Publications by authors named "Bruno R Chrcanovic"

15 Publications

  • Page 1 of 1

A Randomized Clinical Trial Comparing Immediate Loading and Delayed Loading of Single-Tooth Implants: 5-Year Results.

J Clin Med 2021 Mar 5;10(5). Epub 2021 Mar 5.

Department of Prosthodontics, Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden.

The aim of this prospective randomized clinical study was to compare the clinical treatment outcome for single dental implants submitted to either immediate loading (IL) or delayed loading (DL) after 5 years of follow-up. Fifty patients with a missing maxillary tooth (15-25) were randomly allocated to either the IL or DL. The treatment procedures included implant installation in healed sites, temporary screw-retained crown and replacement with a permanent single implant crown. The two groups were evaluated with regard to implant survival, marginal bone level, papillae index, pink and white esthetic score (PES, WES). At the 5-year follow-up the implant survival rate was 100% and 95.8% for IL and DL, respectively. Implant success rate was 91.7% and 83.3% for IL and DL, respectively. The mean ± SD marginal bone loss for IL and DL was -0.50 ± 0.73 mm and -0.54 ± 0.65 mm, respectively. ( = 0.782). Statistically significant less marginal bone loss was found non-smokers ( = 0.021). No statistically significant differences were found for IL and DL concerning papillae index PES and WES after 5 years. This study suggests that implant-supported single crowns in the maxillary aesthetic zone can present similar results with respect to either IL or DL after 5 years.
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http://dx.doi.org/10.3390/jcm10051077DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7961588PMC
March 2021

Long-Term Survival and Complication Rates of Porcelain Laminate Veneers in Clinical Studies: A Systematic Review.

J Clin Med 2021 Mar 5;10(5). Epub 2021 Mar 5.

Department of Prosthodontics, Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden.

The presented study aimed to assess the survival rate of porcelain laminate veneers (PLV) based on a systematic review of the literature. An electronic search was last updated in February 2021. Eligibility criteria included clinical series of patients rehabilitated with PLVs published in the last 25 years, with a minimum follow-up of 3 years. Survival analysis methods were applied. Twenty-five studies were included, with 6500 PLVs. The 10-year estimated cumulative survival rate (CSR) of PLVs was 95.5%. The 10-year CSR of PLVs when fracture, debonding, occurrence of secondary caries, and need of endodontic treatment were considered as isolated reasons for failure were 96.3%, 99.2%, 99.3%, and 99.0%, respectively. PLVs without incisal coverage had a higher failure rate than PLVs with incisal coverage. Non-feldspathic PLVs performed better than feldspathic PLVs. As a conclusion, the 10-year CSR of PLVs was 95.5%, when fracture, debonding, occurrence of secondary caries, and need of endodontic treatment were considered as reasons for restoration failure. Fracture seems to be most common complication of PLVs, followed by debonding, with both more commonly happening within the first years after PLV cementation. PLVs with incisal coverage and non-feldspathic PLVs presented lower failure rates than PLVs without incisal coverage and feldspathic PLVs.
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http://dx.doi.org/10.3390/jcm10051074DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7961608PMC
March 2021

Retrospective study comparing the clinical outcomes of bar-clip and ball attachment implant-supported overdentures.

J Oral Sci 2020 Sep 26;62(4):397-401. Epub 2020 Aug 26.

Department of Prosthodontics, Faculty of Odontology, Malmö University.

The aim of this study was to compare the clinical outcomes of implant-supported overdentures (ODs) with either bar-clip or ball attachments. The implant, prosthesis failure, and technical complications were the outcomes analyzed in this retrospective clinical study conducted in a specialty clinic. Seventy-five patients with 242 implants supported by 76 ODs (36 maxillary, 40 mandibular) were included in the study and followed up for 88.8 ± 82.9 months (mean ± standard deviation). Bar-clip and ball attachments were used in 78.9% and 21.1% of the cases, respectively. Forty-three implant failures (17.8%) in 17 prostheses (17/76; 22.4%) were observed in this study. The average period of implant failure was 43.3 ± 41.0 months, and most of them were maxillary turned implants. The bar-clip system demonstrated more complications in the attachment parts compared to the ball attachment system. Poor retention of the prosthesis was similar between the two systems. Loss of implants resulted in the failure of 10 ODs in this study. ODs opposed by natural dentition or fixed prostheses presented with more complications. The Cox proportional hazards model did not show a significant effect on prosthesis failure for any of the factors. These findings indicated that patients with ODs need constant maintenance follow-ups to address the technical complications and perform prosthodontic maintenance regardless of the attachment system used.
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http://dx.doi.org/10.2334/josnusd.19-0412DOI Listing
September 2020

Retrospective evaluation of implant-supported full-arch fixed dental prostheses after a mean follow-up of 10 years.

