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Biomedical subjects

C M Misch

Publications and source records attributed to C M Misch.

At least 19 recordsLinked to original sources
PubMed2000

Preliminary evaluation of a new dental implant design in canine models.

Problems with crestal bone resorption and bone adaptation to dental implants in compromised and weak bone present clinical challenges due to insufficient bone volume. Mathematical models have shown that a new, square-thread, dental implant design increases functional surface area and reduces shear loading at the implant interface. The aim of this investigation was to evaluate the ability of bone to grow between the threads of the new implant and its general biocompatibility in a canine model. Test implants were placed in the mandibles of four beagle dogs after posterior partial edentulism. Three months after implantation, the animals received independent fixed partial dentures, were followed for an additional 6 months, and then euthanized for histological analyses. Analyses revealed that bone grew between the threads and closely apposed the new implant design. Histological observations also revealed that the inferior aspect of the test implant threads were apposed by more bone than the coronal aspect, suggesting a biological advantage for the compressive load transfer mechanism of the new implant design. The results of this study revealed that the new implant design became osseointegrated with bone growing between the threads of the device.

Animals↗
PubMed2000

Use of the mandibular ramus as a donor site for onlay bone grafting.

Cortical bone grafts harvested from the posterior mandible offer several advantages for bone augmentation prior to implant placement. These grafts maintain their dense quality and exhibit minimal resorption upon incorporation. Considerable amounts of bone can be harvested from this area for use as an onlay graft. In addition, the ramus area has some inherent advantages over other donor sites. This article describes the indications and surgical technique for harvesting bone from the ramus region.

Alveolar Ridge Augmentation↗
PubMed1999

Use of a surgical template for autologous bone grafting of alveolar defects.

This article describes the fabrication of a surgical template for planning and performing the harvest and placement of autologous bone grafts for the reconstruction of alveolar defects before implant placement. A diagnostic cast is altered to replicate the anticipated bone anatomy. The ideal bony contours for implant placement are then created on the cast to form the template. This template may then be used for treatment-planning donor sites for the harvest of corticocancellous bone grafts. The template is sterilized and used by the surgeon in procuring and placing the bone graft. This template allows communication of the prosthetic requirements of the ridge augmentation, as well as ensuring adequate volume and proper positioning of the block graft for eventual implant placement.

Alveolar Bone Loss↗
PubMed1999

A bone quality-based implant system: first year of prosthetic loading.

This interim report presents the data from a prospective study of BioHorizons, a bone quality-based implant system, with four implant designs. The surgical survival of 975 implants was 99.4%, with the survival 100% for D4 bone. Three critical phases of crestal bone loss have been identified: bone remodeling from stage I to stage II surgery; stage II uncovery to prosthesis delivery (transition period); and prosthesis delivery up to the first year of loading (early loading bone loss). The stage I to stage II uncovery crestal bone remodeling resulted in a mean vertical bone loss of 0.21 mm to 0.36 mm (SD = 0.90 mm), dependent on whether the implant became exposed in the oral cavity during osseous healing. No statistically significant difference was found among the four implant designs, diameter, bone density, or location. The stage II to prosthesis delivery mean vertical bone loss ranged from 0.12 mm to 0.20 mm. One hundred three consecutive patients (partially and totally edentulous) were restored, with 360 implants and 105 prostheses in function for a period of 12 to 26 months. No early loading implant failure occurred, and all patients with implants are in satisfactory to optimum health according to the Misch Implant Quality Scale. The mean early loading bone loss was 0.29 mm (SD = 0.99 mm). Past clinical reports in the literature indicate most failures or crestal bone loss occur by the first year of loading. This study suggests the bone quality based dental implant design minimizes overall implant failure and crestal bone loss, regardless of bone density.

Adult↗
PubMed1999

A modified socket seal surgery with composite graft approach.

The contour of the residual ridge is reduced within 1 year by approximately 25% in width after the extraction of a natural tooth. The augmentation of a tooth socket after an extraction decreases the loss of available bone width for an endosteal implant. Grafting at the same time as the extraction has benefits from both a patient and doctor perspective. However, primary closure is more difficult, and may require the facial keratinized gingiva to be undermined and approximated on the crest of the ridge, or the use of membranes, which are exposed during the soft tissue healing. The modified socket seal surgery uses a technique described by Landsberg and couples his procedure with autologous bone harvested from the maxillary tuberosity. As a result, the tooth extraction socket may be augmented with autologous bone and connective tissue with a simplified approach at the same time as the extraction of a tooth.

Alveolar Bone Loss↗
PubMed1998

A bone quality-based implant system: a preliminary report of stage I & stage II.

A system is introduced in which dental implants are specifically designed for containment within four different categories of bone densities. The sizes and the textured surfaces that accompany the gradations of lengths and diameters are standardized for each bone type. A modified thread design focuses on compression of bone rather than on shear, and the geometry of the entire implant body reflects features that are concurrent with a "platform effect." Having been tested by means of finite element analysis and initial animal studies, the results are provided herein for the placement of 364 consecutive implants in five clinical centers on human patients, with surgical survival results of 98.9 percent overall. The initial clinical report of these implants indicates that all bone densities may have similar initial survival rates.

Bone Density↗
PubMed1998

The extracted tooth pontic--provisional replacement during bone graft and implant healing.

