Georg Mailath

Br∢nemark single tooth implants: A preliminary report of 76 implants

Seventy-six Brånemark single-tooth implants were inserted over a 6-year period. Two implants (2.63%) were removed during the follow-up period. All other implants received esthetic and functional single tooth crowns placed on a single tooth abutment or a CeraOne abutment. The most common complication observed was abutment screw loosening, which occurred with 12 crowns. However, it was possible to clearly reduce the occurrence of screw loosening by applying a defined torque. Peri-implant parameters were investigated on 56 implants that were in place for more than 1 year. Acceptable implant function was demonstrated with preestablished clinical parameters and radiographs. Despite the submucosal edge of the crown, peri-implant mucositis was not a major problem. The favorable clinical and esthetic results found in the study encourage an increased application of implants for single tooth restorations.

Long-term implant success at the Academy for Oral Implantology: 8-year follow-up and risk factor analysis

Purpose Rehabilitation of the incomplete dentition by means of osseointegrated dental implants represents a highly predictable and widespread therapy; however, little is known about potential risk factors that may impair long-term implant success. Methods From 2004 to 2012, a total of 13,147 implants were placed in 4,316 patients at the Academy for Oral Implantology in Vienna. The survival rates after 8 years of follow-up were computed using the Kaplan-Meier method, and the impact of patient- and implant-related risk factors was assessed. Results Overall implant survival was 97% and was not associated with implant length (P=0.930), implant diameter (P=0.704), jaw location (P=0.545), implant position (P=0.450), local bone quality (P=0.398), previous bone augmentation surgery (P=0.617), or patient-related factors including osteoporosis (P=0.661), age (P=0.575), or diabetes mellitus (P=0.928). However, smoking increased the risk of implant failure by 3 folds (P<0.001) and a positive history of periodontal disease doubled the failure risk (P=0.001). Conclusions Summing up the long-term results of well over 10,000 implants at the Academy for Oral Implantology in Vienna it can be concluded that there is only a limited number of patients that do not qualify for implant therapy and may thus not benefit from improved quality of life associated with fixed implant-retained prostheses. Graphical Abstract

A preliminary study of monocortical bone grafts for oroantral fistula closure

Sinus floor elevation has become a standard procedure in patients affected by severe maxillary atrophy, before implant placement, provided that the maxillary sinus is intact and uninfected. In the case of an oroantral fistula, simple soft tissue closure may interfere with the process of elevating the Schneiderian membrane. Total regeneration of the bony sinus floor is necessary to prevent disruption of the sinus membrane. In this study, 5 patients with oroantral fistulae of different causes were treated with autogenous monocortical bone blocks harvested from the chin. Press-fit closure for bony repair of the basal maxilla was sufficient in 3 of them. Two patients needed additional internal graft fixation. In the meantime, the 3 aforementioned patients underwent a successful sinus lift procedure. The use of a monocortical bone block for the closure of an oroantral fistula is recommended before internal sinus augmentation.

Five-year results of maxillary intramobile Zylinder implants.

We retrospectively analysed the time-dependent function of 501 Intramobile Zylinder (IMZ) implants inserted between August 1983 and December 1994 to restore partially and fully edentulous maxillae. To ensure the independence of implants when calculating level of significance, we chose one implant per patient at random. This was done 500 times to obtain a representative result. The simplified success rate was 473/501 (92%) whereas the time-related survival probability was 76% after 60 months. In 31% (156/500) of the life-table calculations, implants placed in completely edentulous maxillae showed a significantly lower probability of survival than did those placed in partially edentulous patients (P mean: 0.17; SD: 0.19). Implants, that had been placed in the anterior and premolar regions of edentulous maxillae, had a survival probability of 60%, after 60 months. The survival probability of implants placed in the molar region was 100%, over the same observation period. The patients age, sex, and the time of placement of the implant after tooth extraction had no significant influence on the implants prognosis. The prognosis of implants inserted for partial edentulism meets the criteria proposed for a viable implant system. Our findings indicate that in complete edentulous maxillae, implants should be placed in the posterior rather than in the anterior region, even though this necessitates augmentation procedures such as sinus lift.

Experience with radical surgical treatment of maxillofacial tumours invading the base of the skull. Long term results

A review of patient data of maxillofacial tumours invading the base of the skull shows a relatively high fatality rate as a result of surgical intervention but also an unexpectedly high life expectancy. Surgical intervention seems to be the right choice whenever clinical examination suggest tumour removal is possible even if a tumour cannot be extirpated in one operation and a further operation from a second access is needed.

Regional chemotherapy of inoperable maxillofacial tumours combined with radiotherapy. Long-term results.

At the Department of Oral Maxillo-Facial Surgery, University of Vienna, we have from January 1973 to September 1985, subjected 117 patients with inoperable malignant tumours in the maxillo-facial area to intra-arterial chemotherapy consisting of methotrexate and bleomycin. In this group 103 patients have also been given radiotherapy. In this report only 68 patients of the group of 103 patients who have undergone combined treatment have been considered eligible for evaluation on the basis of their post-therapeutic survival time, which ranged from 2 to 11 years. 10 cases with complete remission and 34 cases with partial remission were observed, indicating that 65% responded to combined treatment.

Immune Activation after Apicoectomy: Comparison between Patients with and without Prophylactic Antibiotic Therapy

Summary In humans neopterin concentrations represent a sensItive index of cell-mediated immune activation. In a previous study, we found significantly increasing neopterin concentrations in patients after dental extractions. In this study, we investigated whether prophylactic antibiotic treatment of patients influenced the course of neopterin levels in patients with apicoectomy. Urinary neopterin concentrations were monitored in 23 patients with apicoectomy in the front region. Urine samples were collected before and on days 1, 3, 5, 7, 9 after apicoectomy. Six patients received antibiotic therapy, 17 were without such treatment. We found that average neopterin concentrations increased preferentially in patients not treated with antibiotics whereas pateints treated with antibiotics showed only a moderate increase of neopterin levels which returned to normal within three days. We conclude that antibiotic treatment is able to reduce immune activation which is frequently seen in patients after apicoectomy, and we assume this maybe also true in patients after dental extractions. Most likely transient bacteraemia is the cause of immune activation in such patients. However, an inhibitory influence of antibiotics on cytokine cascades cannot be ruled out.