Clin Oral Implants Res 2020 Jul 6;31(7):634-645. Epub 2020 Apr 6.

Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.

Objective: To assess the outcomes of implant-supported full-arch fixed dental prostheses (ISFAFDPs) and the supporting implants.

Material And Methods: This retrospective study included patients treated with ISFAFDPs at one specialist clinic. Implant/prosthesis failure and complications were the outcomes analyzed. Survival analysis methods were used.

Results: A total of 709 patients with 869 ISFAFDPs (4,797 implants) were included, with a mean ± SD follow-up of 10.7 ± 7.2 years. A total of 353 implants and 62 prostheses failed. Estimated cumulative survival rates were as follows: 93.3% (95% CI 91.3, 95.3) after 10 years and 87.1% (95% CI 83.4, 90.8) after 20 years. Implants installed in bruxers, smokers, and maxilla had a lower survival than implants installed in non-bruxers, non-smokers, and mandible, respectively. A total of 415 ISFAFDPs (47.8%) presented technical complications, of which 67 (7.7%) presented only occurrences of loss/fracture of implant access hole sealing. Bruxism was a factor to exert a higher risk of screw loosening (HR 3.302; also in younger patients), screw fracture (HR 4.956), ceramic chipping/fracture (HR 5.685), and loss/fracture of acrylic teeth (HR 2.125; this last complication with higher risk also in men, in maxillae, and when the opposing jaw presented natural dentition or fixed prostheses). Patients with bruxism had a statistically significant higher risk of prosthesis failure than non-bruxers (HR 3.276).

Conclusions: ISFAFDPs presented good long-term prognosis. Failure of several supporting implants was the main reason for failure. The results of the present study strongly suggest that bruxism is an important contributor to implant and prosthesis failure, as well as to an increased prevalence of technical complications in ISFAFDPs.
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http://dx.doi.org/10.1111/clr.13600DOI Listing
July 2020

Retrospective clinical evaluation of 2- to 6-unit implant-supported fixed partial dentures: Mean follow-up of 9 years.

Clin Implant Dent Relat Res 2020 Apr 11;22(2):201-212. Epub 2020 Mar 11.

Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.

Background: Implant-supported fixed partial dentures (ISFPDs) are one of the most common options to rehabilitate partially edentulous patients.

Purpose: To assess the clinical outcomes of ISFPDs.

Methods: This retrospective study included all patients treated with ISFPDs with 2 to 6 prosthetic units at one specialist clinic. Implant/prosthesis failure and technical complications were the outcomes analyzed.

Results: Six hundred and forty-two patients with 876 ISFPDs (2241 implants) were included, followed up for 108.0 ± 76.2 months. Eighty-eight prostheses and 112 implants (26 before, 86 after prosthesis installation) failed. The estimated CSR of ISFPDs at 30 years was 72.7%. Smokers presented lower implant survival than nonsmokers. Two hundred and ninety-nine ISFPDs (33.2%) presented technical complications. Bruxism was a factor to exert a higher risk of screw and implant fracture, and ceramic chipping. ISFPDs with cantilever presented higher risk of failure, and screw loosening/fracture. Prostheses supported by implants with internal abutment connection or with two pontics had higher risk of presenting ceramic chipping. Extension of the prosthesis did not seem to exert influence on prosthesis failure/complications.

Conclusions: ISFPDs presented good long-term prognosis. Implant failure was the main reason for ISFPD failure. The results suggest that bruxism and the presence of cantilever may contribute to the increased rate of mechanical complications and prosthesis failure.
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http://dx.doi.org/10.1111/cid.12889DOI Listing
April 2020

Odontogenic myxoma: An updated analysis of 1,692 cases reported in the literature.

Oral Dis 2019 Apr 8;25(3):676-683. Epub 2018 Jun 8.

Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

The aim of the present study was to integrate the available data published on odontogenic myxoma (OM) into a comprehensive analysis of its clinical/radiological features. Electronic search undertaken in January/2018, looking for publications reporting cases of OM. A total of 377 publications were included. We identified 1,692 lesions, and 695 were used for the analysis of recurrence. There is a predominance of OMs in females and in mandibles. OMs usually present with bone expansion, asymptomatic cortical perforation, and a multilocular appearance. Lesion location (maxilla/mandible), bone expansion, cortical bone perforation, locular radiological appearance, tooth resorption, odontogenic epithelial rests, or angular septa are not associated with recurrence. While curettage (31.3%) showed the highest recurrence rate, marginal resection (1.3%) and segmental resection (3.1%) showed the lowest values. Enucleation + peripheral osteotomy (6.7%) showed better results than enucleation (13.1%) or enucleation + curettage (12.7%). In comparison with unilocular lesions, multilocular ones were significantly more prevalent in mandibles, more often presented expansion and cortical bone perforation, had larger mean size, and were more often treated by segmental resection. Conservative surgical procedures are associated with higher probability of recurrence of OM. Taking into consideration the recurrence rate and morbidity associated with different surgical treatments, tumor enucleation followed by peripheral osteotomy should be considered as the first therapeutic choice.
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http://dx.doi.org/10.1111/odi.12875DOI Listing
April 2019

Survival of dental implants placed in sites of previously failed implants.

Clin Oral Implants Res 2017 Nov 14;28(11):1348-1353. Epub 2016 Oct 14.

Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden.

Objectives: To assess the survival of dental implants placed in sites of previously failed implants and to explore the possible factors that might affect the outcome of this reimplantation procedure.

Materials And Methods: Patients that had failed dental implants, which were replaced with the same implant type at the same site, were included. Descriptive statistics were used to describe the patients and implants; survival analysis was also performed. The effect of systemic, environmental, and local factors on the survival of the reoperated implants was evaluated.

Results: 175 of 10,096 implants in 98 patients were replaced by another implant at the same location (159, 14, and 2 implants at second, third, and fourth surgeries, respectively). Newly replaced implants were generally of similar diameter but of shorter length compared to the previously placed fixtures. A statistically significant greater percentage of lost implants were placed in sites with low bone quantity. There was a statistically significant difference (P = 0.032) in the survival rates between implants that were inserted for the first time (94%) and implants that replaced the ones lost (73%). There was a statistically higher failure rate of the reoperated implants for patients taking antidepressants and antithrombotic agents.

Conclusions: Dental implants replacing failed implants had lower survival rates than the rates reported for the previous attempts of implant placement. It is suggested that a site-specific negative effect may possibly be associated with this phenomenon, as well as the intake of antidepressants and antithrombotic agents.
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http://dx.doi.org/10.1111/clr.12992DOI Listing
November 2017

Chemical and Topographic Analysis of Eight commercially Available Dental Implants.

J Contemp Dent Pract 2016 May 1;17(5):354-60. Epub 2016 May 1.

Department of Prosthodontics, Faculty of Odontology, MalmS University, MalmS, Sweden.

Background: Surface characterization of dental implants allows us to better understand the effects of the implant on the host biological response. In this study, we analyzed and compared these characteristics among implants commercially available in South Africa.

Materials And Methods: Eight implants from different manufacturers were chosen for analysis (Touareg, ICE, (R)Evolutions, Uniti, AnyRidge, MIS, Ivory-QSI, Southern), using scanning electron microscopy (SEM), interferometry, and energy dispersive X-ray spectroscopy to study the surface chemical composition and morphology.

Results: The results indicate that variations in manufacturer processes result in implant surfaces that are distinctly different from one another. Most implants presented a moderately rough surface with sandblasted-only implant surfaces having a lower mean value of Sa when compared with sandblasted and acid-etched surfaces. Carbon contamination was detected on all the implants and that of aluminum on five implant surfaces. Ca and P were detected on the surface of Touareg implants, indicating the manufacturer's attempt to enhance osseointegration.

Conclusion: The surface of the implants showed a range of chemical, physical properties, and surface topographies.

Clinical Significance: The results indicate that implant surface treatment is not standardized. This may have clinical implications. Further clinical research is required.
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http://dx.doi.org/10.5005/jp-journals-10024-1855DOI Listing
May 2016

The influence of 1α.25-dihydroxyvitamin d3 coating on implant osseointegration in the rabbit tibia.

J Oral Maxillofac Res 2014 Jul 1;5(3):e3. Epub 2014 Oct 1.

epartment of Prosthodontics, Faculty of Odontology, Malmö University, Malmö Sweden.

Objectives: This study aims to evaluate bone response to an implant surface modified by 1α,25-dihydroxyvitamin D3 [1.25-(OH)2D3] in vivo and the potential link between 1.25-(OH) 2D3 surface concentration and bone response.

