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Biomedical subjects

A D Guckes

Publications and source records attributed to A D Guckes.

24 records · Page 2Linked to original sources
PubMedDate not supplied

Treatment of edentulism using Astra Tech implants and ball abutments to retain mandibular overdentures.

The goal of this study was to provide evidence to support simplified treatment of mandibular edentulism using denture fabrication and implant placement to circumvent the need for second-stage surgeries or prosthodontic superstructures. A 5-year prospective clinical trial is reported, which involved treatment of mandibular edentulism using the single-stage surgical placement of a TiOblast microthreaded titanium screw implant with immediate replacement of a relieved mandibular overdenture and eventual retention of the overdenture with reduced ball abutments. Fifty-eight patients were treated; 116 implants were placed using a single-stage surgical approach, with a duplicate mandibular denture as the tomographic/surgical template. Mandibular dentures were relieved and relined with a tissue conditioning material and placed immediately after implant surgery. After 3 months, Conical Seal Design ball abutments were placed and attachments were secured in the overdentures by heat-polymerizing laboratory reline methods. Five of the 116 consecutively placed implants failed at 2 to 4 months, providing an immediate implant survival rate of 95.69% at the time of attachment connection. Pain and inflammation were not common to all failures, and infection was not reported in any of the 5 failures. The immediate placement of implants by a single-stage surgical procedure in the parasymphyseal region of the mandible, followed by placement of a relined mandibular denture, results in predictable and asymptomatic healing of implants that display the clinical and radiographic features of osseointegration. Encouraging results at the immediate observation period (attachment connection) must be tempered by the need for prudent and detailed clinical and radiologic evaluation over the 5-year trial period.

Adult↗
PubMedDate not supplied

Prognostic variables associated with implant failure: a retrospective effectiveness study.

The purpose of this study was to determine implant survival rates by means of life table analyses for a cohort of patients not part of a prospective efficacy trial and treated by practitioners at varying experience levels. Prognostic variables associated with implant failure were identified by means of proportional hazards models and advanced statistical methods that account for patient effects. Ninety-nine consecutive patients treated from 1987 to 1991 with follow-up to 1994 were included in this retrospective study. A total of 384 dental implants (79.7% Brånemark, 19.3% IMZ plasma-sprayed, 1% IMZ hydroxyapatite-coated) were placed and subsequently supported 108 prostheses. Survival and proportional hazards modeling were used to generate Kaplan-Meier survival curves and to identify variables associated with implant failure. Survey data analysis was used to adjust for any patient effects for variables identified as significant through the proportional hazards models. Thirty-four implants failed over the follow-up period (median follow-up time 3.6 years), resulting in an overall failure rate of 8.9%. Seventeen of 99 patients experienced an implant failure. When prosthesis type was excluded from the modeling process, survey data analysis identified posterior location and an implant width of less than 4.0 mm as being associated with implant failure (all P < .05).

Adult↗
PubMedDate not supplied

Pattern of permanent teeth present in individuals with ectodermal dysplasia and severe hypodontia suggests treatment with dental implants.

PURPOSE: The objective of this study was to assess the pattern of permanent teeth present in a self-selected sample of 17 female and 35 male patients with ectodermal dysplasia presenting for treatment with dental implants. METHODS: Mean age of sample: 18.7 years, age range: 5.9 to 60.9 years. Panoramic radiographs were examined independently by two investigators to determine the permanent teeth present. None of the sample reported extractions of permanent teeth prior to presenting for implants. RESULTS: Permanent teeth most likely to be present, reported as a percentage of the patient sample with that tooth, were: maxillary central incisors (42%), maxillary first molars (41%), mandibular first molars (39%), maxillary canines (22%), mandibular second molars (17%), maxillary second premolars (15%), and mandibular premolars (12%). Comparing dentition by quadrants, mandibular anterior teeth (canines and incisors) were least likely to be present. CONCLUSIONS: Results support previous findings that the maxillary central incisors, maxillary first molars, mandibular first molars, and maxillary canines are the most conserved teeth in hypodontia. Successful use of osseointegrated implants in the anterior mandibles of most of these patients suggests that habilitation of the mandible with dental implant-supported prostheses is a reasonable option.

Adolescent↗