Abstracts
New
Cement
Single Crowns on Osseointegrated Implant After 5 Years: Results
from a Prospective Study on CeraOne
A New Brånemark Single Tooth Abutment:
Handling and Early Clinical Experiences
Ceramic Implant Abutments Used For Short-Span
Fixed Partial Dentures: A Prospective 2-Year Multicenter Study
Ceramic
Implant Abutments Used For Short-Span Fixed Partial Dentures: A
Prospective 5-Year Multicenter Study
Alumina Ceramic Implant Abutments Used For Single-Tooth
Replacement: A Prospective 1- to 3-Year Multicenter Study
AllCeram Crowns For Single Replacement Implant
Abutments
The Effect of the Use of a Counter-Torque Device
on the Abutment-Implant Complex
Bond
Strength of Cements to Titanium, Gold, and Aluminum Oxide
Implant-abutment Stability Following
Preparation and Multiple Tightening-loosening Procedures
Implant-abutment Stability Following
Preapration Procedures Using Ceradapt® Abutments
Wear Characteristics of Grade I Titanium Opposed by
Aluminum OxideAl2O3 Ceramic Abutment For
Single-Tooth Restorations (T-047)
Evaluation of the CeraOne Abutment/Implant Screw
Joint Stability
Cement
Single Crowns on Osseointegrated Implant After 5 Years: Results from
a Prospective Study on CeraOneNew
Andersson B, Ödman P, Lindvall A, and Brånemark
P-I. Cemented single crowns on osseointegrated implants after 5 years:
Results from a prospective study on CeraOne. Int J Prosthodont 1998;11:212218.
Abstract:
The aim of this prospective study was to present the results after
5 years of loading of 65 CeraOne (Nobel Biocare) crowns. Sixty-two
implants in the maxilla and 3 implants in the mandible were placed
in 57 patients. Sixty-two all-ceramic and three metal-ceramic crowns
were cemented. The group comprised the first patients treated with
the CeraOne prosthodontic concept. Eight patients did not complete
the study. Only one implant failed, giving a cumulative success
rate for crowns of 98.5%. The failed implant was replaced: a crown
was cemented and then followed for 5 years without any complications.
Four crowns were recorded as failures, giving a cumulative success
rate for crowns of 93.7%. It should be observed that this result
was very positive, as all crown failures were related to extraordinary
causes and not one was a result of common bite forces or fatigue,
The initial bone loss was in accordance with other studies on Brånemark
implants, and a stable situation was recorded after 2 years for
the supporting bone around implants and adjacent teeth when the
conical implants were excluded. Soft tissues around implants and
adjacent teeth appeared healthy, and the cementation and the placement
of the abutment shoulder in the peri-implant sulcus did not cause
any recession of the peri-implant mucosa.
Conclusions:
CeraOne experienced virtually no complications and proved to be
a highly predictable and a safe prosthodontic concept. CeraOne also
eliminated problems with abutment screw loosening and created a
platform for good esthetic results and satisfied patients.
A
New Brånemark Single Tooth Abutment: Handling and Early Clinical
ExperiencesNew
Andersson B,
Ödman P, Carlsson L, and Brånemark P-I. A new Brånemark
single tooth abutment: Handling and early clinical experiences. Int
J Oral Maxillfac Implants 1992;7:105111.
Abstract:
A new prosthetic concept, available under the name CeraOne,
for single tooth replacement with the Brånemark system is
described. This concept is characterized by a new design of the
prefabricated components. A mechanical torque driver is used together
with a gold screw and a special counter-torque device to ensure
that the screw is tightened in an optimal manner to resist screw
loosening and only transmit minor stress to the fixture interface.
Another characteristic is the use of a prefabricated cap of sintered
aluminum oxide as the basis for the ceramic crown. The crown is
cemented to provide better esthetic possibilities even in situations
of somewhat unfavorable fixture placement.
Conclusions:
The new abutment has been used with clinical success.
Ceramic
Implant Abutments Used for Short-Span Fixed Partial Dentures: A Prospective
2-Year Multicenter StudyNew
Andersson
B, Peter Schärer P, Simion M, and Bergström C. Ceramic implant
abutments used for short-span fixed partial dentures: A prospective
2-year multicenter study. Int J Prosthodont 1999;12:318-324.
Abstract:
This is a 2-year report from an ongoing prospective 5-year multicenter
study. The aim of the study was to evaluate the short- and long-term
clinical function of CerAdapt ceramic abutments supporting short-span
fixed partial dentures (FPD). Initially, 105 Brånemark System
implants were placed in a total of 32 patients at 3 different clinics.