When tooth extraction is required, a provisional restoration may be utilized as an interim prosthesis during bone graft and implant healing. The selection of provisional replacement of the anterior teeth following extraction may have a direct influence on the success of the definitive tooth replacement. This article describes a technique for using the extracted tooth or a denture tooth as an interim prosthesis during bone graft and implant healing. This method of provisionalization offers several advantages, including no adjacent tooth preparation, natural appearance, and retention of the papillae.

Adult↗
PubMed1997

Bur guide surgical template for implant placement in grafted jaws.

This article describes the fabrication of a bur guide surgical template for implant placement in grafted jaws. This surgical template makes use of the disposable titanium implant mounts packaged for implant insertion. The bur guide allows not only for communication of the implant position but for its ideal trajectory as well. It is applicable in cases where adequate bone volume for implant placement is expected, for example, following autogenous bone grafting.

Bone Transplantation↗
PubMed1996

Ridge augmentation using mandibular ramus bone grafts for the placement of dental implants: presentation of a technique.

Local bone grafts are a convenient source of autogenous bone in alveolar reconstruction. The mandibular ramus area provides primarily a cortical graft that is well-suited for veneer-grafting of ridge deficiencies prior to implant placement. The advantages of this method of augmentation include its intraoral access and low morbidity. Similar to bone harvested from the mandibular symphysis, these grafts require short healing periods, exhibit minimal resorption, and maintain their dense quality. Advantages of this donor site over the chin include minimal patient concern for altered facial contour, proximity to posterior mandible recipient sites, and decreased complaints of postoperative sensory disturbances and discomfort. However, the surgical access in some cases is limited, and there is a potential for damage to the mandibular neurovascular bundle. The learning objective of this article is to review and update the reader knowledge of alveolar ridge augmentation using mandibular grafts.

Adult↗
PubMed1995

The repair of localized severe ridge defects for implant placement using mandibular bone grafts.

Severe alveolar deficiencies can prevent ideal implant placement. Management of osseous defects often necessitates autogenous bone grafting. The mandibular symphysis graft technique offers ease of access, good bone quantity for localized repair, a corticocancellous block graft morphology, low morbidity and minimal graft resorption. An improved bone density results along with a shorter healing time as compared with other methods for bone repair. An understanding of graft management and implant placement is essential for clinical success.

Alveolar Process↗
PubMed1993

Finite element stress analysis of tooth-to-implant fixed partial denture designs.

PURPOSE: The purpose of this study was to conduct a three-dimensional finite element stress analysis to compare models representing a natural tooth and an integrated implant connected with rigid and nonrigid prostheses. MATERIALS AND METHODS: The mathematical models described an integrated implant connected to a second premolar tooth with a three-unit metal-ceramic fixed partial denture. In one model, the tooth and implant were rigidly connected, and in the other, a nonrigid connection was assumed. From a simulated vertical load the computer generated resultant stress contours and values (compressive and tensile) in horizontal and vertical dimensions. RESULTS: A comparison of the magnitude and pattern of stresses generated in the models shows minimal differences. Although the maximum stress values were slightly higher in some areas of the rigid prosthesis model, the differences were negligible. CONCLUSIONS: Based on the similarities in both the patterns of stress contours and the stress values generated in the two models, advocating a nonrigid connection because of a biomechanical advantage may be erroneous.

Alveolar Process↗
PubMed1992

Generic terminology for endosseous implant prosthodontics.

Implant dentistry has become an integral treatment modality in the restoration of the complete and partially edentulous patient. Most practitioners have been educated by manufacturer-sponsored courses oriented to the use of a specific implant system. The ever-increasing number of implant systems has made the names of many implant components product-unique and confusing. Fortunately, a prosthetic continuity exists between most implant systems. A generic terminology for endosseous root-form prosthodontics is presented that allows effective communication between members of the profession.

Dental Abutments↗
PubMed1992

Reconstruction of maxillary alveolar defects with mandibular symphysis grafts for dental implants: a preliminary procedural report.

Partially edentulous patients with alveolar defects contraindicating implant placement were treated with bone grafts obtained from the mandibular symphysis. Complications encountered were minor and uneventful. Evaluation 4 months after surgery revealed minimal graft resorption, thus implant placement was possible in all potential sites. Advantages of the symphysis graft include easy access, availability of greater quantities of bone over other intraoral donor sites, low morbidity, no hospitalization, minimal discomfort, no alteration in ambulation, and no cutaneous scar. Compared with other bone regenerative methods for implant placement, a superior quality of bone was found and a shorter healing period is required. Results of this preliminary clinical investigation demonstrate that chin grafts offer a viable alternative for reconstruction of alveolar defects prior to dental implant placement.

Alveolar Bone Loss↗
PubMed1992

The pharmacologic management of maxillary sinus elevation surgery.

The edentulous posterior maxilla often has inadequate bone for endosteal implants. Therefore, implant placement in this area often requires the manipulation of maxillary sinus anatomy. The development of infection following sinus elevation procedures can occur from contamination of the site by oral and/or sinus pathogens or secondary infection from a maxillary sinusitis. The prevention and prompt treatment of complications associated with this surgery can contribute to increased success in this area. The prophylactic use of systemic and local antibiotics and glucocorticosteroids can reduce the risk of infection. If infection develops, culture and sensitivity testing is indicated, with the prescription of empiric antibiotic therapy and decongestants. A knowledge of clinical pharmacology and its therapeutic application is essential for the predictable management of sinus elevation surgery.

Amoxicillin↗