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Objectives The objective of this systematic review was to assess the 5-year and 10-year survival of resin -bonded fixed dental prostheses ( RBBs) and to describe the incidence of technical and biological complications. Materials and Methods An electronic MEDLINE search complemented by manual searching was conducted to identify prospective and retrospective cohort studies and case series on RBBs with a mean follow-up time of at least 5 years. Patients had to have been examined clinically at the follow-up visit. Assessment of the identified studies and data extraction were performed independently by two reviewers. Failure and complication rates were analyzed using robust Poisson regression models to obtain summary estimates of 5- and 10-year proportions. Results The search provided 367 titles and 87 abstracts. Full-text analysis was performed for 22 articles resulting in seven studies that met the inclusion criteria. Five articles were found through manual search, and 17 studies were provided from (Pjetursson et al. 2008, Clinical Oral Implants Research, 19, 131), resulting in an overall number of included studies of 29. Meta-analysis of these studies reporting on 2300 RBBs indicated an estimated survival of resin-bonded bridges of 91.4% (95 percent confidence interval [95% CI]: 86.7-94.4%) after 5 years and 82.9% (95% CI: 73.2-89.3%) after 10 years. A significantly higher survival rate was reported for RBBs with zirconia framework compared with RBBs from other materials. RBBs with one retainer had a significantly higher survival rate ( P < 0.0001) and a lower de-bonding rate ( P = 0.001) compared with RBBs retained by two or more retainers. Moreover, the survival rate was higher for RBBs inserted in the anterior area of the oral cavity compared with posterior RBBs. The most frequent complications were de-bonding (loss of retention), which occurred in 15% (95% CI: 10.9-20.6%) and chipping of the veneering material that was reported for 4.1% (95% CI: 1.8-9.5%) of the RBBs over an observation period of 5 years. Conclusion Despite the high survival rate of RBBs after 5 and 10 years, technical complications like de-bonding and minor chipping were frequent. RBBs with zirconia framework and RBBs with one retainer tooth showed the highest survival rate. [ABSTRACT FROM AUTHOR]

Objectives To determine the effect of various systemic antibiotic prophylaxis regimes on patient-reported outcomes and postsurgical complications in patients undergoing conventional implant installation. Material and methods Three hundred and twenty-nine healthy adults in need of conventional implant installation were randomly assigned to one of four groups: (i) preoperatively 2 g of amoxycillin 1 h before surgery (positive control, PC), (ii) postoperatively 2 g of amoxycillin immediately following surgery (test 1, T1), (iii) preoperatively 2 g of amoxycillin 1 h before and 500 mg thrice daily on days 2 and 3 after surgery (test 2, T2), (iv) preoperatively 2 g of placebo 1 h before surgery (negative control, NC). Subjects were examined clinically by blinded examiners over 8 weeks after implant installation. In addition, Visual Analogue Scales ( VAS) for pain, swelling, bruising and bleeding were obtained over 14 days. ANOVA was performed for the VAS. Chi-square tests were applied for postsurgical complications. Results All VAS scores were low for all groups and decreased over time ( P < 0.001). There were no significant differences for the VAS scores between the various groups at any time point ( P > 0.05). There was only a significant difference in flap closure at week 4, where NC had 5% of the subjects not achieving complete wound closure compared to 0% for the three other groups ( P = 0.01), with no other significant differences for any postsurgical complications ( P > 0.05). Conclusion For standard single implant placement, prophylactic systemic antibiotics either before or after, or before and after the surgical procedure do not improve patient-reported outcomes or prevalence of postsurgical complications. [ABSTRACT FROM AUTHOR]

Objective To compare oral health-related quality of life ( OHRQo L) among subjects who received implant-supported crowns ( ISC) and 2-unit cantilevered resin-bonded bridges ( cRBB) in a bounded single tooth space ( BSTS) after at least 5 years and to investigate factors associated with their OHRQo L. Methods A case-control study among 78 subjects who received ISC or c RBB rehabilitation at a teaching hospital (39 ISCs and 39 c RBBs). OHRQo L was measured using the Oral Health Impact Profile ( OHIP-49) and compared between treatment modality. Variations in OHIP scores with respect to 'minor complications' (repair of the original 'survived' restorations) and 'major complications' (replacement of 'failed' restorations); and number of complications were determined in bivariate and multivariate analyses (negative binominal regression) controlling for socio-demographic and clinical factors. Results Oral Health Impact Profile scores were similar among those who received ISC and c RBB ( P = 0.53). Among subjects with complicated restorations, those with major complications reported significantly higher OHIP scores (poorer OHRQo L) than those with minor complications ( P = 0.02). Subjects who experienced multiple complications had significantly higher OHIP scores (poorer OHRQo L) than those with a single complication ( P = 0.04). In regression analyses (which considered OHIP scores of those with complications), the nature of complications ( P < 0.01), treatment modality ( P = 0.04), and gender ( P = 0.02) emerged as significant factors. Conclusion In the rehabilitation of a BSTS patients, OHRQo L was similar irrespective of treatment modality ( ISC or c RBB). Among those who experienced complications their OHRQo L was associated with the nature of complications, treatment modality and gender. [ABSTRACT FROM AUTHOR]