After initial healing 103 implants remained. For the support of
36 FPDs, 53 ceramic and 50 titanium abutments were connected, 19
on ceramic and 17 on titanium abutments. All patients remained in
the study after 2 years. There was a cumulative survival rate of
97.1% for implants and a cumulative success rate of 97.2% for FPDs
(94.7% for ceramic and 100% for titanium abutment-supported FPDs).
One of the 53 ceramic but none of 50 titanium abutments failed,
giving a cumulative success rate of 98.1% and 100%, respectively,
for the abutments. Soft tissue around abutments and adjacent teeth
appeared healthy. More crown margins were placed submucosally at
titanium (31%) than at (14%) abutments, and the level of the periimplant
musoca was relatively stable in relation to the abutment/crown.
No differences were seen between ceramic and titanium abutments
regarding bleeding to the periimplant mucosa. There was a minimal
marginal bone loss recorded after 1 year, which was lightly more
at titanium (0.4mm) than at ceramic (0.2mm) abutments. All patients
and dentists were satisfied with the achieved esthetic result and
no FPD was remade because of compromised esthetics.
Conclusions:
So far the ceramic abutments have worked very well and the 2-yaear
results have been very encouraging for CerAdapt abutments supporting
short-span FPDs. However, ceramic materials tend to undergo static
fatigue, and it is therefore important to wait for the 5-year results
before making a more definite statement about the long-term prognosis
for CerAdapt abutments.
Ceramic
Implant Abutments Used for Short-Span Fixed Partial Dentures: A Prospective
5-Year Multicenter StudyNew
Andersson
B, Glauser R, Maglione M, and Taylor A. Ceramic implant abutments
used for short-span fixed partial dentures: A prospective 5 Year multicenter
study.
Abstract:
This is the final report of a prospective 5-year multicenter study.
The aim was to evaluate short- and long-term clinical function of
CerAdapt ceramic abutments compared to titanium abutments supporting
short-span fixed partial dentures (FPDs). Initially, 105 Brånemark
System implants were placed in a total of 32 patients at three different
clinics. One hundred three implants remained after initial healing.
Fifty-three ceramic and 50 titanium abutments were connected to
support 36 FPDs, 19 on ceramic and 17 on titanium abutments. Thirty
patients with 29 of initially 36 inserted FPDs were examined after
5 years. There was a cumulative success rate (CSR) of 97.2% for
FPDs (94.7% for ceramic and 100% for titanium abutment-supported
FPDs). One of 53 ceramic and none of 50 titanium abutments failed,
giving a CSR of 98.1% and 100% respectively. There was a mean marginal
bone loss of 0.3 mm and 0.4 mm respectively for ceramic and titanium
abutments. Soft tissues around abutments and adjacent teeth appeared
healthy and no significant differences were recorded for mucosal
bleeding and plaque when ceramic and titanium abutments were compared
(P>0.05). Crown margin at FPD insertion was positioned as follows:
21% submucosally, 33% at the mucosal margin and 45% supramucosally.
Changes of the mucosal level were recorded as 12% of the abutments
with 73% of all changes recorded at ceramic abutments. There was
a balance between more or less exposed crown margins during the
first 2 years in contrast to the 2-5 year period, when all changes
meant less exposed margins. All patients and dentists were satisfied
with the achieved esthetic results and no FPD was remade because
of compromised esthetics.
Conclusions:
The results demonstrate that alumina ceramic abutments supporting
short span FPDs work well also in a 5-year perspective with respect
to function and esthetics.
Alumina
Ceramic Implant Abutments Used for Single-Tooth Replacement: A Prospective
1- to 3-Year Multicenter StudyNew
Andersson
B, Taylor, A, Lang, BR, Scheller H, Bremer BD, Schärer P, Sorensen
JA and Tarnow D. Alumina Ceramic Implant Abutments Used for Single-Tooth
Replacement: A prospective 1- to 3-Year Multicenter Study. Int J Prosthodont
2001;14:432438.
