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Brånemark Novum®: A New Treatment Concept for Rehabilitation of the Edentulous Mandible. Preliminary Results from a Prospective Clinical Follow‐up Study

Identifieur interne : 009886 ( Main/Merge ); précédent : 009885; suivant : 009887

Brånemark Novum®: A New Treatment Concept for Rehabilitation of the Edentulous Mandible. Preliminary Results from a Prospective Clinical Follow‐up Study

Auteurs : Per-Ingvar Br Nemark [Suède] ; Per Engstrand ; Lars-Oluf Öhrnell ; Kerstin Gröndahl [Suède] ; Peter Nilsson ; Kiell Hagberg ; Christina Darle ; Ulf Lekholm [Suède]

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RBID : ISTEX:0FBA0EC814EF7667E7A1BB8C7BD3C1B15FAD53E4

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English descriptors

Abstract

Background: Brånemark fixtures were originally prescribed to be placed in two surgical stages. During the past years, reports on the placement of machined titanium implants in a one‐stage procedure have been published, and the results have been encouraging. Recendy there has been considerable interest in early or immediate loading. Purpose: The purpose of this article is to report the preliminary clinical results of a new method for implant treatment of the edentulous mandible. The new protocol involves prefabricated components and surgical guides, elimination of the prosthetic impression procedure and attachment of the permanent fixed bridge on the day of implant placement. Methods: Fifty patients (26 males, 24 females) received 150 Brånemark Novum implants and were followed from 6 months to 3 years after implant placement. Bone width and height were determined preoperatively with the use of radiographs. The jaw was reduced in height to accommodate three special 5‐mm wide implants. Precise implant positioning was accomplished with special drilling templates. Drill guides were placed over the drilling templates during site preparation using a series of specially designed drills. After the mucosa had been sutured back into position, a prefabricated titanium lower bar was connected with titanium screws to the transmucosal fixture. Another titanium bar was then attached by the prosthodontist, and a bite registration was performed. The bridge was attached to the upper bar. The permanent reconstruction was provided to the patient later the same day. Results: Three implants were lost to follow‐up and three failed, resulting in an overall survival rate of 98%. One prosthesis failed, leaving a prosthetic survival rate of 98%. The average treatment time was approximately 7 hours. At the baseline examination, the marginal bone level was 0.72 mm below the reference point. The average marginal bone loss was 0.2 mm per year and 0.26 mm between the 3‐month and 1‐year control visits. The accumulated mean bone loss, including baseline, was‐1.25 mm. A patient questionnaire demonstrated that 94% of the patients did not experience any discomfort during treatment and all patients would recommend the procedure to others. Conclusion: The results of this study indicate that the precise surgical and prosthetic protocol allows successful prosthetic rehabilitation of mandibular edentulism and that the permanent reconstruction can be provided to the patient on the day of fixture surgery.

Url:
DOI: 10.1111/j.1708-8208.1999.tb00086.x

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ISTEX:0FBA0EC814EF7667E7A1BB8C7BD3C1B15FAD53E4

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<term>Average treatment time</term>
<term>Baseline examination</term>
<term>Bone density</term>
<term>Bone loss</term>
<term>Bone quality</term>
<term>Bone width</term>
<term>Branemark</term>
<term>Branemark implants</term>
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<term>Edentulous mandible</term>
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<term>Evaluation template</term>
<term>Final reconstruction</term>
<term>First year</term>
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<term>Fixture placement</term>
<term>Fixture site</term>
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<term>Guide pins</term>
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<term>Immediate loading</term>
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<term>Implant placement</term>
<term>Implant surgery</term>
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<term>Patient satisfaction</term>
<term>Permanent reconstruction</term>
<term>Preliminary report</term>
<term>Preliminary results</term>
<term>Present study</term>
<term>Promising results</term>
<term>Prospective multicenter study</term>
<term>Prospective study</term>
<term>Prosthesis</term>
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<term>Prosthetic protocol</term>
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<term>Radiograph</term>
<term>Radiographic</term>
<term>Radiographic examinations</term>
<term>Radiographical features</term>
<term>Reference point</term>
<term>Rigid connection</term>
<term>Silicone putty material</term>
<term>Statistical analysis</term>
<term>Surgery</term>
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<term>Template</term>
<term>Temporary screws</term>
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<term>Titanium implants</term>
<term>Titanium screws</term>
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<term>Treatment protocol</term>
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<term>Anterior mandible</term>
<term>Average treatment time</term>
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<term>Evaluation template</term>
<term>Final reconstruction</term>
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<term>Laboratory model</term>
<term>Lekholm</term>
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<term>Silicone putty material</term>
<term>Statistical analysis</term>
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<term>Temporary screws</term>
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<term>Titanium implants</term>
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<front>
<div type="abstract" xml:lang="en">Background: Brånemark fixtures were originally prescribed to be placed in two surgical stages. During the past years, reports on the placement of machined titanium implants in a one‐stage procedure have been published, and the results have been encouraging. Recendy there has been considerable interest in early or immediate loading. Purpose: The purpose of this article is to report the preliminary clinical results of a new method for implant treatment of the edentulous mandible. The new protocol involves prefabricated components and surgical guides, elimination of the prosthetic impression procedure and attachment of the permanent fixed bridge on the day of implant placement. Methods: Fifty patients (26 males, 24 females) received 150 Brånemark Novum implants and were followed from 6 months to 3 years after implant placement. Bone width and height were determined preoperatively with the use of radiographs. The jaw was reduced in height to accommodate three special 5‐mm wide implants. Precise implant positioning was accomplished with special drilling templates. Drill guides were placed over the drilling templates during site preparation using a series of specially designed drills. After the mucosa had been sutured back into position, a prefabricated titanium lower bar was connected with titanium screws to the transmucosal fixture. Another titanium bar was then attached by the prosthodontist, and a bite registration was performed. The bridge was attached to the upper bar. The permanent reconstruction was provided to the patient later the same day. Results: Three implants were lost to follow‐up and three failed, resulting in an overall survival rate of 98%. One prosthesis failed, leaving a prosthetic survival rate of 98%. The average treatment time was approximately 7 hours. At the baseline examination, the marginal bone level was 0.72 mm below the reference point. The average marginal bone loss was 0.2 mm per year and 0.26 mm between the 3‐month and 1‐year control visits. The accumulated mean bone loss, including baseline, was‐1.25 mm. A patient questionnaire demonstrated that 94% of the patients did not experience any discomfort during treatment and all patients would recommend the procedure to others. Conclusion: The results of this study indicate that the precise surgical and prosthetic protocol allows successful prosthetic rehabilitation of mandibular edentulism and that the permanent reconstruction can be provided to the patient on the day of fixture surgery.</div>
</front>
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