Biomedical subjects

Carl E Misch

Publications and source records attributed to Carl E Misch.

23 records · Page 2Linked to original sources

PubMed2003

Immediate occlusal loading for fixed prostheses in implant dentistry.

The majority of clinical reports reveal similar survival rates between immediate-loaded and 2-stage-unloaded healing approaches in the completely edentulous patient. In our prospective study, 31 arches received immediate-loaded restorations in 30 patients, supported by 244 implants. All implants were followed a minimum of 2 years after prosthesis delivery to as long as 6 years. The implant and final prosthesis survival were 100% during this time frame. Nonetheless, these findings do not imply a submerged surgical approach is no longer necessary or prudent in many cases. Future studies may find indications based upon surgical, host, implant, and occlusal-related conditions more beneficial for one versus the other. The strength of bone and the modulus of elasticity are both directly related to bone density. The softest bone type may be 10 times weaker than the most dense types. The microstrain mismatch of titanium and the softest bone is much greater than with the densest bone. As a consequence, higher implant failure and greater crestal bone loss seem likely but as yet has not been reported in the literature. A biomechanical treatment approach to increase surface area and decrease forces applied to the immediate restorations is logical to increase implant survival. Conditions that decrease strain to a developing interface include increasing implant number, implant size, and implant thread number and depth. Patient factors such as parafunction may increase forces to the implant interface, while implant position may be used to decrease forces, especially when a splinted arch form is created. Tables 3 and 4 list guidelines for immediate occlusal loading. As a general principle, the clinical should be able to increase surface area while minimizing occlusal force to ensure long-term success.

Alveolar Bone Loss↗

PubMed2002

Heat generation during implant drilling: the significance of motor speed.

PURPOSE: The purpose of this study was to measure the heat generated from 3 drilling speeds (1,225, 1,667, and 2,500 rpm) using the armamentarium of 4 implant systems. MATERIALS AND METHODS: The mean rise in temperature, the time of drilling, and the time needed for pig jaw bone to return to the baseline temperature were monitored using 4 thermocouple technology. RESULTS: The mean rise in temperature, the time of drilling, and the time needed for the specimens to return to the baseline temperature were lower at 2,500 rpm than at 1,667 or 1,225 rpm (P < or =.05), regardless of the system used. The rpm also directly correlated to the amount of time the bone remained at an elevated temperature. CONCLUSION: From a heat generation standpoint, we conclude that preparing an implant site at 2500 rpm could decrease the risk of osseous damage, which may affect the initial healing of dental implants. This may decrease the devital zone adjacent to an implant after surgery and be most advantageous in immediate load application to dental implants.

Analysis of Variance↗

PubMed2002

The causes of early implant bone loss: myth or science?

The success of dental implants is highly dependent on integration between the implant and intraoral hard/soft tissue. Initial breakdown of the implant-tissue interface generally begins at the crestal region in successfully osseointegrated endosteal implants, regardless of surgical approaches (submerged or nonsubmerged). Early crestal bone loss is often observed after the first year of function, followed by minimal bone loss (< or =0.2 mm) annually thereafter. Six plausible etiologic factors are hypothesized, including surgical trauma, occlusal overload, peri-implantitis, microgap, biologic width, and implant crest module. It is the purpose of this article to review and discuss each factor Based upon currently available literature, the reformation of biologic width around dental implants, microgap if placed at or below the bone crest, occlusal overload, and implant crest module may be the most likely causes of early implant bone loss. Furthermore, it is important to note that other contributing factors, such as surgical trauma and penimplantitis, may also play a role in the process of early implant bone loss. Future randomized, well-controlled clinical trials comparing the effect of each plausible factor are needed to clarify the causes of early implant bone loss.

Alveolar Bone Loss↗

PubMed2002

The effect of bruxism on treatment planning for dental implants.

Bruxism is a potential risk factor for implant failure. Excessive force is the primary cause of late implant complications. An appreciation of the etiology of crestal bone loss, failure of implants, failure to retain implant restorations, and fracture of components will lead the practitioner to develop a treatment plan that reduces force on implants and their restorations. The forces are considered in terms of magnitude, duration, direction, type, and magnification. Once the dentist has identified the source(s) of additional force on the implant system, the treatment plan is altered to contend with and reduce the negative sequelae on the bone, implant, and final restoration. One viable approach is to increase the implant-bone surface area. Additional implants can be placed to decrease stress on any one implant, and implants in molar regions should have an increased width. Use of more and wider implants decreases the strain on the prosthesis and also dissipates stress to the bone, especially at the crest. The additional implants should be positioned with intent to eliminate cantilevers when possible. Greater surface area implant designs made of titanium alloy and with an external hex design can also prove advantageous. Anterior guidance in mandibular excursions further decreases force and eliminates or reduces lateral posterior force. Metal occlusal surfaces decrease the risk of porcelain fracture and do not require as much abutment reduction, which in turn enhances prosthesis retention. The retention of the final prosthesis or super-structure is also improved with additional implant abutments. Night guards designed with specific features also are a benefit to initially diagnose the influence of occlusal factors for the patient, and as importantly, to reduce the influence of extraneous stress on implants and implant-retained restorations.

Bite Force↗

PubMed2002

Implant dentistry.

Explore the source record for details and available documents.

Dental Implantation, Endosseous↗