Objective To compare 'survival' and 'success' of implant-supported crowns (ISC) and tooth-supported 2-unit cantilevered resin-bonded bridges ( cRBB) in the rehabilitation of a bounded single tooth space (BSTS), after an observation period of ≥5 years. Methods A case-control study among subjects who received ISC or cRBB rehabilitation at a teaching hospital. The (i) survival (retention in mouth) and (ii) success (absence of complications requiring intervention) for the ISCs and cRBBs were compared (overall, supporting structures and that of the prostheses). Rates of survival and success were compared using log-rank statistics. Prevalence of survival and success (categories) were compared by chi-square/Fisher's exact test. Results Seventy eight subjects participated in this study (39 ISC and 39 cRBB cases). Both had a mean observation time exceeding 100 months, P > 0.05. ISCs and cRBBs had similar survival rates: overall ( P = 0.96), supporting structures ( P = 0.14) and prostheses ( P = 0.44) There was a significant difference in the rate of overall success between ISCs and cRBBs ( P = 0.03), specifically with respect to the success rate of the supporting structures ( P = 0.03). There was also a significant difference in the prevalence of supporting structures categorized as a 'success': ISCs (69.2%) and cRBBs (89.7%), P = 0.03. Biological complications of supporting structures were more common among ISCs (25.6%) compared with cRBBs (7.7%), P = 0.03. Conclusion Implant-supported crowns and cRBBs in the rehabilitation of a BSTS survive similarly after at least 5 years. However, cRBBs had a higher success rate and were more frequently categorized as successful than ISCs. Notably, there were fewer biological complications of cRBBs supporting structures than ISCs. [ABSTRACT FROM AUTHOR]

Objectives To assess the 5-year survival rates and incidences of complications of cemented and screw-retained implant reconstructions. Methods An electronic Medline search complemented by manual searching was conducted to identify randomized controlled clinical trials (RCTs), and prospective and retrospective studies giving information on cemented and screw-retained single-unit and multiple-unit implant reconstructions with a mean follow-up time of at least 1 year. Assessment of the identified studies and data abstraction were performed independently by three reviewers. Failure rates were analyzed using Poisson regression models to obtain summary estimates and 95% confidence intervals of failure rates and 5-year survival proportions. Results Fifty-nine clinical studies were selected from an initial yield of 4511 titles and the data were extracted. For cemented single crowns the estimated 5-year reconstruction survival was 96.5% (95% confidence interval ( CI): 94.8-97.7%), for screw-retained single crowns it was 89.3% (95% CI: 64.9-97.1%) ( P = 0.091 for difference). The 5-year survival for cemented partial fixed dental prostheses ( FDPs) was 96.9% (95% CI: 90.8-99%), similar to the one for screw-retained partial FDPs with 98% (95% CI: 96.2-99%) ( P = 0.47). For cemented full-arch FDPs the 5-year survival was 100% (95% CI: 88.9-100%), which was somewhat higher than that for screw-retained FDPs with 95.8% (95% CI: 91.9-97.9%) ( P = 0.54). The estimated 5-year cumulative incidence of technical complications at cemented single crowns was 11.9% and 24.4% at screw-retained crowns. At the partial and full-arch FDPs, in contrast, a trend to less complication at the screw-retained was found than at the cemented ones (partial FDPs cemented 24.5%, screw-retained 22.1%; full-arch FDPs cemented 62.9%, screw-retained 54.1%). Biological complications like marginal bone loss >2 mm occurred more frequently at cemented crowns (5-year incidence: 2.8%) than at screw-retained ones (5-year incidence: 0%). Conclusion Both types of reconstructions influenced the clinical outcomes in different ways, none of the fixation methods was clearly advantageous over the other. Cemented reconstructions exhibited more serious biological complications (implant loss, bone loss >2 mm), screw-retained reconstructions exhibited more technical problems. Screw-retained reconstructions are more easily retrievable than cemented reconstructions and, therefore, technical and eventually biological complications can be treated more easily. For this reason and for their apparently higher biological compatibility, these reconstructions seem to be preferable. [ABSTRACT FROM AUTHOR]

Objectives The objective of this systematic review was to assess the 5- and 10-year survival of implant-supported fixed dental prostheses ( FDPs) and to describe the incidence of biological and technical complications. Methods An electronic Medline search complemented by manual searching was conducted to identify prospective and retrospective cohort studies and case series on FDPs with a mean follow-up time of at least 5 years. Patients had to have been examined clinically at the follow-up visit. Failure and complication rates were analyzed using standard and random-effects Poisson regression models to obtain summary estimates of 5-year and 10-year survival and complication rates. Results The updated search provided 979 titles and 257 abstracts. Full-text analysis was performed for 90 articles resulting in a total 32 studies that met the inclusion criteria. Meta-analysis of these studies indicated an estimated survival of implants supporting FDPs of 95.6% after 5 years and 93.1% after 10 years. When machined surface implants were excluded from the analysis and only rough surface implants included, the survival rate increased to 97.2% after 5 years. The survival rate of implant-supported FDPs was 95.4% after 5 years and 80.1% after 10 years of function. When the analysis was done exclusively for metal-ceramic FDPs, hence the old gold-acrylic FDPs were excluded, the survival rate increased significantly. The survival rate of metal-ceramic implant-supported FDPs was 96.4% after 5 years and 93.9% after 10 years. Only 66.4% of the patients were free of any complications after 5 years. The most frequent complications over the 5-year observation period were fractures of the veneering material (13.5%), peri-implantitis and soft tissue complications (8.5%), loss of access hole restoration (5.4%), abutment or screw loosening (5.3%), and loss of retention of cemented FDPs (4.7%). Conclusion It may be concluded that implant-supported fixed dental prostheses ( FDPs) are a safe and predictable treatment method with high survival rates. However, biological and technical complications were frequent (33.6%). To minimize the incidence of complications, dental professionals should make great effort in choosing reliable components and materials for implant-supported FDPs and the patients should be placed in well-structured maintenance system after treatment. [ABSTRACT FROM AUTHOR]

