Journal of Periodontal and Implant Science

Korean Academy of Periodontology (대한치주과학회)
권호 표지

Implant-Supported Fixed Prostheses for the rehabilitation of distal free end in periodontally compromised dentitions Number of fixtures affecting bone tissue change

치주질환에 이환된 환자에서 구치 상실 치열 수복을 위한 임플란트 수복

  • Yi, Seung-Won (Department of Dentistry, Wonju Medical College, Yonsei University) ;
  • Kim, Young-Soo (Department of Dentistry, Wonju Medical College, Yonsei University)
  • 이승원 (연세대학교 원주의과대학 치과학교실) ;
  • 김영수 (연세대학교 원주의과대학 치과학교실)
  • Published : 2005.03.30
Download PDF
⟨ Previous Next ⟩

Abstract

Number of fixtures supporting prosthesis for rehabilitation of partial edentulism in distal area is an important factor in distal area to the bone tissue response around dental implant. Optimal number and optimal positioning of dental implant has leaded to the stable condition of bone tissue and successful long-term treatment outcome. This clinical and radiographic study was performed to document and evaluate the short-term result of occlusal rehabilitation by means of implant-supported fixed prostheses (ISPs) especially for partial edentulism in distal area in patients treated for advanced periodontal disease and to verify the number of fixture affecting the bone tissue response. A total of 30 consecutive patients referred because of advanced periodontal disease were included. Before the implant therapy was initiated, periodontal treatment was performed and the outcome evaluated during at least a 6-month period. An individual maintenance care program was designed for each patient. All 75 implants were placed using a 2-stage surgical approach. The patients were divided into 2 groups, in one of which two fixtures were placed and in the other of which three fixtures were placed with tripodal geometry. Following installation of the ISPs, all patients underwent a baseline examination including evaluation of i) oral hygiene, and ii) periodontal/ peri-implant conditions, and iii) radiographs. These examinations were repeated annually during the 1 or 2-year observation period. The results were as follows: 1.No single implant was lost during the observation follow-up period. 1.The percentage of plaque harboring surfaces and bleeding units upon probing were found to be low (<10%), and no soft tissue complications were recorded. 1.Two-fixture group showed bone destruction ranged from 0.0mm to 1.5mm and the mean was 0.31mm. Three-fixture group showed more bone destruction of 0.51mm. There was no statistically difference between two groups. These results suggested that the factor for success is not the number of fixture but the strict maintenance of peri-implant tissue health and initial stability of fixture.

