Surgical guidestents for placement of implants.
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Biomedical subjects
Publications and source records attributed to D G Garver.
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An approach to soft tissue management and surgical crown/root sectioning for submucosal vital root retention has been presented. Attention to detail during soft tissue reflection, tooth sectioning, and the relaxing of attached mucogingival tissues is very important. Adequate healthy soft tissue is necessary for proper suturing over the retained roots. Postoperative complications are reduced by placement of well-fitted prostheses. Clinical evaluation of this technique has proved it to be highly successful.
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Some physical properties of nonprecious alloys were compared after repeated casting without the addition of any new alloy. The tensile strength, percentage of elongation, and hardness properties were determined and compared. There were no significant differences observed in the physical properties tested among any of the four generations of casting. This finding indicates that the metal can be reused for at least four generations.
A research protocal for submucosal vital root retention in humans has been developed based on laboratory animal studies. Procedures, patient management, and statistical results have been reported in a series of three articles. Changes in techniques have also been reported, along with explanation of a flowchart for tooth root retention and alveolar ridge preservation. Some ideas for future investigations are presented. Vital root retention in humans appears to be a valid means of retaining residual bony ridge tissues to a greater degree than when patients are rendered totally edentulous.
A protocol based upon findings in laboratory animal studies was established for the retention of vital roots for overdenture support in humans. Ten patients with a mean age of 54.5 years and a postsurgical mean time of 11.1 months had 45 vital teeth buried submucosally under complete overdentures. Of the 45 teeth, 37 remained vital, seven were endodontically treated due to acute pulpal response following surgery, and one tooth has been extracted. A mean interproximal bone loss of 1.1 mm had occurred at the time the data were tabulated for this report. This project included a cross section of patient types, tooth selection, and surgical and prosthodontic management that varied slightly from the methods utilized in earlier patient treatment. The inclusion of maxillary teeth, the increased thoroughness of root surface roundings, and the utilization of root canal therapy with subsequent reburying of apulpally involved teeth expanded the scope of this research. A final report on this project will be forthcoming when all patients have been followed for a 24-month period.
With increasing experience in the technique, it has become apparent that more generous contouring of the retained root after amputation is desirable. The effect is to produce a more rounded ridge instead of the "boxy" one that would result from mere horizontal sectioning of the crown structure. The surgical sectioning of vital teeth, followed by anequate mucoperiosteal eversion suturing, has proved to be successful. Periodontal evaluation of each tooth seems to be paramount to success or failure. Accurate impression-making and postsurgical treatment including soft acrylic resin relines and removal of pressure spots appear to be next in importance. Age of the patient, condition of the clinical crowns, and length of surgical procedures did not seem to affect normal healing in the patients involved in the project.
A method has been described that may help the dentist in removing ceramic-metal restorations that resist easy removal from the teeth during the fitting procedure and after temporary or final cementation.
The background, rationale, and technique for fabricating the remodified Hart-Dunn attachment system have been presented. This subpontic attachment is a product of clinical experience in managing the unilateral distal extension removable partial denture patient. Minimal retention, reduced torque throughout the arch during function, and distribution of force according to sound mechanical principles make this remodified subpontic attachment the preferred method of treating most unilateral distal extension removable partial denture patients.
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