Aim The aim of this search was to assess the biological consequences that overload might have on already osseointegrated oral implants through a systematic screening of the scientific literature. Method Detailed searches through PUBMED, OVID, EMBASE and LILACS databases were made. Articles published up to December 2011 and those reported on the clinical, radiographic and/or histological outcome of oral implants subjected to so-called overload were considered eligible for inclusion. Identified studies were assessed by one non-blinded reviewer according to well-defined inclusion and exclusion criteria. When doubt arose, the co-authors were counselled until final agreement was obtained. The PICO questions formulated was:'what is the effect of overload vs. no overload on bone/implant loss in clinically stable implants?' Results The database searches as well as additional hand searching, resulted in 726 potentially relevant titles. Eventually, 16 clinical and 25 animal studies were considered relevant to the topic. After inclusion/exclusion criteria assessment, all clinical studies and all but three animal studies and one systematic review were considered at high risk of bias and excluded. The included animal studies did not reveal an association between overload and peri-implant bone loss in the absence of peri-implant inflammation, whereas in its presence, overload seemed to aggravate the peri-implant tissue breakdown. Conclusions The effect of implant overload on bone/implant loss in clinically well-integrated implants is poorly reported and provides little unbiased evidence to support a cause-and-effect relationship. The PICO question remained unanswered. At the animal level, 'overload', mimicked by supra-occlusal contacts acting in an uninflamed peri-implant environment, did not negatively affect osseointegration and even was anabolic. In contrast, supra-occlusal contacts in the presence of inflammation significantly increased the plaque-induced bone resorption. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the clinical outcome of custom-made zirconia abutments for implant-supported single-tooth restorations up to 5 years after insertion. Material and methods: The study comprises two parts: (Part 1) retrospective evaluation of records of 130 patients treated with 185 single-tooth implant restorations using zirconia abutments; (Part 2) clinical examination of 25 patients with 40 restorations placed >3 years ago. Oral surgeons placed the implants. The prosthodontic treatment was provided at a prosthodontic specialist clinic. The restoration was either an all-ceramic crown for cementation or a screw-retained one-piece restoration with the veneering porcelain baked directly to the zirconia abutment. Registration of all patients' records comprised clinical and radiographic data from insertion of the restoration up to the last visit at the clinic. Results: Parts 1 and 2: The zirconia abutments performed well over the follow-up period. The rates of both technical and biological complications were low, and the patients were in general extremely satisfied with the restorations. No all-ceramic crowns fractured during the observation period. Two abutments (1%) fractured, one at insertion, the other after 2 months. Part 2: There were no significant differences for changes in any of the soft tissue registrations or the peri-implant marginal bone level between the conventional two-piece abutment-crown restoration and the one-piece restoration. The peri-implant bone level changes from placement to the clinical examination 3-5 years later were small (mean 0.29 mm, SD 0.87 mm). Conclusion: Zirconia abutments for single-implant crowns seem to demonstrate good short-term technical and biological results. To cite this article: Ekfeldt A, Fürst B Carlsson GE. Zirconia abutments for single-tooth implant restorations: a retrospective and clinical follow-up study. Clin. Oral Impl. Res. 22, 2011; 1308-1314 doi: 10.1111/j.1600-0501.2010.02114.x [ABSTRACT FROM AUTHOR]

To evaluate the biological and technical complication rates of fixed dental prostheses (FDP) with end abutments or cantilever extensions on teeth (FDP-tt/cFDP-tt) on implants (FDP-ii/cFDP-ii) and tooth-implant-supported (FDP-ti/cFDP-ti) in patients treated for chronic periodontitis. From a cohort of 392 patients treated between 1978 and 2002 by graduate students, 199 were re-examined in 2005. Of these, 84 patients had received ceramo-metal FDPs (six groups). At the re-evaluation, the mean age of the patients was 62 years (36.2-83.4). One hundred and seventy-five FDPs were seated (82 FDP-tt, 9 FDP-ii, 20 FDP-ti, 39 cFDP-tt, 15 cFDP-ii, 10 cFDP-ti). The mean observation time was 11.3 years; 21 FDPs were lost, and 46 technical and 50 biological complications occurred. Chances for the survival of the three groups of FDPs with end abutments were very high (risk for failure 2.8%, 0%, 5.6%). The probability to remain without complications and/or failure was 70.3%, 88.9% and 74.7% in FDPs with end abutments, but 49.8-25% only in FDPs with extensions at 10 years. In patients treated for chronic periodontitis and provided with ceramo-metal FDPs, high survival rates, especially for FDPs with end abutments, can be expected. The incidence rates of any negative events were increased drastically in the three groups with extension cFDPs (tt, ii, ti). Strategic decisions in the choice of a particular FDP design and the choice of teeth/implants as abutments appear to influence the risks for complications to be expected with fixed reconstruction. If possible, extensions on tooth abutments should be avoided or used only after a cautious clinical evaluation of all options. Brägger U, Hirt-Steiner S, Schnell N, Schmidlin K, Salvi GE, Pjetursson B, Matuliene G, Zwahlen M, Lang NP. Complication and failure rates of fixed dental prostheses in patients treated for periodontal disease. Clin. Oral Impl. Res. , 2011; 70-77. doi: 10.1111/j.1600-0501.2010.02095.x [ABSTRACT FROM AUTHOR]

