Figure 4. Patient satisfaction throughout the study
Figure 3. Bone level changes from loading to 5-year follow up
Figure 2. Clinical parameters and soft tissue parameters. a Modified plaque index. Error bars indicate standard deviation. * = p ≤ 0.05, *** = p ≤ 0.001. b Sulcus bleeding index. Error bars indicate standard deviation. * = p ≤ 0.05, *** = p ≤ 0.001. c Pocket probing depth. The asterisk represents statistically significant differences (* = p ≤ 0.05) observed between ...
Figure 1. Study flow diagram: follow up status and reasons for not completing the study; six-month, 2-year and 4-year follow up was optional
Figure 1. Study flow diagram: follow up status and reasons for not completing the study; six-month, 2-year and 4-year follow up was optional
Table 4 Life table analysis showing the cumulative success rate according to Albrektsson et al. and Buser et al.
Interval(months)
Implants in interval
According to Albrektsson et al.
According to Buser et al.
Implants withdrawn during interval
Failures during interval
Cumulative success rate (%)
Implants withdrawn during interval
Failures during interval
Cumulativ...
Table 3 Patient demographics with respect to implants
Overall
Subgroup*
Platform switching
Platform matching
Total Implants, n
285
203*
68*
Number of implants placed per patient, n (%)
1
125 (63.8)
97 (67.4)
20 (48.8)
2
56 (28.6)
37 (25.7)
16 (39.0)
3
12 (6.1)
7 (4.9)
5 (12.2)
4
3 (1.5)
3 (2.1)
0 (0.0)
Implant...
Table 2 Patient demographics
Overall
Subgroup*
Platform switching
Platform matching
Patients, n (%)
196 (100)
144
41
Sex, n (%)
Male
87 (44.4)
62 (43.1)
19 (46.3)
Female
109 (55.6)
82 (56.9)
22 (53.7)
Age, years
Mean (SD)
51.5 (14.2)
53.1 (14.4)
47.4 (12.9)
Range
17.9–82.1
17.9–82.1
19.3–78.5
Pr...
Investigator*
City/country
Number of patients included
Number of implants included
Dr. Helfried Hulla
Strass in Steiermark, Austria
10
15
Prof. DDr. Gerald Krennmair
Marchtrenk, Austria
10
20
Dr. S. Marcus Beschnidt (PI)
Baden-Baden, Germany
8
12
Dr. Karl-Ludwig Ackermann
Filderstadt, Germany
14
18
Dr. Thomas Barth
Leipzig, Germany
15
28
Dr...
Abbreviations
ASA:
American Society of Anesthesiologists
MPI:
Modified Plaque Index
PPD:
Pocket probing depth
RCT:
Randomized controlled clinical trial
SBI:
Sulcus Bleeding Index
SD:
Standard deviation
SLA:
Sand-blasted, large grit, acid-etched
References
Hjalmarsson L, Gheisarifar M, Jemt T. A systematic review of survival of s...
The appearance of poorer oral hygiene later in the study also appears to correspond with the drop in follow-up attendance, which again supports the importance of follow-up. All other complications could be resolved and were not persisting. Furthermore, patients selected for inclusion in this study were optimal candidates for dental implants. Though the inclusion criteria predestinate the patient s...
At 5-year follow-up, the overall SBI was 0.32 ± 0.49, reflective of no bleeding given that 0 equals no bleeding and 1 equals isolated bleeding spots visible [27]. The PPD initially decreased within the first 6 months from which point it significantly increased to 2.34 ± 1.18 mm at 5-year follow-up.
Nevertheless, the measured mean PPD still reflects the norm for conventionally placed i...
On the one hand, the variety of bone level changes in this study may be explained by different vertical soft tissue thicknesses, but cannot be validated due to these missing data. On the other hand, there are multiple confounding factors influencing the change in bone level, such as the size of the platform (mismatch), occlusal loading, and the microgap. Additional to the standard success criteria...
Over the 5-year study period, we report
At 3-year follow-up, bone loss was noted in one patient (reclassified as peri-implantitis at the 4-year follow-up) and an important bone loss (due to poor oral hygiene and bruxism; two implants) in a patient with psychosocial issues who could not be treated during the study. Such a patient would not have been included in an RCT.
Consequently, three implants were lost based on the bone loss criter...
Discussion and conclusions
This large, multicenter study provides real-life long-term data on 285 implants placed in 196 patients. The results show that the placement of CAMLOG SCREW-LINE implants with platform-matching or platform-switching abutments results in high survival and success in the long term. The overall success rate for implants was 97.1% at 5-year post-loading, and 97.4% and 96.2...
Jemt papilla score
At loading, the Jemt papilla score was 1.93 ± 1.01, significantly increasing to 2.14 ± 0.95 at 5-year follow-up (p = 0.023) (Fig. 2d). For the platform-switching subgroup, a significant difference was observed between baseline and 5-year follow-up (p
Implant survival
The cumulative survival rate was 100% at 1-year follow-up, 99.6% at 3-year follow-up, and 98.6% at 5-year follow-up. All three late failures were in the platform-switching subgroup.
