Implant selection considerations and criteria.
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Biomedical subjects
Publications and source records attributed to D Y Sullivan.
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PURPOSE: This report presents the preliminary results of a prospective multicenter study to evaluate the efficacy of a chemically etched pure titanium surface on screw-type dental implants. MATERIAL AND METHODS: The results of 147 implants placed in 75 patients were evaluated and followed for up to 3 years, using clinical and radiographic examinations. The implants were inserted to support single crowns, overdentures, and fixed prostheses, as dictated by the individual patient's need. RESULTS: Of the 147 implants placed, 5 were lost and the remaining implants were followed throughout, to the end of the study period. Crestal bone levels adjacent to each implant were monitored and the amount of total bone loss was calculated. Clinically healthy peri-implant gingival tissues were observed on 95% of the implants, whereas 88.3% demonstrated no bleeding on probing and no recession during the follow-up period. According to the criteria used in this study, the total success rate was calculated to be 96.6%.
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Implant positioning in a mesio-distal, bucco-lingual, and apical-occlusal direction is a prerequisite in developing a good emergence profile and creating optimum aesthetics. The use of a healing abutment and the following healing and maturation of soft periimplant tissue develop a subgingival dimension that allows an emergence profile of the final restoration that is consistent with the size of the tooth to be replaced and the adjacent teeth. The learning objective of this article is to review and update the knowledge of single tooth implants and their management.
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Mechanical in vitro tests of the Brånemark implant disclose that the screw joint which attaches the prosthetic gold cylinder and the transmucosal abutment to the fixture forms a flexible system. This inherent flexibility seems to match well the vertical mobility of a supporting tooth connected to the implant. Calculations of vertical load distribution based on measured flexibility data demonstrate that the forces are shared almost equally between tooth and implant even without taking the flexibility of the surrounding bone or the prosthesis into account. The therapy of a single Brånemark implant connected to a natural tooth should be considered without any additional element of a flexible nature. Mechanical tests and theoretical considerations, however, indicate that the transverse mobility of the connected tooth should be limited and that the attachment of the prosthesis to the tooth should be of a rigid design to avoid gold-screw loosening.
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During the past 5 years, tremendous advancements have been made in the application of the principles of osseointegration to esthetic dentistry. Long-term predictability, combined with time-honored esthetic principles, can now greatly benefit patients previously burdened by removable dental appliances.
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A method of solving some problems inherent with osseointegrated implant prosthesis has been presented. A removable flange can reestablish lip support or block escape of unwanted air while allowing the access necessary for competent hygiene procedures. Overdentures may be indicated to provide the prosthetic gingival surface necessary for adequate food control or speech.
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