Annals of periodontology最新文献

{"title":"The Influence of Preoperative Antibiotics on Success of Endosseous Implants at 36 Months","authors":"Daniel M. Laskin,&nbsp;C. Daniel Dent,&nbsp;Harold F. Morris,&nbsp;Shigeru Ochi,&nbsp;John W. Olson","doi":"10.1902/annals.2000.5.1.166","DOIUrl":"10.1902/annals.2000.5.1.166","url":null,"abstract":"<p>The benefits of prophylactic antibiotics are well recognized in dentistry. However, their routine use in the placement of endosseous dental implants remains controversial. As part of the comprehensive Dental Implant Clinical Research Group (DICRG) clinical implant study, the preoperative or postoperative use of antibiotics, the type used, and the duration of coverage were left to the discretion of the surgeon. These data for 2,973 implants were recorded and correlated with failure of osseointegration during healing (Stage 1), at surgical uncovering (Stage 2), before loading the prosthesis (Stage 3), and from prosthesis loading to 36 months (Stage 4). The results showed a significantly higher survival rate at each stage of treatment in patients who had received preoperative antibiotics. <i>Ann Periodontol 2000;5:166-174.</i></p>","PeriodicalId":79473,"journal":{"name":"Annals of periodontology","volume":"5 1","pages":"166-174"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1902/annals.2000.5.1.166","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68174178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction, Methodology, and Summary of Results for the Dental Implant Clinical Research Group Studies","authors":"Harold F. Morris","doi":"10.1902/annals.2000.5.1.1","DOIUrl":"10.1902/annals.2000.5.1.1","url":null,"abstract":"","PeriodicalId":79473,"journal":{"name":"Annals of periodontology","volume":"5 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1902/annals.2000.5.1.1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68172578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival and Stability (PTVs) of Six Implant Designs From Placement to 36 Months","authors":"Harold F. Morris,&nbsp;Shigeru Ochi","doi":"10.1902/annals.2000.5.1.15","DOIUrl":"10.1902/annals.2000.5.1.15","url":null,"abstract":"<p><b>Background:</b> Numerous new implant designs and materials have become available over the last decade, each with special claims of superiority in restoring complex cases. Differences in existing clinical databases, study designs, and methods of determining failures/survival are seldom standardized, which complicates comparisons of clinical performance of these new designs. Little information is available concerning the changes in stability of various designs and materials following clinical loading.</p><p><b>Methods:</b> A total of 30 VA medical centers and 2 dental schools combined to form the Dental Implant Clinical Research Group (DICRG). More than 2,900 implants were placed, restored and data gathered from the time of placement to 36 months. Implant stability from uncovering to 36 months and survival from placement to 36 months were determined. Survival was determined using two different approaches—considering all implants removed at any time, regardless of the reason (DICRG approach), and considering only those that were removed following loading of the prosthesis (post-loading approach). Survival was also determined for each of the three phases of implant treatment—phase 1, from the time of placement to uncovering and abutment connection; phase 2, from uncovering to placement and loading of the prosthesis; and phase 3, from loading of the prosthesis to 36 months.</p><p><b>Results:</b> The two approaches to determining survival for each implant design and/or material included in the study showed differences in reported numbers ranging from 1.1% to 21.7%. The largest difference in survival was for the commerically pure titanium screw (used in this study only in the maxillary completely edentulous applications), which showed a 21.7% greater survival rate. With the DICRG approach, the hydroxyapatite (HA)-cylinder had the highest survival (97.5%). When considering the post-loading approach, the titanium-alloy screw had the highest survival (99.4%), with the HA-cylinder having the next highest survival (98.6%). The HA-cylinder did not show increased stability from uncovering to 36 months, and the HA-grooved implant became less stable.</p><p><b>Conclusions:</b> HA-coated implants demonstrated the highest survival rate; 2) the post-loading analysis approach inflated survival; 3) non-HA implants showed increased stability following loading; 4) HA-coated implants showed a slight decrease or no change in stability; and 5) the clinical significance of the changes in implant stability must be determined for the long term. <i>Ann Periodontol 2000;5:15-21.</i></p>","PeriodicalId":79473,"journal":{"name":"Annals of periodontology","volume":"5 1","pages":"15-21"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1902/annals.2000.5.1.15","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68174162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implant Survival in Patients With Type 2 Diabetes: Placement to 36 Months","authors":"Harold F. Morris,&nbsp;Shigeru Ochi,&nbsp;Sheldon Winkler","doi":"10.1902/annals.2000.5.1.157","DOIUrl":"10.1902/annals.2000.5.1.157","url":null,"abstract":"<p><b>Background:</b> Because the life expectancy of individuals continues to increase, dentists providing dental implant treatment can expect to see an increasing number of patients with diabetes mellitus. Today, there are little data available concerning the clinical outcomes involving the use of implant treatment for patients with diabetes mellitus. There are three types of diabetes mellitus: Type 1 (insulin dependent), Type 2 (non-insulin dependent), and gestational. Because of possible complications from patients with diabetes mellitus, they are excluded from participation in most clinical studies of endosseous dental implant survival.