Abstract:
The aim of the study was to compare results after 1 and 3 years
when single crowns supported by CerAdapt (test) ceramic abutments
or CeraOne (control) titanium abutments were loaded. The material
was divided into two groups: in group A, 69 (34 test, 35 control)
abutments/crowns from all involved clinics were followed for 1 year;
and in group B, 20 (10 test, 10 control) abutments/crowns from one
of the clinics were followed for 3 years. No implant failed, giving
a cumulative success rate of 100% for the implants. Two CerAdapt
abutments in group A fractured, giving a cumulative success rate
of 93% for the CerAdapt and 100% for the CeraOne abutments after
1 year. No abutment failed in group B, giving a cumulative success
rate 100 % both for the CerAdapt and the CeraOne abutments between
1 and 3 years. The CerAdapt fractures might have been due to the
fact that the abutments were impaired through too-extensive preparation
and/or had been exposed to a too-high bending moment. Almost no
marginal bone loss was recorded, indicating a stable bone situation
both a CerAdapt and CeraOne abutments on single-tooth implants.
Healthy conditions, with a relatively stable level of the periimplant
mucosa in relation to the abutment/crown, were recorded for soft
tissues both at CerAdapt and CeraOne abutments. Both clinicians
and patients rated the esthetic result as excellent for practically
all cases.
Conclusions:
The results demonstrate the esthetic possibilities and the safety
of single-tooth replacement when accepted treatment concepts are
followed and documented components are used. The tested abutments
worked well, although the fractured CerAdapt abutments indicate
that ceramic abutments are more sensitive to handling procedures
than the titanium abutments.
AllCeram
Crowns for Single Replacement Implant AbutmentsNew
Razzoog
ME, Lang LA, and McAndrew KS. AllCeram crowns for single replacement
implant abutments. J Prosthet Dent 1997; 78,486-9.
Abstract:
Clinicians who are comfortable with traditional porcelain fused
to metal restorations may find the thickness of veneering porcelain
addition to the CeraOne single tooth ceramic cap disconcerting.
When using a premanufactured ceramic cap to fit the space of the
final restoration, substantial amounts of unsupported
veneer porcelain may be required to achieve tooth contact to adjacent
or opposing dentition. A potential problem of weak, unsupported
veneer porcelain has been addressed by a modification of an existing
manufacturing process.
Conclusions:
By using CAD/CAM technology, a custom-designed Procera AllCeram
coping can be created for the implant abutment that eliminates any
concerns regarding the resultant design of the underlying ceramic
cap substructure.
The
Effect of the Use of a Counter-Torque Device on the Abutment-Implant
ComplexNew
Lang
LA, May KB, and Wang RF. The effect of the use of a counter-torque
device on the abutment-implant complex. J Prosthet Dent 1999; 81:411-7.
Abstract:
This study examined the tightening force transmitted to the implant
with and without the use of a counter-torque device during the tightening
of the abutment screw. Forty Brånemark implants and 10 CeraOne,
Estheticone, Procera, and AuraAdapt abutments formed the experimental
populations. Samples in each group were further divided into 2 groups,
1 group was tightened with a torque controller without the use of
a counter-torque device, whereas the other used counter-torque device.
Samples were positioned in a special holder within the grips of
a Tohnichi BTG-6 torque gauge for measuring transmitted forces.
There were significant differences (P=.0001) in the tightening forces
transmitted to the implant with and without the use of a counter-torque
device when tightening the abutment screws.
Conclusions:
An average of 91% of the recommended preload tightening torque was
transmitted to the implant-bone interface in the absence of a counter-torque
device. In all abutments systems, less that 10% of the recommended
preload tightening torque was transmitted to the implant when the
counter-torque de vice was used. Although the uncontrolled force
transmitted as a result of tightening without a counter-torque device
is only speculative at this point in time, it may lead to premature
loss of implants. The allowable magnitude of force that the implant-bone
interface can withstand is presently unknown.
Bond
Strength of Cements to Titanium, Gold, and Aluminum Oxide
Sierraalta M, Razzoog ME, Lang BR, and Yaman P. Bond strength
of cements to titanium, gold, and aluminum oxide. [Abstract # 928]
J Dent Res 1999;221.