Objectives: To assess retrospectively, over at least 5 years, the incidences of technical and biological complications and failures in young adult patients with birth defects affecting the formation of teeth. Material and methods: All insurance cases with a birth defect that had crowns and fixed dental prostheses (FDPs) inserted more than 5 years ago were contacted and asked to participate in a reexamination. Results: The median age of the patients was 19.3 years (range 16.6–24.7 years) when prosthetic treatment was initiated. Over the median observation period of 15.7 years (range 7.4–24.9 years) and considering the treatment needs at the reexamination, 19 out of 33 patients (58%) with reconstructions on teeth remained free from all failures or complications. From the patients with FDPs and single unit crowns (SCs) on implants followed over a median observation period of 8 years (range 4.6–15.3 years), eight out of 17% or 47% needed a retreatment or repair at some point due to a failure or a complication. From the three groups of patients, the cases with amelogenesis/dentinogenesis imperfecta demonstrated the highest failure and complication rates. In the cases with cleft lip, alveolus and palate (CLAP) or hypodontia/oligodontia, 71% of the SCs and 73% of the FDPs on teeth (FDP T) remained complication free over a median observation period of about 16 years. Sixty-two percent of the SCs and 64% of the FDPs on implants remained complication free over 8 years. Complications occurred earlier with implant-supported reconstructions. Conclusions: Because healthy, pristine teeth can be left unprepared, implant-supported SCs and FDPs are the treatment choice in young adults with birth defects resulting in tooth agenesis and in whom the edentulous spaces cannot be closed by means of orthodontic therapy. However, the trend for earlier and more frequent complications with implant-supported reconstructions in young adults, expecting many years of function with the reconstructions, has to be weighed against the benefits of keeping teeth unprepared. In cases with CLAP in which anatomical conditions render implant placement difficult and in which teeth adjacent to the cleft require esthetic corrections, the conventional FDP T still remains the treatment of choice. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this systematic review was to assess the internationally published survival and complication rates of implant-supported computer-aided designing (CAD) and computer-aided manufacturing (CAM)-fabricated restorations and to compare them with those of conventionally fabricated implant-supported restorations. Methods: An electronic MEDLINE search was conducted to identify prospective and retrospective cohort studies on CAD–CAM fabricated implant-supported restorations with a mean follow-up time of at least 1 year. Failure and complication rates were evaluated and descriptive statistics were performed. Results: An electronic MEDLINE search revealed four studies reporting on implant-supported CAD–CAM fabricated restorations. The cumulative 5-year survival rate of implants supporting full-arch-fixed dental prostheses (FDPs) ranged from 81.4% to 95.6%. Reported survival rates of implants supporting all-ceramic single crowns (SCs) were 100% [95% confidence interval (CI): 92.4–100]. The cumulative 5-year survival rate for full-arch FDPs ranged from 72.2% to 100%. Reported cumulative 5-year survival rates for all-ceramic SCs were 100% (95% CI: 92.4–100%). Technical complications were reported in two of the four selected studies and the estimated annual failure rate for chipping/fracture of the veneering material was 0.43 (95% CI: 0.06–3.06) for implant-supported all-ceramic SCs and 3.61 (95% CI: 2.05–6.36) for implant-supported FDPs. Conclusions: Only a small number of clinical studies reporting on implant-supported CAD–CAM fabricated restorations exists which makes a scientifically valid comparison with conventionally fabricated restorations impossible. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this systematic review was to assess the 5-year survival rates and incidences of complications associated with ceramic abutments and to compare them with those of metal abutments. Methods: An electronic Medline search complemented by manual searching was conducted to identify randomized-controlled clinical trials, and prospective and retrospective studies providing information on ceramic and metal abutments with a mean follow-up time of at least 3 years. Patients had to have been examined clinically at the follow-up visit. Assessment of the identified studies and data abstraction was performed independently by three reviewers. Failure rates were analyzed using standard and random-effects Poisson regression models to obtain summary estimates of 5-year survival proportions. Results: Twenty-nine clinical and 22 laboratory studies were selected from an initial yield of 7136 titles and data were extracted. The estimated 5-year survival rate of ceramic abutments was 99.1% [95% confidence interval (CI): 93.8–99.9%] and 97.4% (95% CI: 96–98.3%) for metal abutments. The estimated cumulative incidence of technical complications after 5 years was 6.9% (95% CI: 3.5–13.4%) for ceramic abutments and 15.9% (95% CI: 11.6–21.5%) for metal abutments. Abutment screw loosening was the most frequent technical problem, occurring at an estimated cumulative incidence after 5 years of 5.1% (95% CI: 3.3–7.7%). All-ceramic crowns supported by ceramic abutments exhibited similar annual fracture rates as metal–ceramic crowns supported by metal abutments. The cumulative incidence of biological complications after 5 years was estimated at 5.2% (95% CI: 0.4–52%) for ceramic and 7.7% (95% CI: 4.7–12.5%) for metal abutments. Esthetic complications tended to be more frequent at metal abutments. A meta-analysis of the laboratory data was impossible due to the non-standardized test methods of the studies included. Conclusion: The 5-year survival rates estimated from annual failure rates appeared to be similar for ceramic and metal abutments. The information included in this review did not provide evidence for differences of the technical and biological outcomes of ceramic and metal abutments. However, the information for ceramic abutments was limited in the number of studies and abutments analyzed as well as the accrued follow-up time. Standardized methods for the analysis of abutment strength are needed. [ABSTRACT FROM AUTHOR]

Objectives: To assess retrospectively the cumulative costs for the long-term oral rehabilitation of patients with birth defects affecting the development of teeth. Methods: Patients with birth defects who had received fixed reconstructions on teeth and/or implants ≥5 years ago were asked to participate in a comprehensive clinical, radiographic and economic evaluation. Results: From the 45 patients included, 18 were cases with a cleft lip and palate, five had amelogenesis/dentinogenesis imperfecta and 22 were cases with hypodontia/oligodontia. The initial costs for the first oral rehabilitation (before the age of 20) had been covered by the Swiss Insurance for Disability. The costs for the initial rehabilitation of the 45 cases amounted to 407,584 CHF (39% for laboratory fees). Linear regression analyses for the initial treatment costs per replaced tooth revealed the formula 731 CHF+(811 CHF × units) on teeth and 3369 CHF+(1183 CHF × units) for reconstructions on implants ( P<.001). Fifty-eight percent of the patients with tooth-supported reconstructions remained free from failures/complications (median observation 15.7 years). Forty-seven percent of the patients with implant-supported reconstructions remained free from failures/complications (median observation 8 years). The long-term cumulative treatment costs for implant cases, however, were not statistically significantly different compared with cases reconstructed with tooth-supported fixed reconstructions. Twenty-seven percent of the initial treatment costs were needed to cover supportive periodontal therapy as well as the treatment of technical/biological complications and failures. Conclusion: Insurance companies should accept to cover implant-supported reconstructions because there is no need to prepare healthy teeth, fewer tooth units need to be replaced and the cumulative long-term costs seem to be similar compared with cases restored on teeth. [ABSTRACT FROM AUTHOR]