</p><p><b>Methods:</b> This study attempted to determine if Type 2 diabetes represents a significant risk factor to the long-term clinical performance of dental implants, using the comprehensive DICRG database. Diabetes was a possible exclusion criterion; however, the final decision on Type 2 patients was left to the dental implant team at the research center. A total of 2,887 implants (663 patients) were surgically placed, restored, and followed for a period of 36 months. Of these, 2,632 (91%) implants were placed in nondiabetic patients and 255 (8.8%) in Type 2 patients. Failures (survival) were compared using descriptive data. Possible clustering was also studied.</p><p><b>Results:</b> A model assuming independence showed that implants in Type 2 patients have significantly more failures (P = 0.020). However, if correlations among implants within the patient are considered, the significance level becomes marginal (P = 0.046). The experience of the surgeon did not produce a clinically significant improvement in implant survival. The use of chlorhexidine rinses following implant placement resulted in a slight improvement (2.5%) in survival in non-Type 2 patients and a greater improvement in Type 2 patients (9.1%); the use of preoperative antibiotics improved survival by 4.5% in non-Type 2 patients and 10.5% in Type 2 patients. The use of HA-coated implants improved survival by 13.2% in Type 2 diabetics.</p><p><b>Conclusion:</b> Type 2 diabetic patients tend to have more failures than non-diabetic patients; however, the influence was marginally significant. These findings need to be confirmed by other scientific clinical studies with a larger Type 2 diabetic sample size.<i>Ann Periodontol 2000;5:157-165.</i></p>","PeriodicalId":79473,"journal":{"name":"Annals of periodontology","volume":"5 1","pages":"157-165"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1902/annals.2000.5.1.157","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68174171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acknowledgments","authors":"","doi":"10.1902/annals.2000.5.1.185","DOIUrl":"https://doi.org/10.1902/annals.2000.5.1.185","url":null,"abstract":"","PeriodicalId":79473,"journal":{"name":"Annals of periodontology","volume":"5 1","pages":"185-187"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1902/annals.2000.5.1.185","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138020898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Two Different Approaches to Reporting Implant Survival Outcomes for Five Different Prosthodontic Applications","authors":"Harold F. Morris,&nbsp;Shigeru Ochi","doi":"10.1902/annals.2000.5.1.90","DOIUrl":"10.1902/annals.2000.5.1.90","url":null,"abstract":"<p><b>Background:</b> Over the years, the definition of implant failure has varied, with some investigators accounting for all implants placed, while others discard failures that occurred before clinical loading. The influence of stresses transmitted to various bone densities, by different prosthetic appliances as well as the method used to determine failures, needs to be clearly understood. This paper reports on the influence of two different methods of determining 36-month survival of implants used to support different dental prostheses.</p><p><b>Methods:</b> More than 2,900 implants with six different designs were placed in 829 patients at 32 study centers and followed for 3 years. The first method of determining survival accounted for all failures from placement through 36 months, while the second method counted only failures from post-loading of the prosthesis to 36 months. Survival curves were used to determine differences in survival outcomes for the two methods.</p><p><b>Results:</b> For the maxillary single-tooth prosthetic application, implant survival from placement to 36 months was 94.7% when all failures were counted and increased to 98.3% with the post-loading method. For upper completely edentulous applications, implant survival was 85.3% with all failures counted and 95.6% with the post-loading method. This 10.3% difference is clinically important. The survival for implants in lower completely edentulous applications increased by 4.4% simply by using the post-loading approach. Implants used for upper posterior, partially edentulous applications involved only hydroxyapatite (HA)- coated implants, and the survival rates were similar (96.4% for all implants and 98.2% for the post-loading method). The difference in reported survival rates for implants in the lower posterior, partially edentulous application was 5.8%. Since failures tended to occur in the earlier phases of treatment, the post-loading approach always resulted in more favorable survival data. With the post-loading approach, valuable information related to implant performance before loading is lost. In all comparisons, HA-coated implant survival was always better than non-HA implants. Clinical investigators should clearly state the method used for determining failures. For all implants included in the study, survival curves illustrated different failure patterns for each method of determining overall survival.