Material And Methods: Twenty-eight implants were divided into 4 groups (1 uncoated control, 3 groups coated with 1.25-(OH)2D3 in concentrations of 10(-8), 10(-7) and 10(-6) M respectively), placed in the rabbit tibia for 6 weeks. Topographical analyses were carried out on coated and uncoated discs using interferometer and atomic-force-microscope (AFM). Twenty-eight implants were histologically observed (bone-to-implant-contact [BIC] and new-bone-area [NBA]).

Results: The results showed that the 1.25-(OH)2D3 coated implants presented a tendency to osseointegrate better than the non-coated surfaces, the differences were not significant (P > 0.05).

Conclusions: The effect of 1.25-(OH)2D3 coating to implants suggested possible dose dependent effects, however no statistical differences could be found. It is thought that the base substrate topography (turned) could not sustain sufficient amount of 1.25-(OH)2D3 enough to present significant biologic responses. Thus, development a base substrate that can sustain 1.25-(OH)2D3 for a long period is necessary in future studies.
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http://dx.doi.org/10.5037/jomr.2014.5303DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4219862PMC
July 2014

Surface structure and mechanical properties of impaction-modified Y-TZP.

Dent Mater 2014 Aug 21;30(8):808-16. Epub 2014 Jun 21.

Department of Materials Science and Technology, Faculty of Odontology, Malmö University, Carl Gustafs väg 34, 205 06 Malmö, Sweden. Electronic address:

Objectives: The objectives of the study were to describe the surface structure and the chemical surface composition of Y-TZP ceramics produced by using the modified additive technique and to evaluate the flexural strength of Y-TZP with or without surface modification and with different pretreatments: etching before or after sintering combined with or without an adhesive cement system.

Methods: Y-TZP discs were used for surface analysis (n=48) and for biaxial flexural strength testing (n=200). The specimens were divided into groups depending on the cementation surface of Y-TZP: unmodified, sandblasted or glass-modified Y-TZP surfaces, and according to the production process: etching before or after sintering.

Results: The surface structure and the chemical composition of glass-modified Y-TZP differ; a rougher surface and phase transformation was identified compared to unmodified Y-TZP. The unmodified Y-TZP groups showed significantly higher flexural strength compared to the glass-modified groups (p<0.001) and showed increased flexural strength after sandblasting (p<0.001). Furthermore, by adding cement to the surface, the value increased even further in comparison with the sandblasted non-cemented specimens (p<0.01). After thermocycling, however, the cement layer on the unmodified and the sandblasted surfaces had air pockets and regions with loose cement.

Significance: A rougher surface structure, superficial glass remnants and a higher content of m-phase was present in the cementation surface of glass-modified Y-TZP. The glass modification creates a bondable cementation surface that is durable. By etching the glass-modified Y-TZP before sintering, a more homogenous surface is created compared to one that is etched after sintering.
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http://dx.doi.org/10.1016/j.dental.2014.05.002DOI Listing
August 2014

Characteristics of 2 Different Commercially Available Implants with or without Nanotopography.

Int J Dent 2013 2;2013:769768. Epub 2013 Oct 2.

Department of Prosthodontics, Faculty of Odontology, Malmö University, 205 06 Malmö, Sweden.

The aim of this study was to assess histologically and histomorphometrically the early bone forming properties after 3 weeks for 2 commercially available implants, one supposedly possessing nanotopography and one without, in a rabbit femur model. Twenty-four implants divided equally into 2 groups were utilized in this study. The first group (P-I MICRO+NANO) was a titanium oxide (TiO2) microblasted and noble gas ion bombarded surface while the second group (Ospol) was anodic oxidized surface with calcium and phosphate incorporation. The implants were placed in the rabbit femur unicortically and were allowed to heal for 3 weeks. After euthanasia, the samples were subjected to histologic sectioning and bone-implant contact and bone area were evaluated histomorphometrically under an optical microscope. The histomorphometric evaluation presented that the P-I MICRO+NANO implants demonstrated significantly higher new bone formation as compared to the Ospol implants. Within the limitations of this study, the results suggested that nanostructures presented significantly higher bone formation after 3 weeks in vivo, and the effect of chemistry was limited, which is indicative that nanotopography is effective at early healing periods.
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http://dx.doi.org/10.1155/2013/769768DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3808707PMC
November 2013

Prevalence of enamel pearls in teeth from a human teeth bank.

J Oral Sci 2010 Jun;52(2):257-60

Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Borizonte, MG, Brazil.