Objectives: To analyze the survival and success rates of implants installed utilizing the (transalveolar) osteotome technique, to compare peri-implant soft tissue parameters and marginal bone levels of osteotome-installed implants with implants placed using standard surgical procedures, and to evaluate patient-centered outcomes. Material and methods: During 2000 to 2005, 252 Straumann® dental implants were inserted in 181 patients. The surgical technique was a modification of the original osteotome technique presented by Summers. In addition to the clinical examination, the patients were asked to give their perception of the surgical procedure, utilizing a visual analogue scale. Results: The cumulative survival rate of the osteotome-installed implants after a mean follow-up time of 3.2 years, was 97.4% (95% confidence intervals: 94.4–98.8%). From the 252 implants inserted, three were lost before loading and another three were lost in the first and second year. According to residual bone height the survival was 91.3% for implant sites with ≤4 mm residual bone height, and 90% for sites with 4 mm and 5 mm, when compared with that of 100% in sites with bone height of above 5 mm. According to implant length the survival rates were 100% for 12 mm, 98.7% for 10 mm, 98.7% for 8 mm and only 47.6% for 6 mm implants. Soft tissue parameters (pocket probing depth, probing attachment level, bleeding on probing and marginal bone levels) did not yield any differences between the osteotome-installed and the conventionally placed implants. More than 90% of the patients were satisfied with the implant therapy and would undergo similar therapy again if necessary. The cost associated with implant therapy was considered to be justified. Conclusion: In conclusion, the osteotome technique was a reliable method for implant insertion in the posterior maxilla, especially at sites with 5 mm or more of preoperative residual bone height and a relatively flat sinus floor. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the pattern of tissue remodeling after maxillary sinus floor elevation using the transalveolar osteotome technique with or without utilizing grafting materials. Methods: During the period of 2000–2005, 252 Straumann® dental implants were inserted using the transalveolar sinus floor elevation technique in a group of 181 patients. For 88 or 35% of those implants, deproteinized bovine bone mineral with a particle size of 0.25–1 mm was used as the grafting material, but for the remaining 164 implants, no grafting material was utilized. Periapical radiographs were obtained with a paralleling technique and digitized. Two investigators, who were blinded to whether grafting material was used or not, subsequently evaluated the pattern of tissue remodeling. Results: The mean residual bone height was 7.5 mm (SD 2.2 mm), ranging from 2 to 12.7 mm. The mean residual bone height for implants placed with grafting material (6.4 mm) was significantly less compared with the implants installed without grafting material (8.1 mm). The implants penetrated on average 3.1 mm (SD 1.7 mm) into the sinus cavity. The measured mean radiographic bone gain using the transalveolar technique without grafting material was significantly less, 1.7 mm (SD 2 mm) compared with a mean bone gain of 4.1 mm (SD 2.4 mm), when grafting material was used. Furthermore, the probability of gaining 2 mm or more of new bone was 39.1% when no grafting material was used. The probability increased to 77.9% when the implants were installed with grafting material. Conclusion: When the transalveolar sinus floor elevation was performed without utilizing grafting material, only a moderate gain of new bone could be detected mesial and distal to the implants. On the other hand, when grafting material was used, a substantial gain of new bone was usually seen on the radiographs. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of the present study was to evaluate the survival rate of dental implants in previously failed implant sites. In addition, factors that might affect the outcome of these redo procedures were also explored. Material and methods: Patients that had failed dental implants, which were replaced with the same implant type at the same site, were included. Data on the failed implants were collected. The same parameters, along with the interval between retrieval and re-implantation, were collected for the second set of implants. Descriptive statistics were used to describe the patients and implants. Life table analysis of these implants was tabulated for both implant sets. The effect of systemic, environmental and local factors on the survival of the redo dental implants was evaluated. Results: Fifty-six patients with a total of 79 redo implants were included in this study. Implants were followed for 7–78 months (mean 29.9±2). Thirteen implants failed that resulted in an overall survival rate of 83.5%. Successful implants had greater diameter (4.05±0.52 mm) than failed implants (3.72±0.56 mm); however, these differences were only marginal ( P=0.06). Conversely, smoking habits, implants length and location, mode of placement and spontaneous exposure did not have a significant effect on the outcome of this procedure. Conclusion: Redo of dental implants has a lesser survival rate compared with previous reports for implants in pristine sites. These results were not associated with most implant- and/or patient-related factors. Thus, a possible negative effect that is associated with the specific implant's site might account for this phenomenon. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this systematic review was to assess the 5-year survival of implant-supported single crowns (SCs) and to describe the incidence of biological and technical complications. Methods: An electronic MEDLINE search complemented by manual searching was conducted to identify prospective and retrospective cohort studies on SCs with a mean follow-up time of at least 5 years. Failure and complication rates were analyzed using random-effects Poisson' s regression models to obtain summary estimates of 5-year proportions. Results: Twenty-six studies from an initial yield of 3601 titles were finally selected and data were extracted. In a meta-analysis of these studies, survival of implants supporting SCs was 96.8% [95% confidence interval (CI): 95.9–97.6%] after 5 years. The survival rate of SCs supported by implants was 94.5% (95% CI: 92.5–95.9%) after 5 years of function. The survival rate of metal–ceramic crowns, 95.4% (95% CI: 93.6–96.7%), was significantly ( P=0.005) higher than the survival rate, 91.2% (95% CI: 86.8–94.2%), of all-ceramic crowns. Peri-implantitis and soft tissue complications occurred adjacent to 9.7% of the SCs and 6.3% of the implants had bone loss exceeding 2 mm over the 5-year observation period. The cumulative incidence of implant fractures after 5 years was 0.14%. After 5 years, the cumulative incidence of screw or abutment loosening was 12.7% and 0.35% for screw or abutment fracture. For supra-structure-related complications, the cumulative incidence of ceramic or veneer fractures was 4.5%. Conclusion: It can be concluded that after an observation period of 5 years, high survival rates for implants and implant-supported SCs can be expected. However, biological and particularly technical complications are frequent. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of this systematic review were to assess the 5-year survival of resin-bonded bridges (RBBs) and to describe the incidence of technical and biological complications. Methods: An electronic Medline search complemented by manual searching was conducted to identify prospective and retrospective cohort studies on RBBs with a mean follow-up time of at least 5 years. Patients had to have been examined clinically at the follow-up visit. Assessment of the identified studies and data extraction were performed independently by two reviewers. Failure and complication rates were analyzed using random-effects Poissons regression models to obtain summary estimates of 5-year proportions. Results: The search provided 6110 titles and 214 abstracts. Full-text analysis was performed for 93 articles, resulting in 17 studies that met the inclusion criteria. Meta-analysis of these studies indicated an estimated survival of RBBs of 87.7% (95% confidence interval (CI): 81.6–91.9%) after 5 years. The most frequent complication was debonding (loss of retention), which occurred in 19.2% (95% CI: 13.8–26.3%) of RBBs over an observation period of 5 years. The annual debonding rate for RBBs placed on posterior teeth (5.03%) tended to be higher than that for anterior-placed RBBs (3.05%). This difference, however, did not reach statistical significance ( P=0.157). Biological complications, like caries on abutments and RBBs lost due to periodontitis, occurred in 1.5% of abutments and 2.1% of RBBs, respectively. Conclusion: Despite the high survival rate of RBBs, technical complications like debonding are frequent. This in turn means that a substantial amount of extra chair time may be needed following the incorporation of RBBs. There is thus an urgent need for studies with a follow-up time of 10 years or more, to evaluate the long-term outcomes. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this systematic review was to assess and compare the 5- and 10-year survival of different types of tooth-supported and implant-supported fixed dental prosthesis (FDPs) and single crowns (SCs) and to describe the incidence of biological and technical complications. Methods: Three electronic searches complemented by manual searching were conducted to identify prospective and retrospective cohort studies on FDPs and SCs with a mean follow-up time of at least 5 years. Patients had to have been examined clinically at the follow-up visit. Failure and complication rates were analyzed using random-effects Poisson' s regression models to obtain summary estimates of 5- and 10-year survival proportions. Results: Meta-analysis of the included studies indicated an estimated 5-year survival of conventional tooth-supported FDPs of 93.8%, cantilever FDPs of 91.4%, solely implant-supported FDPs of 95.2%, combined tooth-implant-supported FDPs of 95.5% and implant-supported SCs of 94.5%. Moreover, after 10 years of function the estimated survival decreased to 89.2% for conventional FDPs, to 80.3% for cantilever FDPs, to 86.7% for implant-supported FDPs, to 77.8% for combined tooth-implant-supported FDPs and to 89.4% for implant-supported SCs. Despite high survival rates, 38.7% the patients with implant-supported FDPs had some complications after the 5-year observation period. This is compared with 15.7% for conventional FDPs and 20.6% for cantilever FDPs, respectively. For conventional tooth-supported FDPs, the most frequent complications were biological complications like caries and loss of pulp vitality. Compared with tooth-supported FDPs, the incidence of technical complications was significantly higher for the implant-supported reconstructions.The most frequent technical complications were fractures of the veneer material (ceramic fractures or chipping), abutment or screw loosening and loss of retention. Conclusion: On the basis of the results of the present systematic review, planning of prosthetic rehabilitations should preferentially include conventional end abutment tooth-supported FDPs, solely implant-supported FDPs or implant-supported SCs. Only for reasons of anatomical structures or patient-centered preferences and as a second option should cantilever tooth-supported FDPs or FDPs supported by combination of implants and teeth be chosen. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this systematic review was to assess the 5-year survival rates and incidences of complications of all-ceramic fixed dental prostheses (FDPs) and to compare them with those of metal–ceramic FDPs. Methods: An electronic MEDLINE and Dental Global Publication Research System search complemented by manual searching was conducted to identify prospective and retrospective cohort studies on all-ceramic and metal–ceramic reconstructions with a mean follow-up time of at least 3 years. Patients had to have been examined clinically at the follow-up visit. Assessment of the identified studies and data abstraction was performed independently by three reviewers. Failure rates were analyzed using standard and random-effects Poisson regression models to obtain summary estimates of 5-year survival proportions. Results: The search provided 3473 titles for single crowns and FDPs and resulted in 100 abstracts for all-ceramic FDPs. Full-text analysis was performed for 39 articles, resulting in nine studies of ceramic FDPs that met the inclusion criteria. The data on survival and complication rates of metal–ceramic FDPs were obtained from a previous systematic review of Tan et al. (2004) and the updated version from the same authors ( Pjetursson et al. 2007 ). In Poisson regression meta-analysis, the 5-year survival of metal–ceramic FDPs was significantly ( P<0.0001) higher with 94.4% [95 confidence interval (CI): 91.1–96.5%] than the survival of all-ceramic FDPs, being 88.6% (95 CI: 78.3–94.2%). The frequencies of material fractures (framework and veneering material) were significantly ( P<0.0001) higher for all-ceramic FDPs (6.5% and 13.6%) compared with those of metal–ceramic FDPs (1.6% and 2.9%). Other technical complications like loss of retention and biological complications like caries and loss of pulp vitality were similar for the two types of reconstructions over the 5-year observation period. Conclusion: Based on the present systematic review of all-ceramic FDPs, significantly lower survival rates at 5 years were seen compared with metal–ceramic FDPs. The most frequent reason for failure of FDPs made out of glass-ceramics or glass-infiltrated ceramics was fracture of the reconstruction (framework and veneering ceramic). However, when zirconia was used as framework material, the reasons for failure were primarily biological and technical complications other than framework fracture. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this systematic review was to assess the 5-year survival rates of all-ceramic single crowns and to compare it with the survival rates of metal–ceramic crowns and to describe the incidence of biological and technical complications. Methods: An electronic Medline and Dental Global Publication Research System search complemented by manual searching was conducted to identify prospective and retrospective cohort studies on all-ceramic and metal–ceramic crowns with a mean follow-up time of at least 3 years. Patients had to have been examined clinically at the follow-up visit. Assessment of the identified studies and data abstraction was performed independently by two reviewers. Annual failure rates were analyzed using standard and random-effects Poisson regression models to obtain summary estimates of survival proportions. Results: The search provided 3473 titles and 177 abstracts. Full-text analysis was performed for 86 articles, resulting in 34 studies that met the inclusion criteria. In meta-analysis, the 5-year survival of all-ceramic crowns was estimated at 93.3% (95% confidence interval (CI): 91.1%–95%) and 95.6% (95% CI: 92.4%–97.5%) for metal–ceramic crowns. All-ceramic crowns were also analyzed according to the material utilized. Densely sintered alumina (Procera®technique) crowns showed the highest 5-year survival rate of 96.4%, followed by reinforced glass–ceramic crowns (Empress®technique) and InCeram-crowns with survival rates of 95.4% and 94.5%, respectively. A significantly lower survival rate of 87.5% was calculated for glass–ceramic crowns after 5 years. All-ceramic crowns were also grouped and analyzed regarding the position in the mouth. All four types of all-ceramic crowns showed lower survival rates when seated on posterior teeth. Moreover, for glass–ceramic crowns (84.4%) and InCeram-crowns (90.4%), this difference reached statistical significance ( P=0.009, P=0.028). Conclusion: Based on the present systematic review, all-ceramic crowns, when used for anterior teeth, showed survival rates at 5 years comparable to those seen for metal–ceramic crowns. When used for posterior teeth, the survival rates at 5 years of densely sintered alumina crowns (94.9%) and reinforced glass–ceramic crowns (93.7%) were similar to those obtained for metal–ceramic crowns. Furthermore, lower survival rates of 90.4% and 84.4% can be expected for InCeram crowns and glass–ceramic crowns when utilized for premolars and molars. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study has been to review the incidence of biological and technical complications in case of tooth–implant-supported fixed partial denture (FPD) treatments on the basis of survival data regarding clinical cases. Material and methods: Based on the treatment documentations of a Bundeswehr dental clinic (Cologne-Wahn German Air Force Garrison), the medical charts of 83 patients with tooth-implant-supported FPDs were completely recorded. The median follow-up time was 4.73 (time range: 2.2–8.3) years. In the process, survival curves according to Kaplan and Meier were applied in addition to frequency counts. Results: A total of 84 tooth-implant (83 patients) connected prostheses were followed (132 abutment teeth, 142 implant abutments (Branemark, Straumann). FPDs: the time-dependent illustration reveals that after 5 years, as many as 10% of the tooth-implant-supported FPDs already had to be subjected to a technical modification (renewal ( n=2), reintegration ( n=4), veneer fracture ( n=5), fracture of frame ( n=2)). In contrast to non-rigid connection of teeth and implants, technical modification measures were rarely required in case of tooth-implant-supported FPDs with a rigid connection. There was no statistical difference between technical complications and the used implant system. Abutment teeth and implants: during the observation period, none of the functionally loaded implants ( n=142) had to be removed. Three of the overall 132 abutment teeth were lost because of periodontal inflammation. The time-dependent illustration reveals, that after 5 years as many as 8% of the abutment teeth already required corresponding therapeutic measures (periodontal treatment (5%), filling therapy (2.5%), endodontic treatment (0.5%)). After as few as 3 years, the connection related complications of implant abutments (abutment or occlusal screw loosening, loss of cementation) already had to be corrected in approximately 8% of the cases. In the utilization period there was no screw or abutment fracture. Conclusion: Technical complications of implant-supported FPDs are dependent on the different bridge configurations. When using rigid functional connections, similarly favourable values will be achieved as in case of solely implant-supported FPDs. In this study other characteristics like different fixation systems (screwed vs. cemented) or various implant systems had no significant effect to the rate of technical complications. [ABSTRACT FROM AUTHOR]