Clinical parameters/soft tissue parameters
Plaque index
Mean modified plaque indices were very low at below 0.5 for all but one measurement throughout the course of the study (Fig. 2a). At loading...
Results
Patient demographics
In total, 196 patients from 17 centers met the inclusion criteria for this study and were included in the per-protocol analysis. In total, 285 implants were placed (Table 1). At the 5-year follow-up, data were available for the 137 patients who completed the study (Fig. 1). Patient demographic data is presented in Tables 2 and 3.
Implant success
Implant success...
The primary stability of the implant was assessed during surgery. Implant success and survival were evaluated in the group of implants restored with abutments [5, 29] at both placements of the provisional and definitive prostheses and at each follow-up visit thereafter. Implants were deemed successful in accordance with the criteria for implant success laid down by Albrektsson et al. [30]. Implan...
Assessments
Throughout the study, only radiographs consistent with standard implant procedures were taken. Bone level changes were assessed based on available and evaluable standardized periapical radiographs with a film-holder using parallel-technique or panoramic radiographs (depending on the standard in the study centers). Baseline was defined as the time of the first prosthetic installati...
The treatment indications were single or multiple tooth replacement in the maxilla or mandible without the use of simultaneous augmentation or membrane, of which the implants were to be restored with either fixed single crown or fixed partial denture restorations.
Treatment procedure
Patients were to be treated according to standard practice for implant procedures applicable in the countries par...
Methods
Study design
This was a prospective multicenter non- interventional study to assess implant success and survival rates in daily dental practices using the CAMLOG SCREW-LINE implants (CAMLOG Biotechnologies AG, Basel, Switzerland) used with or without platform-switching abutments. Patients were enrolled over a period of 2 years from October 2008 to September 2010 from 17 sites across f...
In the present study, CAMLOG SCREW-LINE implants with the Promote plus surface (sandblasted and acid-etched surface) were used. These implants in combination with platform-matching abutments have been shown to have high long-term success rates ranging from 97.8 to 100% at 5-year to 10-year follow-up [9,10,11,12,13]. They can be restored with either platform-matching or platform-switching abutments...
Background
Success and survival rates of endosseous implants are well-documented in a number of controlled clinical trials and systematic reviews [1,2,3]. Generally, controlled trials evaluate endosseous implants in specific clinical situations; thus, the patient population is subjected to rigorous inclusion criteria and follow-up. Accordingly, controlled clinical trials do not reflect th...
Implant success and survival rates in daily dental practice: 5-year results of a non-interventional study using CAMLOG SCREW-LINE implants with or without platform-switching abutments
Abstract
Background
The performance of dental implants in controlled clinical studies is often investigated in homogenous populations. Observational studies are necessary to evaluate the outcome of implant resto...
How do we define a case of peri‐implantitis in day‐to‐day clinical practice and teaching situations?
Diagnosis of peri‐implantitis requires:
Presence of bleeding and/or suppuration on gentle probing.
Increased probing depth compared to previous examinations.
Presence of bone loss beyond crestal bone level changes resulting from initial bone remodeling.
In the a...
The following case definitions and characteristics of peri‐implant health, peri‐implant mucositis, and peri‐implantitis should be viewed within context of several potential confounding factors.
It is known that there is no generic implant and that there are numerous implant designs with different surface characteristics, surgical and loading protocols. The degree of physiological remodeli...
What are the main factors associated with hard‐ and soft‐tissue deficiencies at potential implant sites?
The healing process following tooth loss leads to diminished dimensions of the alveolar process/ridge representing hard‐ and soft‐tissue deficiencies. Larger deficiencies may occur at sites exposed to the following factors: loss of periodontal support, endodontic in...
What is peri‐implantitis?
Peri‐implantitis is a plaque‐associated pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri‐implant mucosa and subsequent progressive loss of supporting bone.
What is the evidence for plaque/biofilm as a principal etiological factor for peri‐implantitis?
There is evidence ...
What are the clinical characteristics of peri‐implant mucositis?
The main clinical characteristic of peri‐implant mucositis is bleeding on gentle probing. Erythema, swelling and/or suppuration may also be present.
Does peri‐implant mucositis exist in the absence of clinical signs of inflammation?
Clinical signs of inflammation are necessary for a diagnosis of peri...
What are the clinical characteristics of a healthy peri‐implant site?
In health, the peri‐implant site is characterized by absence of erythema, bleeding on probing, swelling and suppuration.
What are the main clinical differences between healthy peri‐implant and periodontal tissues?
In health, there are no visual differences between peri‐implant and periodontal t...
The objective of Workgroup 4 was to present a classification on peri‐implant diseases and conditions. Five position papers describing the characteristics of peri‐implant health, peri‐implant mucositis, peri‐implantitis, soft and hard tissue deficiencies and case definitions and diagnostic considerations were prepared prior to the workshop.
In preparing this consensus report regarding...
Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions
Abstract
A classification for peri‐implant diseases and conditions was presented. Focused questions on the characteristics of peri‐implant health, peri‐implant mucositis, peri‐implantitis, and soft‐ and hard‐tissue deficiencies were addressed.
...