Achieving the wow factor in a dental implant practice.
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Biomedical subjects
Publications and source records attributed to D M Vassos.
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A two-site clinical study of hydroxyapatite-coated cylindrical titanium alloy implants was undertaken to evaluate their efficacy. Observations were recorded before surgery, at first-stage surgery, at second-stage surgery, at loading, and at quarterly postrestoration prophylactic examinations and annual comprehensive patient visits. Implant failure criteria included mobility, peri-implant radiolucency, fracture, exfoliation, removal for any reason, and patient reported pain on palpation. Soft tissue indices were monitored as part of the study. Postrestoration implant performance was analyzed using life table methodology. From the 316 implants restored in 154 patients, 11 implants in 8 patients failed before prosthetic attachment, for a surgical success rate of 96.4 percent. Four implants failed during an observation period extending up to 85 months after completion of prosthetic treatment. The Cutler-Ederer life table success rate after 6 years was 97.8 percent. No significant adverse events were reported during the observation period. Results of this investigation suggest that hydroxyapatite-coated cylindrical titanium alloy implants are an effective treatment modality.
Single-stage implant placement surgery offers patients a number of advantages. These include reduced cost and time commitments and greater comfort, function, and convenience. This article reports on the results of using a single-stage technique with 58 patients fitted with 240 implants. No implant failures were detected in any patients prior to the final attachment of a Dolder bar. Among the 27 patients and the 125 implants followed for a longer period of time, 99.2% exhibited no signs of implant mobility or pain. Indicators of gingival health and oral hygiene ranged in quality from acceptable to ideal.
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A data subset from an ongoing prospective multicenter clinical study of threaded hydroxyapatite-coated implants was evaluated to assess safety and efficacy of the implants when placed in the anterior mandible to support overdentures. Observations were recorded before surgery, at first-stage surgery, at second-stage surgery, at loading, and at quarterly postrestoration prophylactic exams and annual comprehensive patient visits. Implant failure criteria included mobility, radiographic evidence of bone loss greater than one-third the length of the implant or peri-implant radiolucency, fracture, exfoliation, removal for any reason, and patient reported pain upon palpation. Soft tissue indices were monitored as part of the study. Postrestoration implant performance was analyzed using life-table methodology. From the 2,062 implants restored in 720 patients in the parent study, a total of 660 implants in 174 patients were included in the anterior mandibular overdenture data subset. Twelve implants in 8 patients failed at or before second-stage surgery for a surgical success rate of 98.2 percent. Five implants failed during an observation period extending up to 72 months after completion of prosthodontic treatment. The Cutler-Ederer life table success rate after 5 years was 97.8 percent. No significant adverse events were reported during the observation period. Results of this investigation suggest that threaded hydroxyapatite-coated implants are effective when placed in anterior mandibular regions in support of overdentures.
A data subset from an ongoing prospective multicenter clinical study of threaded hydroxyapatite-coated implants was evaluated to assess safety and efficacy of the implants when used to support fixed prostheses in the posterior mandible. Observations were recorded before surgery, at first-stage surgery, at second-stage surgery, at loading, and at quarterly postrestoration prophylactic exams and annual comprehensive patient visits. Implant failure criteria included mobility, radiographic evidence of bone loss greater than one-third the length of the implant or peri-implant radiolucency, fracture, exfoliation, removal for any reason, and patient reported pain upon palpation. Soft tissue indices were monitored as part of the study. Postrestoration implant performance was analyzed using life-table methodology. From the 2,062 implants restored in 720 patients in the parent study, a total of 423 implants in 195 patients were included in the posterior mandibular data subset. Thirteen implants failed at or before second-stage surgery for a surgical success rate of 96.9 percent. Prosthodontics was completed, and one or more postrestoration annual follow-up visits occurred for 314 implants as of the interim analysis cutoff date. Fourteen implants failed during an observation period extending up to 62 months after completion of prosthodontic treatment. One failed implant was removed, whereas the 13 remaining implants are functional despite having been identified as failures under the protocol criteria. The Cutler-Ederer life table success rate after 5 years was 92.2 percent. Results of this investigation suggest that threaded hydroxyapatite-coated implants are effective when placed in posterior mandibular regions in support of fixed prostheses.
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A data subset from an ongoing prospective multicenter clinical study of threaded hydroxyapatite-coated implants was evaluated to assess safety and efficacy of the implants in anterior maxillary regions when used to support fixed prostheses. Observations were recorded before surgery, at first-stage surgery, at second-stage surgery, at loading, and at quarterly post-restoration prophylactic exams and annual comprehensive patient visits. Of 2,062 implants restored in 720 patients in the parent study, a total of 95 implants in 54 patients met the criteria for inclusion into this portion. Implant failure criteria included mobility, radiographic evidence of bone loss greater than one-third the length of the implant or peri-implant radiolucency, fracture, exfoliation, removal for any reason, and patient reported pain upon palpation. Soft tissue indices were monitored as part of the study. Post-restoration implant performance was analyzed using life-table methodology. No failures were observed before prosthodontic rehabilitation. Three implants failed during an observation period of up to 5 years after completion of prosthodontic treatment. The Cutler-Ederer life table success rate after 5 years was 93.4 percent. Results of this investigation suggest that threaded hydroxyapatite-coated implants are safe and effective when placed in anterior maxillary regions to support fixed prostheses.
An ongoing prospective clinical trial is being conducted at three study sites to evaluate the safety and efficacy of a threaded, hydroxylapatite-coated implant (Steri-Oss Inc., Yorba Linda, CA) in a patient population reflective of the investigators' overall population of implant candidates. The 2062 implants placed and restored among 720 patients over the five-year period up to the study interim analysis cut-off date (November, 1994) include over 600 implants and 200 patients at each study site. Mean age and sex distribution of patients were comparable among the study sites. Study design attributes included well-defined patient selection criteria, standardized study procedures, standardized measurement and observation methodology, complete data accountability, and rigorously applied implant success/failure criteria. Thirty-five implants were considered failures at exposure, and the surgical success rate was 98.3%. Of 65 implants that failed post-restoration, three were removed, while 62 remained functional and in service. The five-year post-restoration follow-up success rate, determined by means of life table methodology, was 96.0%. By region, the five-year life table success rates post-restoration were 94.3% in the anterior maxilla, 96.6% in the posterior maxilla, 97.2% in the anterior mandible, and 95.6% in the posterior mandible. Adverse events occurred in association with less than 1% of the implants placed.
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Implant dentistry has made great advances since its inception several decades ago. As a result, predictability and success have reached high levels. Nonetheless, efforts continue to further refine implant design, materials, and techniques to reduce even the small percentage of failures that still occur. As part of this effort, the authors for the past six years have conducted clinical trials of Steri-Oss threaded titanium implants and HA-coated implants. The results have been consistent with the body of implant research reported since the 1970s. Optimum implant performance is realized when a well-designed system such as those tested is utilized in association with astute clinical judgment.
When faced with a patient with relative medical or psychological contra-indications, the practitioner may be tempted to withhold dental implant treatment because of the risks. Yet, for some highly motivated but compromised patients, the potential benefits of implant treatment can be an overriding consideration. In the case presented here, a 56-year-old patient who had undergone two series of radiation therapy and surgery for recurring cancer of the tongue was treated first with a subperiosteal, and, when the subperiosteal was removed after six years, the patient was treated with endosseous implants. This treatment significantly improved the patient's life without further negative effect on her medical condition.
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Explore the source record for details and available documents.