To assess prospectively over 10 years the incidences of technical and/or biological complications and failures occurring in a cohort of consecutive partially edentulous patients with fixed reconstructions on implants of the ITI® Dental Implant System.Eighty-nine patients were available, 34 (38.2%) were male, 55 (61.8%) were female. At the 10-year examination (range 8–12 years), they were 58.9 years old (range 28–88 years).Single crowns (SC): 48 patients had been restored with 69 SC on 69 implants. Five of the implants with the crowns were lost because of biological failures. Two crowns (2.9%) were remade because of technical failures. Total failure amounted to seven (10%). Implant borne fixed partial dentures (I-I FPD): In 29 patients who had been restored with 33 implant borne suprastructures, the total number of failed I-I FPD was 2 (6.1%). Tooth–implant borne fixed partial dentures (I-T FPD): In 21 patients, 22 mixed tooth–implant borne reconstructions were constructed. The number of failed FPD reached 7 (31.8%). Statistically significantly fewer biological failures occurred with I-I FPD compared with the I-T FPDs (ANOVA, Bonferroni,P=0.022). The I-T FPDs experienced statistically significantly more frequent technical failures compared with the other two groups of suprastructures (P=0.003, 0.031). Consequences of complications: The occurrence of loss of retention as a complication increased the odds ratio (OR) to 17.6 (P<0.001) to end up in a technical failure. Similarly, the event of a porcelain fracture increased the OR for the suprastructure to be a failure at 10 years to 11.0 (P≤0.004). Treatment of periimplantitis increased the OR to 5.44 (P≤0.011) to result in a biological failure compared with implants in which this type of treatment was not applied.The three groups of suprastructures demonstrated marked differences in their patterns of failures and complications. Complications increased the risk for failure. Support by CRF, University of Berne, Switzerland.To cite this article:Brägger U, Karoussis I, Persson R, Pjetursson B, Salvi G, Lang NP. Technical and biological complications/failures with single crowns and fixed partial dentures on implants: a 10-year prospective cohort study.Clin. Oral Impl. Res.doi: 10.1111/j.1600-0501.2005.01105.x [ABSTRACT FROM AUTHOR]