</p><p><b>Conclusion:</b> Reporting of implant survival rates based on the post-loading method provides more favorable survival rates; however, accounting for all implants provides a more accurate method of determining survival. <i>Ann Periodontol 2000;5:90-100.</i></p>","PeriodicalId":79473,"journal":{"name":"Annals of periodontology","volume":"5 1","pages":"90-100"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1902/annals.2000.5.1.90","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68174053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Smoking on 3-Year Clinical Success of Osseointegrated Dental Implants","authors":"Paul M. Lambert,&nbsp;Harold F. Morris,&nbsp;Shigeru Ochi","doi":"10.1902/annals.2000.5.1.79","DOIUrl":"10.1902/annals.2000.5.1.79","url":null,"abstract":"<p><b>Background:</b> Health risks associated with smoking have been exhaustively documented and include increased incidence of periodontal disease, greater risk of osteitis following oral surgery, and compromised wound healing due to hypoxia. Information related directly to dental implants, although limited, points to higher rates of implant failures among smokers than non-smokers. This paper reports on long-term clinical outcomes of osseointegrated dental implants placed in smokers and non-smokers in a longitudinal clinical study of endosseous dental implants.</p><p><b>Methods:</b> In 1990, the Dental Implant Clinical Research Group (DICRG) of the Department of Veterans Affairs (DVA) launched an 8-year, randomized, prospective clinical study of more than 2,900 endosseous dental implants in more than 800 patients at 32 study centers. Confounding variables, including smoking patterns, were recorded. For this report, new follow-up data were analyzed for two groups: 1) current smokers and 2) those who never smoked combined with those who quit. Most of the variables recorded for each implant were screened on a univariate basis as possible predictors associated with implant survival/failure. Those with P values less than 0.15 and those likely to be a factor of clinical importance were placed in a logistic regression equation and analyzed for a simultaneous effect on survival. A step-wise procedure was used to eliminate those variables that showed the least significance, until only those variables with a Wald chi-square of significance in the presence of others remained. The effects of clustering within patients and of unbalanced distribution within hospitals were standardized to facilitate analysis of influence of demographic variables. The GEE analysis was performed with the patient as the primary cluster.</p><p><b>Results:</b>Current data do not support earlier findings that smoking contributes to early implant failure (placement to uncovering). A trend of greater failures in smokers appeared between the time after uncovering and before insertion of the prosthesis. Hydroxyapatite (HA)-coated implants had significantly lower failure rates. For the entire 3-year period, overall failures were significantly higher for smokers than non-smokers.</p><p><b>Conclusions:</b> Results suggest that increased implant failures in smokers are not the result of poor healing or osseointegration, but of exposure of peri-implant tissues to tobacco smoke. Data also suggest that detrimental effects may be reduced by: 1) cessation of smoking; 2) the use of preoperative antibiotics; and 3) the use of HA-coated implants.<i>Ann Periodontol 2000;5:79-89.</i></p>","PeriodicalId":79473,"journal":{"name":"Annals of periodontology","volume":"5 1","pages":"79-89"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1902/annals.2000.5.1.79","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68173941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Bone Thickness on Facial Marginal Bone Response: Stage 1 Placement Through Stage 2 Uncovering","authors":"J. Robert Spray,&nbsp;C. Gary Black,&nbsp;Harold F. Morris,&nbsp;Shigeru Ochi","doi":"10.1902/annals.2000.5.1.119","DOIUrl":"10.1902/annals.2000.5.1.119","url":null,"abstract":"<p><b>Background:</b> Various causes of facial bone loss around dental implants are reported in the literature; however, reports on the influence of residual facial bone thickness on the facial bone response (loss or gain) have not been published. This study measured changes in vertical dimension of facial bone between implant insertion and uncovering and compared these changes to facial bone thickness for more than 3,000 hydroxyapatite (HA)-coated and non–HA-coated root-form dental implants.</p><p><b>Methods:</b> Subjects were predominantly white males, 18 to 80+ years of age (mean 62.9 years), who were patients at 30 Department of Veterans Affairs Medical Centers and two university dental clinics. Alveolar ridges ranged from normal to resorbed with intact basal bone. Following preparation of the osteotomy site, direct measurements with calipers were made of the residual facial bone thickness, approximately 0.5 mm below the crest of the bone. The distance from the top of the implants to the crest of the facial bone was also measured using periodontal probes. Implants were uncovered between 3 to 4 months in the mandible and 6 to 8 months in the maxilla after insertion. Facial bone response was the difference between the height of facial bone at Stage 1 (insertion) and Stage 2 (uncovering).