation time of 7.6 years (range 6 months to 15 years). The marginal tissues were examined by conventional periodontal clinical methods and standardised radiography. Microbiological samples and biopsies of the soft marginal barrier tissues were retrieved for dark-field and histological analysis, respectively. The percental ratios of abutment surfaces devoid of plaque and without signs of gingivitis, were 46% and 20%, respectively. In contrast to earlier studies, the presence of plaque and gingivitis was significantly correlated. This relationship was probably due to more plaque being present. The mean probing depth was 3.8 mm. In 40% of the measurements, the probing depths were 3 mm or less, and in 45% between 4 and 5 mm, whereas they only in 15% were 6 mm or more. They were greater in upper than in lower jaws and were found to be significantly correlated with gingivitis. Attached gingiva surrounded about 51% of the buccal and lingual abutment surfaces. The marginal bone height changes were very small during the follow-up period (0.07 mm annually). Coccoid cells and non-motile rods dominated the microflora to 94% in the 48 samples taken. Out of the 19 biopsies, 58% showed healthy mucosa and a further 37% had the lowest inflammation score. The indications of gingivitis and deep pockets at the clinical examination were not found accompanied by an accelerated marginal bone loss, nor by a microflora or histological changes indicative of periodontitis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

The condition of the soft tissues at tooth and fixture abutments supporting fixed bridges. A microbiological and histological study.

In 10 partially edentulous patients provided with fixed bridgework supported by the combination of tooth and titanium fixture abutments, the condition of the soft tissues surrounding the abutments was examined. Sampling of supra- and subgingival plaque was performed from both teeth and fixtures. The samples were analyzed regarding the total bacterial counts, the relative distribution of bacterial morphotypes and the cultivable microflora. From each patient, soft tissue biopsies were obtained from 1 tooth and 1 fixture abutment, and the specimens were analyzed for the presence and extension of inflammatory cell infiltrates. The microbiological examination showed that the distribution of bacterial morphotypes in the supra- and subgingival plaque both at teeth and fixtures were similar, irrespective of localization and type of abutment. Nonmotile rods dominated the microflora, whereas spirochetes were either not detected or occurred in very low proportions. From the histological analysis, it was found that a majority of the soft tissue biopsies (75-80%) from both tooth and fixture sites contained only very small inflammatory cell infiltrates.

Adult↗
PubMed1985

Marginal tissue reactions at osseointegrated titanium fixtures.

A longitudinal prospective and a cross-sectional retrospective study were undertaken in order to investigate the marginal tissue reactions at osseointegrated titanium fixtures and their abutments, supporting fixed bridges. Conventional clinical periodontal examination methods were combined with a serial-identical radiography. At the termination of the studies samples were taken for microbiological and histological analyses. Altogether the reactions at 220 fixtures in 40 jaws were explored. The clinical parameters were not found correlated with the other examination methods. Only 0.9 mm marginal bone was lost as a mean during the first year and then not more than 0.05-0.07 mm as a mean annually for the follow-up years. A stress-related remodelling of the perifixtural bone was observed radiographically. The microbiotia in the gingival pockets was dominated by cocci and non-motile rods (94%), indicating a favourable composition if similar findings had been observed at teeth. Half the number of the biopsies had no inflammatory infiltrates and a further third had the lowest inflammatory score in a 3-grade scale. The results indicate that the soft tissue surrounding the gingival part of osseointegrated fixtures remains remarkably healthy, which, in combination with the annual minor loss of marginal bone, is an indication of good long-term clinical prognosis.

Alveolar Process↗
PubMed1985

Tissue integrated prostheses in clinical dentistry.

Implants can be anchored to bone either by a sheath of non-mineralized connective tissue or by osseointegration. The latter gives a firm, intimate and lasting connection. The requirements for osseointegration and the evidence that it occurs are reviewed together with its indications within dentistry. Treatment procedures with jaw-bone anchored bridges on osseointegrated implants are summarized. The series treated comprised about 6000 implants in 1000 jaws of 1000 patients. About 1500 implants were statistically analysed after observation times of 5-12 years. The longest observation period is presently 19 years. Only 14 patients had to revert to removable dentures. The masticatory function of the patients was restored to the same level as that of patients with natural dentitions of corresponding extent. Psycho-socially the patients were almost entirely relieved of their previous severe handicaps related to edentulousness. In all lower and 90 per cent of upper jaws the bridges were continuously stable. The marginal soft tissue reactions were mild and the marginal bone loss less than 1.0 mm during the first year and thereafter only 0.05-0.07 mm annually. After the first year hardly any implants were lost and almost no marginal bone. The implant survival rates were 84 and 93 per cent for those in upper and lower jaws respectively. These results allow a very predictable prognosis to be given for tissue integrated prostheses.

Adult↗
PubMed1984

An experimental and clinical study of osseointegrated implants penetrating the nasal cavity and maxillary sinus.

Implants were inserted in the upper jaw of three dogs in such a way that they penetrated the bone wall of the nasal cavity. The dogs were killed one year later, and the hard and soft tissues around the penetrating implants were analyzed. Radiographic and histologic examinations did not show any signs of adverse tissue reaction. The implants were all integrated in bone without fibrous tissue formation in the interface. A total of 139 implants, which pierced the bone of the sinus or nasal cavity, were inserted in the upper jaws of 101 patients. Forty-four sinus- and 47 nasal-penetrating implants were observed for five to ten years. The success rates were 70% and 72%, respectively. For 25 sinus- and 23 nasal-penetrating implants that were observed for two to five years, the success rates were 88% and 96%, respectively. The implant losses in nearly all clinical cases occurred during the first two years of function.

Animals↗
PubMed1983

Osseointegrated titanium fixtures in the treatment of edentulousness.

A 91 per cent positive 5-9 year result has been reported when using titanium implants and gold bridges to restore edentulous jaws. About 400 consecutive patients have been operated. The reasons for the good results are believed to depend on the anchorage of the implants in the living bone without interposing soft tissue layers. Repeated X-rays ensuring a strict parallelism are used to indicate direct bone integration. Some implants had to be removed in spite of still being anchored in the bone. In these cases SEM and TEM provided direct evidence of an osseointegration.

Dental Implantation↗
PubMed1981

A 15-year study of osseointegrated implants in the treatment of the edentulous jaw.

Osseointegration implies a firm, direct and lasting connection between vital bone and screw-shaped titanium implants of defined finish and geometry-fixtures. Thus, there is no interposed tissue between fixture and bone. Osseointegration can only be achieved and maintained by a gentle surgical installation technique, a long healing time and a proper stress distribution when in function. During a 15-year period (1965-1980), 2768 fixtures were installed in 410 edentulous jaws of 371 consecutive patients. All patients were provided with facultatively removable bridges and were examined at continuous yearly controls. The surgical and prosthetic technique was developed and evaluated over a pilot period of 5 years. The results of standardized procedures applied on a consecutive clinical material with an observation time of 5-9 years were thought to properly reflect the potential of the method. In this group, 130 jaws were provided with 895 fixtures, and of these 81% of the maxillary and 91% of the mandibular fixtures remained stable, supporting bridges. In 89% of the maxillary and 100% of the mandibular cases, the bridges were continuously stable. During healing and the first year after connection of the bridge, the mean value for marginal bone loss was 1.5 mm. Thereafter only 0.1 mm was lost annually. The clinical results achieved with bridges on osseointegrated fixtures fulfill and exceed the demands set by the 1978 Harvard Conference on successful dental implantation procedures.

Adult↗
PubMedDate not supplied

[Intraosseous implants].

Explore the source record for details and available documents.

Dental Implantation, Endosseous↗