Keywords

References

  1. Chace R Sr, Low SB. Survival characteristics of perioclontally-involved teeth: A 40-year study. J Periodontol 1993; 64: 701-705 https://doi.org/10.1902/jop.1993.64.8.701
  2. Ericsson I, Lekholm U, Branemark PI, et al, A clinical evaluation of fixed-bridge restorations supported by the combination of teeth and osseointegrated titanium implants. J Clin Periodontol 1986;13: 307-312 https://doi.org/10.1111/j.1600-051X.1986.tb02227.x
  3. Ericsson I, Glantz PO, Branemark PI. Use of implants in restorative therapy in patients with reduced periodontal tissue support. Quintessence Int 1988;19: 801-807
  4. Ericsson I., Glantz O, Branernark PI. Partial edentulism. In 'Advanced Osseointegration Surgery: Applications in the Maxillofacial Region'; 1992: 194-209. Eds. Worthington, p. & Branemark, P, I. Quintessence Publishing Co, Carol Stream, Illinois
  5. Yi SW, Ericsson I, Wennstrom J, et al Long-term follow-up of cross-arch fixed partial dentures in patients with advanced periodontal destruction. I. Evaluation of the supporting tissues. Acta Odontol Scand 1995; 53: 242-248 https://doi.org/10.3109/00016359509005980
  6. Isidor F. Loss of osseointegration caused by occlusal overload of oral implants. A clinical and radiographic study in monkeys. Clin Oral Implants Res 1996; 7: 143-152 https://doi.org/10.1034/j.1600-0501.1996.070208.x
  7. Isidor F. Histological evaluation of peri-implant bone at implants subjected to occlusal overload or plaque accumulation. Clin Oral Implants Res 1997; 8: 1-9 https://doi.org/10.1111/j.1600-0501.1997.tb00001.x
  8. Miyata T, Kobayashi T, Araki H, et al, The influence of controlled occlusal overload on periimplant tissue: A histological study in monkeys. Int J Oral Maxillofac Implants 1998;13: 677-683
  9. Renouard F, Rangert B. Eds, Risk Factors in Implant Dentistry - Simplified Clinical Analysis for Predictable Treatment. Quintessence, Berlin, 1999
  10. Lekholm U, Ericsson I, Adell R, et al, The condition of the soft tissues at tooth and fixture abutments supporting fixed bridges. J Clin Periodontol 1986;13:558-562 https://doi.org/10.1111/j.1600-051X.1986.tb00847.x
  11. Mombelli A, Marxer M, Gaberhuel T, et al, The microbiota of osseointegrated implants in patients with a history of periodontal disease. J Clin Periodontol 1995; 22: 124-130 https://doi.org/10.1111/j.1600-051X.1995.tb00123.x
  12. Leonhardt A, Adolfsson B, Lekholm U, et al, A longitudinal microbiological study on osseointegrated titanium implants in partially edentulous patients. Clin Oral Implants Res 1993; 4: 113-120 https://doi.org/10.1034/j.1600-0501.1993.040301.x
  13. Papaioannou W, Quitynen M, Van Steenberghe D. The influence of periodontitis on the subgingival flora around implants in partially edentulous patients. Clin Oral Implants Res 1996; 7: 405-409 https://doi.org/10.1034/j.1600-0501.1996.070415.x
  14. Leonhardt A, Berglundh T, Ericsson I, et al, Putative periodontal pathogens on titanium implants and teeth in experimental gingivitis and periodontitis in beagle-dogs. Clin Oral Implants Res 1992; 3: 112-119 https://doi.org/10.1034/j.1600-0501.1992.030303.x
  15. Mombelli A, Van Oosten MAC, Schurch E, et al. The microbiota associated with successful or failing osseointegrated titanium implants. Oral Microbiol Immunol 1987; 2: 145-151 https://doi.org/10.1111/j.1399-302X.1987.tb00298.x
  16. Rosenberg ES, Torosian JP, Slots J. Microbial differences in 2 clinically distinct types of failures of osseointegrated implants. Clin Oral Implants Res 1991; 2: 135-144 https://doi.org/10.1034/j.1600-0501.1991.020306.x
  17. Van Winkelhoff AJ, Wolf JWA. Actinobacillus actinomycetemcomitans-associated peri-implantitis in an edentulous patient. A case report. J Clin Periodontol 2000; 27: 531-535 https://doi.org/10.1034/j.1600-051x.2000.027007531.x
  18. Yi SW, Ericsson, I., Carlsson, G. E., et al, Implant-supported fixed prostheses for the reha-bilitation of periodontally compromised dentition. A 3-year prospective clinical study. Clinical Implant Dentistry and Related Research 3, 125-134 https://doi.org/10.1111/j.1708-8208.2001.tb00132.x
  19. Nyman S, Lindhe J. A longitudinal study of combined periodontal and prosthetic treatment of patients with advanced periodontal disease. J Periodontol 1979; 50: 163-169 https://doi.org/10.1902/jop.1979.50.4.163
  20. Lekholm U, Zarb G. Patient selection and preparation. In: Branemark PI, Zarb GA & Albrektsson T. Eds, Tissue integrated prostheses osseointegration in clinical dentistry, 1985; 199-209. Chicago, Quintessence Publ Co Inc
  21. Arvidson K, Bystedt H, Ericsson I. Histometric and ultrastructural studies of tissues surrounding Astra Dental Implants in dogs. Int J Oral Maxillofac Implants 1990; 5: 127-134
  22. Arvidson K, Bystedt H, Frykholm A, et al, A 3year clinical study of Astra Dental Implants in the treatment of edentulous mandibles. Int J Oral Maxillofac Implants 1992; 7: 321-329
  23. Arvidson K, Bystedt H, Frykholm A, et al. Fiveyear follow-up report of the Astra Dental Implant system for restoration of edentulous upper jaws. J Dent Res 1996; 75: 349: Abstract
