No abstract

This retrospective study describes the effect of smoking on initial fixture failure before functional loading with fixed prosthetic restorations. Of 208 installed Brånemark fixtures in the mandible, only 1 failed (0.5%), and no detrimental effect of smoking on fixture survival could be detected. In the maxilla, 10/244 fixtures failed (4%); 7/78 fixtures failed in smokers and 3/166 in nonsmokers. The failure rate before loading was 9% in smokers versus 1% in nonsmokers and was statistically significant, despite the fact that bone quality in both groups was comparable. Failed fixtures occurred in 31% of the smokers, despite often excellent bone quality, long fixture length or good initial stability. Only 4% of the nonsmokers had failures, in most cases related to poor bone quality. It is concluded that smoking is a significant although not the only important factor in the failure of implants prior to functional loading. Prospective studies are needed to assess the risk of implant failure in conjunction with smoking. In the mean time, patients should be informed of the adverse effect of smoking.

Intra-coronal compartments of screw-retained fixed restorations were heavily contaminated. The restorative margin may have been the principal pathway for bacterial leakage. Contamination of abutment screws most likely occurred from the peri-implant sulcus via the implant-abutment interface and abutment-prosthesis interface.

Immediate loading of a full-arch maxillary bridgework on 7-9 Astra Tech TiOblast implants is a predictable treatment option with 100% fixture survival and stable bone-to-implant contact up to 3 years. The steady state in bone remodelling is indicative of a good long-term prognosis in non-smokers but smokers seem to be more prone to bone loss.

In this study, patient opinion on oral rehabilitation by means of Brånemark implants was investigated. All patients were referred to a periodontal clinic for implant installation and treated by one and the same operator. Prosthetic restorations were performed by dentists, who had no previous experience with prostheses on implants, but had completed a postgraduate training course. Patient opinion was obtained through questionnaires, pertaining to satisfaction and oral function. A comparison was made between pre-implant situation, short-term (< 4 months) and long-term functioning (3 years) with the implant-restorative rehabilitation. In total, 61 patients participated in the study; 23 received a full lower arch bridge and 18 a full upper arch bridge, while 20 patients got partial bridges. Of 298 installed implants, 7 failed at abutment connection (2.3%) and 1 during the 3-year follow-up interval (0.3%). The study results indicated that a great majority of patients were very satisfied with the treatment. Comfort with eating, aesthetics, phonetics and overall satisfaction improved significantly and nearly all patients said that they would undergo the treatment again or recommend it to others. Patients experienced their implants as "natural" teeth. The conclusion is that rehabilitation ad modum Brånemark, even in the hands of non-specialized dentists, can be of high quality, improving oral function and satisfying the needs and demands of patients.