</p><p><b>Results:</b>The mean facial bone thickness after osteotomies were made was 1.7 ± 1.13 mm. When a mean facial bone thickness of 1.8 ± 1.41 mm or larger remained after site preparation, bone apposition was more likely to occur. The mean facial bone response for 2,685 implants was −0.7 ± 1.70 mm. For implants integrated at uncovering, the mean bone response was −0.7 ± 1.69 mm, and −2.8 ± 1.57 mm for implants mobile at uncovering. Bone quality-4 had the least facial bone response, −0.5 ± 2.11 mm. Bone responses were similar for both HA-coated and non—HA-coated implants.</p><p><b>Conclusions:</b> Significantly greater amounts of facial bone loss were associated with implants that failed to integrate. As the bone thickness approached 1.8 to 2 mm, bone loss decreased significantly and some evidence of bone gain was seen. There was no statistically or clinically significant difference in bone response between HA-coated and non—HA-coated implants. <i>Ann Periodontol 2000;5:119-128.</i></p>","PeriodicalId":79473,"journal":{"name":"Annals of periodontology","volume":"5 1","pages":"119-128"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1902/annals.2000.5.1.119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68172492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implant Surface Coating and Bone Quality-Related Survival Outcomes Through 36 Months Post-Placement of Root-Form Endosseous Dental Implants","authors":"Richard S. Truhlar,&nbsp;Harold F. Morris,&nbsp;Shigeru Ochi","doi":"10.1902/annals.2000.5.1.109","DOIUrl":"10.1902/annals.2000.5.1.109","url":null,"abstract":"<p>Survival rates from placement to 36 months were reported for the ongoing Dental Implant Clinical Research Group studies of root-form endosseous dental implants. Failure rates for all implants were similar in bone qualities 1 and 2 (6.2% and 6.7%, respectively) and slightly higher in bone qualities 3 and 4 (8.5% and 8.7%, respectively). Hydroxyapatite (HA)-coated implants had an overall failure rate of 3.9% over 36 months in all bone qualities combined, while non-coated implants had a 13.4% failure rate for the same parameters. For each bone quality, there was a significant difference in implant survival for the non-coated implants (<i>P</i> &lt;0.01). The highest failure rates for non-coated implants were in bone qualities 3 and 4 (19.1% and 25.5%, respectively). No major difference in survival was found for HA-coated implants placed in each bone quality. Possible reasons for the differences in survival are discussed. <i>Ann Periodontol 2000;5:109-118.</i></p>","PeriodicalId":79473,"journal":{"name":"Annals of periodontology","volume":"5 1","pages":"109-118"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1902/annals.2000.5.1.109","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68172858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Methodological Study for the Analysis of Apatite-Coated Dental Implants Retrieved From Humans","authors":"D.E. MacDonald,&nbsp;F. Betts,&nbsp;S.B. Doty,&nbsp;A.L. Boskey","doi":"10.1902/annals.2000.5.1.175","DOIUrl":"10.1902/annals.2000.5.1.175","url":null,"abstract":"<p>The stability of thermally processed hydroxyapatite coatings for oral and orthopedic bioprostheses has been questioned. Information on the chemical changes, which occur with hydroxyapatite biomaterials postimplantation in humans, is lacking. The purpose of this investigation was to begin to examine post-implantation surface changes of hydroxyapatite- coated implants using scanning electron microscopy (SEM), x-ray microanalysis (EDAX), Fourier transform infrared spectroscopy (FTIR), and x-ray diffraction (XRD). Three retrieved dental implant specimens from humans following clinical failure due to peri-implantitis were examined. Unimplanted cylinders served as controls. Clinically, the retrieved specimens were all enveloped by a fibrous tissue capsule with bone present at the apical extent of the implant. SEM analysis showed that the retrieved surfaces were coated with both calcified and proteinaceous deposits. EDAX scans of the retrieved specimens demonstrated evidence of hydroxyapatite coating loss reflected by increasing titanium and aluminum signals. Other foreign ions such as sodium, chloride, sulfur, silica, and magnesium were detected. XRD of the control specimens showed that the samples were predominantly apatite; however, two peaks were detected in the diffraction pattern, which are not characteristic of hydroxyapatite, indicating that small amounts of one or more other crystalline phases were also present. The retrieved specimens showed slightly larger average crystal size relative to the control sample material, and the non-apatite lines were not present. FTIR evaluation of the retrieved specimens revealed the incorporation of carbonate and organic matrix on or into the hydroxyapatite. Narrowing of and increased detail in the phosphate peaks indicated an increase in average crystal size and/or perfection relative to the controls, as did the XRD results. Based on these results, we conclude that chemical changes may occur within the coating, with the incorporation of carbonate and concomitant reduction in hydroxyapatite coating thickness. Thermodynamic dissolution-reprecipitation of the coating itself and subsequent surface insult by bacterial and local inflammatory components may be involved with these changes. <i>Ann Periodontol 2000;5:175-184.</i></p>","PeriodicalId":79473,"journal":{"name":"Annals of periodontology","volume":"5 1","pages":"175-184"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1902/annals.2000.5.1.175","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68173707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}