The objective of this systematic review was to assess the 5- and 10-year survival of combined tooth–implant-supported fixed partial dentures (FPDs) and the incidence of biological and technical complications.An electronic MEDLINE search supplemented by manual searching was conducted to identify prospective and retrospective cohort studies on FPDs with a mean follow-up time of at least 5 years. Patients had to have been examined clinically at the follow-up visit. Assessment of the identified studies and data abstraction was performed independently by two reviewers. Failure and complication rates were analyzed using random-effectsPoissonregression models to obtain summary estimates of 5- and 10-year survival proportions.From a total of 3844 titles and 560 abstracts, 176 articles were selected for full-text analysis, and 13 studies met the inclusion criteria. Meta-analysis of these studies indicated an estimated survival of implants in combined tooth–implant-supported FPDs of 90.1% (95 percent confidence interval (95% CI): 82.4–94.5%) after 5 and 82.1% (95% CI: 55.8–93.6%) after 10 years. The survival rate of FPDs was 94.1% (95% CI: 90.2–96.5%) after 5 and 77.8% (95% CI: 66.4–85.7%) after 10 years of function. There was no significant difference in survival of tooth and implant abutments in combined tooth–implant FPDs. After an observation period of 5 years, 3.2% (95% CI: 1.5–7.2%) of the abutment teeth and 3.4% (95% CI: 2.2–5.3%) of the functionally loaded implants were lost. After 10 years, the corresponding proportions were 10.6% (95% CI: 3.5–23.1%) for the abutment teeth and 15.6% (95% CI: 6.5–29.5%) for the implants. After a 5 year observation period, intrusion was detected in 5.2% (95% CI: 2–13.3%) of the abutment teeth. Intrusion of abutment teeth were almost exclusively detected among non-rigid connections.Survival rates of both implants and reconstructions in combined tooth–implant-supported FPDs were lower than those reported for solely implant-supported FPDs (). Hence, planning of prosthetic rehabilitation may preferentially include solely implant-supported FPDs. However, anatomical aspects, patient centered issues and risk assessments of the residual dentition may still justify combined tooth–implant-supported reconstructions.It was evident from the present search that tooth–implant-supported FPDs have not been studied to any great extent and hence, there is a definitive need for more longitudinal studies examining these reconstructions.To cite this article:Lang NP, Pjetursson BE, Tan K, Brägger U, Egger M, Zwahlen M. A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. II. Combined tooth–implant-supported FPDs.Clin. Oral Impl. Res.doi: 10.1111/j.1600-0501.2004.01118.x [ABSTRACT FROM AUTHOR]