Abstract:
The purpose of this investigation was to measure the in-vitro tensile
bond strength of two cements when bonding titanium to densely sintered
aluminum oxide and titanium to gold. Forty disks of Grade I titanium,
twenty (20) disks of densely sintered aluminum oxide (Procera®
AllCeram, Nobel Biocare, AB), and twenty (20) gold samples formed
the experimental population for this study. The samples were divided
among four groups. Group 1 consisted of 10 titanium disks that were
bonded to 10 aluminum oxide disks using Fuji Plus. Group 2 consisted
of 10 titanium disks bonded to 10 air-abraded gold samples using
Fuji Plus. Group 3 consisted of 10 titanium disks bonded to 10 silanated
aluminum oxide disks with Panavia 21. Group 4 consisted of 10 titanium
disks bonded to 10 air-abraded gold samples with Panavia 21. In
each group the cements were applied according to the manufacturers
instructions. All samples were kept in 100% humidity at room temperature
for 7 days following cementation. After 7 days, the 40 samples were
subjected to a tensile load using an Instron testing machine at
a cross-head speed of 0.5 mm/min. The tensile bond strength for
Group 1 or titanium bonded to aluminum oxide using Fuji Plus was
13.60 ± 3.35 MPa. Group 2 or titanium bonded to air-abraded gold
using Fuji Plus was 11.32 ± 4.53 MPa. Group 3 or titanium bonded
to silanated aluminum oxide disks using Panavia 21 was 15.95 ± 6.25
MPa. Group 4 or titanium bonded to air-abraded gold using Panavia
21 was 16.81 ± 6.14 MPa.
Conclusions:
A two-way ANOVA demonstrated a significantly higher bond strength
(P> 0.05) for Group 4 or titanium bonded to air-abraded gold using
Panavia 21 (16.81 ± 6.14 MPa) as compared to Group 2 or titanium
bonded to air-abraded gold using Fuji Plus (11.32 ± 4.53 MPa). No
significant differences were found when bonding titanium to aluminum
oxide using Fuji Plus (13.60 ± 3.35 MPa) as compared to Panavia
21 (15.95 ± 6.25 MPa).
Implant-abutment
Stability Following Preparation and Multiple Tightening-loosening
Procedures
Sierraalta M, Zhang F, and Razzoog ME. Implant-abutment
stability following preparation and multiple tightening-loosening
procedures. [Abstract # 1226] J Dent Res 2000;279.
Abstract:
Custom preparable abutments for dental implants require preparation
prior to the fabrication of implant supported restorations. The
purpose of this study was to determine the implant-abutment joint
stability following preparation procedures in an in-vivo simulation,
and to evaluate the joint stability after repeated tightening and
loosening of retaining screws. Nobel Biocare implant/custom abutment
units were used in this study. Thirty implant/abutment samples were
divided into 3 groups. Group 1 consisted of 10 Brånemark®
3.75 mm implants with 10 TiAdapt® Regular Platform (RP) abutments.
Group 2 consisted of 10 Brånemark® 3.3 mm implants with
10 Narrow Platform (NP) abutments. Group 3 consisted of 10 Brånemark®
5.0 mm implants with 10 Wide Platform (WP) abutments. The abutments
were placed on their respective implant samples aand tightened to
the appropriate level for each implant/abutment system Each group
was further subdivided into 2 groups (A and B) with 5 abutments
in each group. Group A abutments were prepared with appropriate
instrumentation and Group B was not prepared and served as the controls.
A Tohnichi BTG-6 torque gauge was used to record the force required
to loosen the abutment from the implant following preparation. Following
the recording of the initial loosening data, each sample was retighten
and loosened again and the data recorded. Tighten-loosening procedure
was repeated for five sequences for each sample. Data was analyzed
with the Students t-test, an analysis of variance, and the
Post-Hoc test for multiple comparisons.
Conclusions:
The mean de-torque value for the prepared NP implant/abutment samples
were significantly different from the mean de-torque value of the
NP implant/abutment control samples. No significant differences
were observed between the 5 tightening-loosening sequences with
the RP implant/abutments but a significant difference was found
for both NP and WP groups. The Post-Hoc test demonstrated that there
was a significant difference between the first loosening of the
retaining screw and the other 4 tightening-loosening sequences in
the NP and WP implant/abutments. In this in-vivo simulation model,
the preparation of titanium custom abutments did not appear to negatively
effect the torque-to-loosen the retaining screws.
Implant-abutment
Stability Following Preparation Procedures Using Ceradapt® Abutments
Sierraalta M, Vivas J, and
Razzoog ME. Implant-abutment stability following preparation procedures
using Ceradapt® abutments. [Abstract # 1236] J Dent Res 2001;190.
Abstract:
The purpose of this study was to determine the implant/abutment
joint stability following preparation procedures using the Nobel
Biocare Ceradapt® abutment. Two groups formed the experimental
populations. Group 1 consisted of ten (10) Ceradapt abutments combined
with ten (10) Brånemark 3.75 mm Regular Platform implants.