Enamel pearls are anatomical structures that can bring about clinical implications if associated with the retention of plaque, in turn resulting in periodontal disease. In an attempt to avoid periodontal disease, the removal and treatment of these enamel pearls, may be a necessity in some circumstances. A total of 45,785 extracted teeth from a human teeth bank were analyzed for the presence of enamel pearls. The most prevalent anatomical location of enamel pearls was the permanent maxillary first and second molar region. An association between the prevalence of enamel pearls and dental class (P < 0.001) was observed, most frequently in the maxillary molars. In the maxillary molars, the most prevalent anatomical location of enamel pearls in the first and second molars was the furcation between the distobuccal and palatal roots. Enamel pearls are a common observation in molars in general, but are most commonly found in maxillary molars.
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http://dx.doi.org/10.2334/josnusd.52.257DOI Listing
June 2010

Accuracy evaluation of computed tomography-derived stereolithographic surgical guides in zygomatic implant placement in human cadavers.

J Oral Implantol 2010 14;36(5):345-55. Epub 2010 Jun 14.

Pontifícia Universidade Católica de Minas Gerais, Minas Gerais, Brazil.

Presurgical planning is essential to achieve esthetic and functional implants. For implant planning and placement, the association of computer-aided design (CAD) and computer-aided manufacturing (CAM) techniques furnishes some advantages regarding tridimensional determination of the patient's anatomy and fabrication of both anatomic models and surgical guides. The goal of this clinical study was to determine the angular deviations between planned and placed zygomatic implants using stereolithographic surgical guides in human cadavers. A total of 16 zygomatic implants were placed, 4 in each cadaver, with the use of stereolithographic (SLA) surgical guides generated by computed tomography (CT). A new CT scan was made after implant insertion. The angle between the long axis of the planned and actual implants was calculated. The mean angular deviation of the long axis between the planned and placed implants was 8.06 ± 6.40 (mean ± SD) for the anterior-posterior view, and 11.20 ± 9.75 (mean ± SD) for the caudal-cranial view. Use of the zygomatic implant, in the context of this protocol, should probably be reevaluated because some large deviations were noted. An implant insertion guiding system is needed because this last step is carried out manually. It is recommended that the sinus slot technique should be used together with the CT-based drilling guide to enhance final results. Further research to enhance the precision of zygomatic implant placement should be undertaken.
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http://dx.doi.org/10.1563/AAID-JOI-D-09-00074DOI Listing
November 2010

Anatomical variation in the position of the greater palatine foramen.

J Oral Sci 2010 Mar;52(1):109-13

Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil.

The present study measured the position of the greater palatine foramen relative to adjacent anatomical landmarks in Brazilian skulls. The perpendicular distance of the greater palatine foramen to the midline maxillary suture in Brazilian skulls was about 14 mm and the distance of greater palatine foramen to the incisive foramen was approximately 36 mm. The distance of greater palatine foramen to the posterior border of the hard palate was approximately 3 mm, and the mean angle between the midline maxillary suture and the line from the incisive foramen and the greater palatine foramen was 22.71 degrees . In almost 70% of the cases, the greater palatine foramen opened in an anterior direction. The mean palatine length was approximately 52 mm. In the greater majority of the skulls (93.81%), the greater palatine foramina were opposite or distal to the maxillary third molar. These data will be helpful in comparing these skulls to those from various other regions as well as comparing skulls of different races. It can also provide professionals with anatomical references, in order to block the maxillary division of the trigeminal nerve through the greater palatine foramen. Our results would help clinicians locate the greater palatine foramen in patients with and without upper molars.
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http://dx.doi.org/10.2334/josnusd.52.109DOI Listing
March 2010

Dermoid cyst of the floor of the mouth.

ScientificWorldJournal 2003 Mar 24;3:156-62. Epub 2003 Mar 24.

Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.

Dermoid cysts of the floor of the mouth are rare lesions thought to be caused by entrapment of germinal epithelium during the closure of the mandibular and hyoid branchial arches. They usually present as a nonpainful swelling. This type of lesion occurs more frequently in patients between 15 and 35 years, but can be seen in all age ranges. Histologically, all dermoids are lined by epidermis. The contents of the cyst lining determine the histological categories of the cyst: epidermoid, if epidermis is lining the cyst; dermoid, if skin annexes exist; or teratoid, if there are tissues derivated from the three germinal layers. Anatomical classification is useful for surgical approach choice, intra- or extraorally. This report presents a case of a dermoid cyst of the floor of the mouth in a 12-year-old patient, and a review of all steps necessary for its diagnosis and treatment was made.
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http://dx.doi.org/10.1100/tsw.2003.04DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5974892PMC
March 2003