The objective of this systematic review was to assess the survival of cantilever fixed partial dentures (FPDs) and the incidence of biological and technical complications.An electronic MEDLINE search supplemented by manual searching was conducted to identify prospective and retrospective cohort studies on FPDs with a mean follow-up time of at least 5 years. Patients had to have been examined clinically at the follow-up visit. Assessment of the identified studies and data abstraction was performed independently by two reviewers. Failure and complication rates were analyzed using random-effectsPoissonregression to obtain summary estimates of 10-year survival proportions.From a yield of 3658 titles and 211 abstracts, 81 articles were selected for full-text analysis, finally resulting in 13 studies that met the inclusion criteria. Meta-analysis of these studies resulted in an estimated survival rate of cantilever FPDs of 81.8% (95 percent confidence interval (95% CI): 78.2–84.9%) and success rate (free of all complications) of 63% (95% CI: 54.7–70.2%) after 10 years. The most common biological complication was loss of pulp vitality (32.6%) followed by caries at abutment teeth (9.1%). After a 10-year observation period 2.6% of the FPDs were lost as a result of dental caries and 1% due to recurrent periodontitis. The most frequent technical complication was loss of retention (16.1%) followed by material fractures (5.9%). The cumulative incidence of fractures of abutment teeth was 2.9% and 2.4% of the FPDs were lost as a result of abutment tooth fracture after an observation period of 10 years.This systematic review on cantilever fixed partial dentures indicated that survival and success rates of cantilever fixed partial dentures were lower than those of conventional end-abutment supported FPDs described in a review byand biological and technical complications were frequent.To cite this article:Pjetursson BE, Tan K, Lang NP, Brägger U, Egger M, Zwahlen M. A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. IV. Cantilever or extension FPDs.Clin. Oral Impl. Res.doi: 10.1111/j.1600-0501.2004.01120.x [ABSTRACT FROM AUTHOR]

Adverse occlusal forces can result in mechanical complications of implant components. While unacceptably high incidences of mechanical failures have been reported for the two-stage external hex screw-type implant systems, the standard-diameter ITI® solid-screw implant does not seem to be vulnerable to these problems. The 8° Morse taper has eliminated abutment screw loosening and fracture. The incidence of prosthetic screw loosening has been minimized by the 45° bevel on the implant shoulder and by the 1.5 mm vertical abutment walls. The design of the standard-diameter solid-screw ITI implant and the material used in its fabrication (cold worked type IV cp titanium) have eliminated fixture fracture. However, because there have been some reported instances of fractures involving reduced-diameter and hollow implants, these designs should be used with caution. [ABSTRACT FROM AUTHOR]

Objective: Information of implant periapical lesion(IPL) is insufficient by now. The aim of this review is to analyze the possible causes of IPL and to find out the proper treatment protocol., Material and Methods: A systematic literature search was carried out (up to June 2012) using relevant search terms in PUBMED. And a case of IPL with histological evaluation is reported., Results: The IPL is accompanied by the radiolucency around the apex of the implant and usually presents symptoms of red, pain, tenderness, swelling, or fistulous tract. It may occur due to infection, overheating, poor bone quality of the implant site, etc. Debridement is considered as the crucial procedure of the treatment, and the prognosis is normally good when assessed by clinical parameters and radiograph., Conclusion: The causes of IPL seem to be multifactorial. Most of the cases are connected with pre-existing infection. Elimination of the infection is the only consensus of the treatment protocols., (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)