Peter J. Henry

Nine clinical centers using the Brånemark System participated in a prospective study of 159 partially edentulous patients between 18 and 70 years of age. Clinical parameters evaluated were plaque index, gingivitis, pocket depth, bleeding index, tooth mobility, and stomatognathic function. Initially, 558 fixtures were placed and 521 remained in the study following prosthesis placement (199 prostheses in 154 patients). Fixtures were lost or unaccounted for because of nonintegration prior to prosthesis fabrication (19), patient withdrawal (11), prosthodontic reasons (6), and failure during prosthetic procedures (1). Failure was primarily attributable to unfavorable bone quality, sex (more in males), and smaller fixture size. Complications and failure related to other patient characteristics are presented. After 1 year of a 5-year study, preliminary results suggest that a success rate equal to or better than that obtained with edentulous patients may be expected.

A total of 127 partially edentulous patients, treated according to the Brånemark protocol, was followed for 10 years after completion of prosthetic treatment. The patients ranged in age from 18 to 70 years, and 57% were female. Four hundred sixty-one implants were placed in 56 maxillae and 71 mandibles. In 125 patients, 163 fixed partial prostheses were attached to the implants; a majority of the prostheses (83%) were located in posterior regions. At the end of the 10-year period, 73% of the implants could be traced either as failed or in function, providing cumulative implant survival rates of 90.2% and 93.7% for the maxilla and mandible, respectively. Of the original fixed prostheses, 63% (cumulatively 86.5%) were still in use, whereas the level of continuous cumulative prosthesis function, including primary and remade restorations, was 94.3% at the end of the evaluation period. Marginal bone resorption at the implants was low (mean = 0.7 mm), and mucosal health was good. No severe complications apart from the above-mentioned implant and prosthetic failures were reported. The Brånemark Implant System is a safe and predictable method for restoring partially edentulous patients, as demonstrated by this 10-year follow-up investigation.

The dependence of vascular relaxation on an intact endothelium and the relationship between relaxation and cyclic GMP accumulation were determined in coronary arteries isolated from cardiac transplantation patients with or without coronary atherosclerosis. In nonatherosclerotic arteries, the endothelium-dependent agent acetylcholine produced concentration-related relaxations. In atherosclerotic arteries, endothelium-dependent relaxations were abolished with acetylcholine, partly suppressed with substance P and histamine, and completely preserved with the ionophore A23187. In these arteries, the endothelium-independent agent nitroglycerin remained fully active. Accumulation of cyclic GMP in atherosclerotic strips was suppressed with acetylcholine but unattenuated with A23187 and nitroglycerin. In aortas from rabbits with diet-induced atherosclerosis, there was likewise an impaired cholinergic relaxation and cyclic GMP accumulation in the presence of preserved responses to A23187 and nitroglycerin. The results demonstrate that impaired cholinergic responses in atherosclerotic arteries reflect a muscarinic defect and not an inability of endothelium to release endothelial factor or smooth muscle to respond to it.

One hundred seven Brånemark implants were placed in 92 patients participating in an international multicenter trial on single-implant restorations at seven centers. The patients were followed for 5 years in a prospective study focusing on implant success and crown function. Plaque and gingival indexes, as well as probing depths, were recorded around teeth and implants. The marginal bone level at implants was determined from intraoral radiographs. Only three implants (2.8%) had been lost at the final annual checkup. During the follow-up period, a total of 17 patients dropped out or were excluded because of nonconformity with the protocol. Based on the remaining patients, a total of 86 implants were clinically and radiographically evaluated at the 5-year follow-up period, resulting in a cumulative success rate of 96.6% (71 implants) in the maxillae and 100% (15 implants) in the mandibles. Plaque and gingival indexes showed a similar pattern of good health around both natural teeth and titanium abutments. The marginal bone loss during the 5-year period did not exceed 1 mm as a mean for all implants analyzed. The most frequent complication recorded during the follow-up was loosening of the abutment fixation screw. The outcome of this study indicated that safe and highly predictable results can be obtained for 5 years when Brånemark implants are used to support single-tooth restorations.

We tested the effects of nifedipine, a calcium antagonist, on atherogenesis in rabbits fed a 2% cholesterol diet. The drug was given orally, 40 mg/dl, and control rabbits received placebo. Nifedipine was well tolerated, and evoked only transient, moderate reductions in arterial pressure. Plasma total cholesterol after 8 wk before killing the rabbits was similar in the placebo and nifedipine-treated groups, averaging 1,903 +/- 138 (n = 13) and 1,848 +/- 121 mg/dl (n = 13; mean +/- SE; P greater than 0.8). In placebo-treated rabbits, aortic lesions stainable with Sudan IV covered 40 +/- 5% of the intimal surface, and the cholesterol concentration in aortic tissue was 47 +/- 5 mg/g protein. Corresponding values for the aortas from nifedipine-treated rabbits were significantly lower and averaged 17 +/- 3% (P less than 0.001) and 29 +/- 2 mg/g protein (P less than 0.001). We conclude that nifedipine suppressed atherogenesis without reducing hypercholesterolemia.