One (1) implant and one (1) abutment formed a sample. Group 1 was
further subdivided into two groups of five (5) samples. For Group
1A, the abutment preparation involved the total length of the abutment.
For Group 1B, the abutment preparation involved only the incisal
one-third. Group 2 consisted of five (5) Ceradapt abutments combined
with five (5) Brånemark 3.75 mm Regular Platform implants.
The samples in Group 2 formed the controls that were not prepared.
The abutments in Groups 1 and 2 were positioned onto their respective
implants and the abutment screws were tightened using the appropriate
tightening torque. Samples in Groups 1A and 1B were then prepared
according to the preparation guidelines. Following preparation a
Tohnichi BTG-6 torque gauge was used to record the force needed
to loosen the abutment screws in Groups 1 and 2. The mean torque
required to loosen the abutment screws in Group 1A = 24.43 Ncm.
The mean torque for Group 1B = 21.41 Ncm. The mean torque for the
control Group 2 = 21.70 Ncm. The loosening torque data were subjected
to a One-way ANOVA. No significant differences were found when the
screw loosening data for Groups 1A and 1B were compared to Group
2.
Conclusions:
Preparation of the Ceradapt® abutment when positioned onto a
Brånemark 3.75 mm Regular Platform implant does not significantly
effect the screw joint stability at the abutment/implant interface.
Wear
Characteristics of Grade I Titanium Opposed by Aluminum Oxide
Armellini D,
Wagner W, Razzoog ME, and Lang BR. Wear characteristics of Grade 1
titanium opposed by aluminum oxide. [Abstract # 1775] J Dent Res 1999;327.
Abstract:
Implant transmucosal abutments fabricated in densely sintered aluminum
oxide have been developed for attachment to titanium implants. While
offering the advantages of improved esthetics with excellent biocompatibility,
the potential for micromovement of the abutment and possible damage
to the bearing surface of the implant has not been investigated.
The purpose of this investigation was to measure the wear of titanium
when opposed by aluminum oxide or titanium in a simulated in-vivo
environment. A specially designed wear machine was used to measure
the vertical loss in height of titanium abraders that opposed disks
of aluminum oxide and titanium. Titanium abraders were positioned
in contact opposing sample disks of aluminum oxide or titanium.
The abrader was rotated against the opposing disk for 10,000 cycles
in a simulated oral environment under a load of 454 gms. Wear was
reported as mean wear in microns and the data was analyzed using
an analysis of variance (ANOVA).
Conclusions:
The wear of the titanium abrader when opposed by aluminum oxide
was 192 microns while the wear of the titanium abrader when opposed
by titanium was 165 microns. The analysis of variance demonstrated
that although a higher wear was observed for titanium when opposed
by aluminum oxide no significant difference was found when compared
to the wear of titanium when opposed by titanium P=0.39).
Al2O3
Ceramic Abutment For Single-Tooth Restorations (T-047)
Investigators: Multicenter
Abstract:
Eight clinics in Europe and the United States will participate in
this study. This aim of the project is to evaluate the short- and
long-term clinical function of Al2O3 ceramic abutments with regard
to hard and soft tissue reactions. The study is also evaluating
the mechanical function of the ceramic abutments. The patients included
in this study will receive one or two single-tooth restorations
in the premolars, canines or incisors regions. The CeraOne abutment
will be used as a control abutment, and the choice between a test
or a control abutment will be made according to a randomization
procedure. Patients included in this study will be followed for
five years according to a specific study design with scheduled follow-up
visits.
Evaluation
of the CeraOne abutment/implant screw joint stability
Investigators: KB May, LA Lang, ME Razzoog, and BR Lang
Abstract:
The purpose of this project is to evaluate the influence of
the external hexagon of the implant and the internal hexagon of
the abutment on the implant/abutment interface and screw joint stability
for the CeraOne abutment. The null hypothesis to be tested will
be: There is no change in the screw joint stability following
an application of a cyclic light functional load when the interface
between the implant fixture hex head and the abutment component
internal hex are in tight contact as compared to the joint stability
under conditions of a minimal and non-existent hex interlock.
The experimental design for this project will require the establishment
of three populations. The first population (A) will examine the
screw joint stability in the presence of the normal hex interlock.
Condition (B) will examine the joint stability under the condition
of a minimal hex interlock and condition (C) will examine a non-existent
hex interlock. Five samples will form the experimental populations
for each condition. Each condition will be examined using the Universal
Instron testing device under conditions of a cyclic light functional
load. Data from this project will be correlated with a similar experiment
using the finite element method.
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