A Case Report on Gardner Syndrome With Dental Implant Treatment and a Long-Term Follow-Up.

A case of Gardner syndrome (GS) in a 37-year-old woman is presented in which rehabilitation with dental implant treatment was followed for 7 years. The course of diagnostics and treatment is followed through an overview of 45 tissue biopsy and cytology samples during a period of 30 years. The patient was diagnosed with GS after a routine review of an oral panoramic radiograph presenting with multiple osteomas and multiple unerupted supernumerary teeth. Biopsy results and surgical procedures with histopathologic diagnoses from 1986 to 2016 are presented. Histologic analysis of the sampled jawbone showed a picture similar to an osteoid osteoma. The installed implant was functionally stable, with no clinical or radiographic events observed at yearly visits, for 7 years. In 1991, benign tumors appeared; in 2014, multiple adenomas were found in the small intestine and rectum. This case report shows the potential for dental implant treatment in a patient with GS.

Long-term function of single-implant restorations: a 17- to 19-year follow-up study on implant infraposition related to the shape of the face and patients' satisfaction.

BACKGROUND: Various levels of infraposition of single-implant restorations have been observed in long-term follow-up studies, but little knowledge is available on the biological mechanism behind this pattern. PURPOSE: The primary aim of this study is to report the frequency and severeness of implant infraposition in the anterior single-implant application after 17 to 19 years in function and, secondly, to try to relate these observations to anatomical appearance of the shape of the face of the patient. MATERIALS AND METHODS: The present study comprised of 57 patients who were provided with 65 CeraOne™ single-tooth restorations (Nobel Biocare AB, Gothenburg, Sweden) between 1989 and 1991. Altogether 46 of these patients were treated with single implants in the anterior region. Besides clinical and radiographic data, clinical photographs, study casts, and patient's assessment of the long-term aesthetic result (visual analog scale) was collected at the termination of the present study. The degree of implant crown infraposition was related to assessed facial shape and to patient and clinical assessment of the aesthetic result by means of Pearson's correlation test. To increase the numbers of patients, another group of 25 patients presented in another similar study were pooled with the present material for prevalence calculations. RESULTS: Altogether 47 patients showed up for the final examination after an average of 18 years (82%). Two implants failed (18 years cumulative survival rates [CSR]- 96.8%) and eight original single-crown restorations were replaced (CSR 83.8%). Three of the replaced crowns were replaced because of infraposition of the crowns. About 40% of the patients showed signs of infraposition, similar in younger and older age groups, but more frequently observed in female patients at termination of the study (p < 0.05). There was a weak trend indicating an association between "long-face" appearance and infraposition of the crown restoration (p > 0.05), and patients were more satisfied with the aesthetic clinical result than the participating clinicians (p < 0.05). CONCLUSION: Single-implant restorations in the anterior upper jaw may present small degrees of infraposition in long-term perspectives. Female patients seem to be at a higher risk of infraposition (p < 0.05), but no clear relationship between age at implant placement or facial shape and degree of infraposition was possible to establish (p > 0.05). Patients were more satisfied with the aesthetic result, as compared with the clinicians (p < 0.05), and patients seemed to pay less attention to the degree of infraposition in their aesthetic assessments, as compared with most of the clinicians.

Long-term follow-up of CeraOne™ single-implant restorations: an 18-year follow-up study based on a prospective patient cohort.

BACKGROUND: Knowledge on long-term clinical performance of more than 5 years on the single-implant CeraOne™ (Nobel Biocare AB, Gothenburg, Sweden) concept is limited. PURPOSE: The aim of this study is to report the long-term clinical performance of the first CeraOne single-implant restorations, installed 17 to 19 years ago. MATERIALS AND METHODS: The group comprised 57 patients provided with 65 CeraOne single-tooth restorations. Sixty-two all-ceramic and three metal-ceramic crowns were cemented between 1989 and 1991. Patients were followed up clinically and with intraoral radiographs at placement, after 1, 5, and between 17 and 19 years after placement. RESULTS: Data were available for altogether 48 patients, followed up on an average time of 18 years. Excluding deceased patients (n=2) and failed implant patients (n=2), only five patients were lost to follow-up (8.8%). Two implants failed, resulting in an 18-year implant cumulative success rate (CSR) of 96.8%, and altogether eight original single-crown restorations were replaced (CSR 83.8%). The most common reason for crown replacement was infra-position of the implant crown (n=3). Many of the remaining original crowns showed various signs of implant crown infraposition at the termination of the study. In general, the soft tissue at the restorations was assessed to be healthy and comparable with the gingiva at the adjacent natural teeth. Bone levels were on an average stable with only few patients exhibiting bone loss of more than 2mm during 18 years in function. CONCLUSION: This long-term follow-up study of single-implant restorations shows encouraging results with few implant failures and minimal bone loss over an 18-year period. Original single-crown restorations were replaced more frequently, because of, for example, implant crown infraposition and veneer fractures. The CeraOne concept proved to be a highly predictable and safe prosthodontic treatment.