title: Long-term clinical, microbiological, and radiographic outcomes of Brånemark™ implants installed in augmented maxillary bone for fixed full-arch rehabilitation.
abstract: OBJECTIVE
  The purpose of this study was to document the long-term outcome of Brånemark implants installed in augmented maxillary bone and to identify parameters that are associated with peri-implant bone level.
  
  
  METHODS
  Patients of a periodontal practice who had been referred to a maxillofacial surgeon for iliac crest bone grafting in the atrophic maxilla were retrospectively recruited. Five months following grafting, they received 7-8 turned Brånemark implants. Following submerged healing of another 5 months, implants were uncovered and restorative procedures for fixed rehabilitation were initiated 2-3 months thereafter. The primary outcome variable was bone level defined as the distance from the implant-abutment interface to the first visible bone-to-implant contact. Secondary outcome variables included plaque index, bleeding index, probing depth, and levels of 40 species in subgingival plaque samples as identified by means of checkerboard DNA-DNA hybridization.
  
  
  RESULTS
  Nine out of 16 patients (eight females, one male; mean age 59) with 71 implants agreed to come in for evaluation after on average 9 years (SD 4; range 3-13) of function. One implant was deemed mobile at the time of inspection. Clinical conditions were acceptable with 11% of the implants showing pockets ≥ 5 mm. Periodontopathogens were encountered frequently and in high numbers. Clinical parameters and bacterial levels were highly patient dependent. The mean bone level was 2.30 mm (SD 1.53; range 0.00-6.95), with 23% of the implants demonstrating advanced resorption (bone level > 3 mm). Regression analysis showed a significant association of the patient (p < .001) and plaque index (p = .007) with bone level.
  
  
  CONCLUSIONS
  The long-term outcome of Brånemark implants installed in iliac crest-augmented maxillary bone is acceptable; however, advanced peri-implant bone loss is rather common and indicative of graft resorption. This phenomenon is patient dependent and seems also associated with oral hygiene.
authors: Periodontitis, professor and chairman, University of Ghent, Faculty of Medicine and Health Sciences, Dental School, Department of Periodontology and Oral Implantology, Ghent Belgium.
authors: Hugo
authors: H
authors: De Bruyn
authors: student undergraduate dentistry, University of Ghent, Faculty of Medicine and Health Sciences, Dental School Department of Periodontology and Oral Implantology, Ghent, Belgium.
authors: Peter
authors: P
authors: Bouvry
authors: periodontist, Centre for Periodontology and Oral Implantology, Heverlee, Belgium.
authors: Bruno
authors: B
authors: Collaert
authors: maxillofacial surgeon, professor and chairman, AZ Sint-Jan, Department of Oral and Maxillofacial Surgery, Bruges, Belgium.
authors: Calix
authors: C
authors: De Clercq
authors: periodontist, professor, University of Berne, Department of Periodontology, Division of Oral Microbiology, Berne, Switzerland; and periodontist, professor, University of Washington, Department of Periodontics, Seattle, WA, USA.
authors: G Rutger
authors: GR
authors: Persson
authors: professor, Free University of Brussel (VUB), Dental Medicine, Brussels, Belgium, and assistant professor, University of Ghent, Faculty of Medicine and Health Sciences, Dental School, Department of Periodontology and Oral Implantology, Ghent, Belgium.
authors: Jan
authors: J
authors: Cosyn
mesh_terms: D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000209:etiology*; D016025:Bone Transplantation; D004269:DNA, Bacterial / Q000032:analysis; D015921:Dental Implants / Q000009:adverse effects; D003773:Dental Plaque / Q000382:microbiology; D003774:Dental Plaque Index; D019094:Dental Prosthesis, Implant-Supported; D003824:Denture, Complete; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D009693:Nucleic Acid Hybridization; D009910:Oral Hygiene; D011859:Radiography; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D004269:DNA, Bacterial; D015921:Dental Implants