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T Albrektsson

Publications and source records attributed to T Albrektsson.

171 records · Page 10Linked to original sources

Suggested guidelines for the topographic evaluation of implant surfaces.

The bone anchorage components of commercially available oral implant systems differ in surface roughness by at least sixfold. Correct reporting of the surface roughness of implant systems is important, since one cannot exclude the possibility that surface roughness will influence clinical results. However, many confusing statements are found in the literature when the surface topography of implants is described. Different measuring instruments and techniques strongly influence the outcome of a topographic characterization. Furthermore, a screw-type design introduces problems for most measuring instruments. Without a standard procedure, it is generally impossible to compare values from one study with another. The aim of the present study was to suggest standards for topographic evaluation of oral implants in terms of measuring equipment, filtering process, and selection of parameters. It is suggested that the measuring instrument be able to measure all parts of a threaded implant if the investigation relates to such a design. Preferably, 3-dimensional measurements should be performed. On screw-type implants, tops, valleys, and flanks should be evaluated. At least 3 samples in a batch should be evaluated, filter size must be specified, and at least one of each height, spatial, and hybrid parameter should be presented.

Biocompatible Materials↗

Direct bone anchorage of oral implants: clinical and experimental considerations of the concept of osseointegration.

The term osseointegration is analyzed in relation to its theoretical and clinical definitions, and comparisons are made to other implant modalities. The term osseointegration has a clear clinical meaning, but there is doubt about its precise usage in an experimental setting. Clinically, an implant can be described as osseointegrated if there is no discernable movement when force is applied to the fixture. This is in contrast to implants surrounded by fibrous connective tissue, which move within soft tissue. Newly developed laboratory techniques may be used in the future to precisely characterize osseointegration in the laboratory.

Alveolar Process↗

Current interpretations of the osseointegrated response: clinical significance.

The so-called concept of osseointegration demands both histomorphometric as well as clinical descriptions and definitions. The understanding of both of these aspects is still evolving and impacts significantly on the ongoing clinical determinants of success. This paper reviews some of the current clinical concerns regarding the clinical evaluation of osseointegrated implants.

Alveolar Bone Loss↗

Bone tissue response to commercially pure titanium implants blasted with fine and coarse particles of aluminum oxide.

The present study compares the bone response to commercially pure titanium screws with two different degrees of surface roughness. Implants blasted with 25- and 250-micron particles of aluminum oxide were placed in rabbit tibiae after the surface roughness of the implants had been measured. After 4 weeks, there was a significantly higher bone-to-metal contact for implants blasted with 25-micron particles compared to those blasted with 250-micron particles. The present study indicates that a highly increased surface roughness compared to a moderately increased one is a short-term disadvantage for bone tissue.

Aluminum Oxide↗

A 1-year follow-up of implants of differing surface roughness placed in rabbit bone.

Screw-shaped implants were prepared with three different surface topographies: One was left as machined, ie, a turned surface, and two were blasted surfaces with differing degrees of surface roughness. The surface topography was measured with a confocal laser scanning profilometer and the surface roughness was characterized using height and spatial descriptive parameters. The turned surface had an average surface roughness of 0.96 micron and an average peak spacing of 8.6 microns. The two blasted surfaces had surface roughness values of 1.16 microns and 1.94 microns, respectively; the corresponding values for the peak spacing parameter were 10.00 microns and 13.22 microns, respectively. After 1 year in rabbit bone, the bone response to the turned implants was compared with the response to the two blasted implant surfaces. Firmer bone fixation was found for the two blasted surfaces, with statistically significant increases in removal torque and percentage of bone-to-metal contact. Furthermore, about 2 mm from the implant surface, the titanium release was similar for the turned and the 25-micron aluminum oxide-blasted implants.

Aluminum Oxide↗

A qualitative and quantitative method for evaluating implant success: a 5-year retrospective analysis of the Brånemark implant.

A proposed protocol and differentiated success criteria for long-term evaluation of oral implants are presented. The protocol and criteria were applied to a retrospective patient material treated during a 1-year period and followed for 5 years. The protocol comprised a two-stage analysis of the collected clinical data. First, a quantitative analysis of the outcome was made using a life table. Based on the information obtained during the follow-up, each implant was categorized into one of three groups: unaccounted for, failure, or survival. A qualitative analysis of the survival group was then performed by active testing against defined criteria. Depending on the modes of clinical and radiographic examinations and their results, surviving implants were either further assigned to one of three success grades or remained in the survival group. The data are presented in a four-field table at one level of success. Strict success criteria together with individual stability testing and radiographic examination of each consecutive implant should be used when a new implant system is evaluated or when a new application is explored. Radiography alone and more moderate success criteria may be used to document routine treatments, provided that an already well-documented implant system is studied.

Adult↗

Tissue regeneration in bony defects adjacent to immediately loaded titanium implants placed into extraction sockets: a study in dogs.

In this study of six greyhound mandibles, 24 implants were placed into extraction sockets. Eighteen of the implants were connected with abutments and immediately placed into normal function, and the remaining six submerged implants served as controls. At placement, dehiscence areas were created adjacent to 12 of the implants to study bone regeneration in extended membrane-protected defects. Six of the defects were covered with expanded polytetrafluoroethylene membranes, and six of the defects were augmented with autologous bone grafts and covered with expanded polytetrafluoroethylene material. The clinical and radiographic evaluations demonstrated that all implants achieved functional osseointegration and no implants were lost. Implant sites where membranes were used to regenerate bone over dehiscence defects demonstrated a high rate of membrane exposure and variable response to treatment. On completion of the study at 16 weeks, histomorphometric analysis demonstrated osseointegration with direct bone-to-implant contact for all implants, although the percentage of contact varied considerably. Histomorphometry indicates that the quality of osseointegration may be less favorable than the clinical and radiographic result would suggest.

Alveolar Process↗

A quantitative comparison of machined commercially pure titanium and titanium-aluminum-vanadium implants in rabbit bone.

Screw-shaped implants made from rods of commercially pure titanium (grade 1) and titanium-aluminum-vanadium (grade 5) were machined, and the implant surface structures were numerically described before being placed in rabbit tibiae for healing periods of 1 months, 6 months, and 12 months. Quantitative comparisons of the removal torque (Ncm) necessary to loosen the implants from the bone bed were performed. Short-term (1 month) observations revealed no significant differences between the two tested materials. However, after 6 and 12 months, the commercially pure titanium implants were significantly more stable in the bone bed, as compared to the alloy samples. After 6 months, the commercially pure titanium had a mean removal torque of 29 Ncm versus 23 for the alloy (P = .01), and after 12 months, the mean removal torque was 38 Ncm for commercially pure titanium as compared to 35 Ncm for the alloy (P = .01). Quantifications of the bone tissue response to the materials did not show any significant differences; however, the commercially pure titanium showed a tendency to have a higher percentage of bone in contact with the implant as compared to the alloy screws. Bone volumes in the threads were similar. The absence of any quantitative light microscopic difference after 1 month following placement may relate to the fact that there was a sparse amount of bone, since the tissue was in the organization/granulation phase. After 6 and 12 months of follow-up, substantial bone formation had occurred, resulting in significantly increased removal torques for the commercially pure titanium samples.

Alloys↗