  24. Arvidson K, Bystedt H, Frykholm A, et al, Fiveyear prospective follow-up report of the Astra Tech Dental Implant System in the treatment of edentulous mandibles. Clin Oral Impl Res 1998; 9: 225-234 https://doi.org/10.1034/j.1600-0501.1998.090403.x
  25. Gotfredsen K, Nimb L, Hjorting-Hansen E, et al, Histomorphometric and removal torque analysis for TiO2-blasted titanium implants. Clin Oral Implants Res 1992; 3: 77-84 https://doi.org/10.1034/j.1600-0501.1992.030205.x
  26. Olefjord I, Hansson S. Surface analysis of four dental implant systems. Int J Oral Maxillofac Implants 1993; 8: 32-40
  27. Jemt T, Laney WR, Harris D, et al. Osseointegrated implants for single tooth replacement: A l-year report from a multicenter prospective study. Int J Oral Maxillofac Implants 1991; 6: 29-36
  28. Eggen S. Standardiserad intraoral rontgenteknik, Tandlakartidningen 1976; 17: 867-872
  29. Muhlemann HR, Son S. Gingival sulcus bleeding, a leading symptom in initial gingivitis. Helv Odontol Acta 1971; 15: 107-113
  30. Bragger U. Radiographic parameters for the evaluation of periimplant tissues. Periodontol 2000 1994; 4: 87-97 https://doi.org/10.1111/j.1600-0757.1994.tb00009.x
  31. Adell, R, Eriksson B, Lekholm U, et al. A longterm follow-up study of osseointegrated implants in the treatment of totally edentulous jaws. Int J Oral Maxillofac Implants 1990; 5: 347-359
  32. Albrektsson T, Zarb G, Worthington P, et al, The long-term efficacy of currently used dental implants: A review and proposed criteria of success. Int J Oral Maxillofac Implants 1986; 1: 11-25
  33. Van Steenberghe D. A retrospective multicenter evaluation of the survival rate of osseointegrated fixtures supporting fixed partial prosthesis in the treatment of partial edentulism. J Prosthet Dent 1989; 61: 217-222 https://doi.org/10.1016/0022-3913(89)90378-8
  34. Albrektsson T. On long-term maintenance of the osseointegrated response. Austr Prosthodont J 1993; 7: 15-24
  35. Jemt T. Fixed implant-supported prostheses in the edentulous maxilla. A five-year follow-up report. Clin Oral Impl Res 1994; 5: 142-147 https://doi.org/10.1034/j.1600-0501.1994.050304.x
  36. Lekholm, U., van Steenberghe, D., Herrman, I. et al, Osseointegrated implants in the treatment of partially edentulous jaws: A prospective 5year multicenter study. Int J Oral Maxillofac Implants 1994; 9: 627-635
  37. Lekholm U, Gunne J, Henry P, et al, Survival of the Branemark implant in partially edentulous jaws: A 10-year prospective multicenter study. Int J Oral Maxillofac Implants 1999; 14: 639-645
  38. Lindquist LW, Carlsson GE, Jemt T. A prospective 15-year follow-up study of mandibular fixed prostheses supported by osseointegrated implants. Clin Oral Implants Res 1996; 7: 627-635
  39. Buser D, Mericske-Stern R, Bernard J, et al, Long-term evaluation of non-submerged ITI implants. Part I: 8-year life table analysis of a prospective multicenter study with 2359 implants. Clin Oral Implants Res 1997; 8: 161-172 https://doi.org/10.1034/j.1600-0501.1997.080302.x
  40. Makkonen TA, Holmberg S, Niemi L. et al, A 5year prospective clinical study of Astra Tech dental implants supporting fixed bridges or overdentures in the edentulous mandible. Clin Oral Implants Res 1997; 8: 469-475 https://doi.org/10.1034/j.1600-0501.1997.080605.x
  41. Karlsson S, Wennstrom J, Lindhe J. Restoration of function with the use of dental implants in periodontally compromised patients: A 5-year study. Int J Prosthodont 1999; 12: 462, abstract
  42. Lindhe J, Nyman, S. (1998). Treatment planning. In Lindhe J, Karring T & Lang NP. Eds, Clinical Periodontology and Implant Dentistry 1998; 420-437. Munksgaard, Copenhagen, Denmark
  43. Ellegaard B., Baelum V, Karring T. Implant therapy in periodontally compromised patients. Clin Oral Implants Res 1997; 8: 180-188 https://doi.org/10.1034/j.1600-0501.1997.080304.x
  44. van Steenberghe D, De Mars G, Quirynen M, et al, A prospective split-mouth comparative study of two screw-shaped self-tapping pure titanium implant systems. Clin Oral Implants Res 2000; 11: 202-209 https://doi.org/10.1034/j.1600-0501.2000.011003202.x
  45. Rangert B, Jemt T, Jorneus L. Forces and moments on Branemark implants. Int J Oral Maxillofac Implants 1989; 4: 241-247
  46. Rangert B, Krogh PHJ, Langer B, et al, Bending overload and implant fracture. Int J Oral Maxillofac Implants 1995; 10: 326-334
  47. Rangert B, Sullivan R, Jemt T. Load factor control for implants in the posterior partially edentulous segment. Int J Oral Maxillofac Implants 1997; 12: 360-370
  48. Norton MR. An in vitro evaluation of the strength of an internal conical interface to a butt joint interface in implant design. Clin Oral Implants Res 1997; 8: 290-344 https://doi.org/10.1034/j.1600-0501.1997.080407.x
  49. Brunski J. In vivo bone response to biomechanical loading at the bone/dental implant interface. Adv Dent Res 1999; 13: 99-119 https://doi.org/10.1177/08959374990130012301
  50. van Steenberghe D, Naert I. The first two-stage dental implant system and its clinical application. Periodontology 2000 1998; 17: 89-95 https://doi.org/10.1111/j.1600-0757.1998.tb00126.x
  51. Jaffin RA, Berman CL. The excessive loss of Branemark fixtures in type IV bone: a 5-year analysis. J Periodontol 1991; 62: 2-4 https://doi.org/10.1902/jop.1991.62.1.2