Biomedical subjects
Publications and source records attributed to F V Panno.
Problems that can occur when single implants are utilized to restore first molar teeth include the frequent loosening of screws, as well as screws and/or implant breakage. These may result from torquing and rotational movements of the prosthesis during masticatory and parafunctional mandibular movements. When sufficient bone and mesio-distal restorative space is present, the placement of two implants should be considered.
Sinus lift and augmentation procedures with simultaneous insertion of cylindrical root form implants can be used to treat the atrophic posterior maxilla. The long-term use of a second stage provisional prosthesis is emphasized. The recommended metal-reinforced acrylic resin provisional restoration allows treatment and/or removal of a failing implant and progressive loading before fabrication of the definitive prosthesis. Modifications in prosthesis fabrication after sinus lift surgery and augmentation procedures are discussed.
Combination metal-and-acrylic-resin fixed provisional prostheses can be used in implant dentistry as an alternative to a removable provisional prosthesis. They may be fabricated in the laboratory and inserted on the day of fixture placement to ensure that the patients may return to their normal lifestyles with minimal discomfort or interruption in function and esthetics. These interim restorations may be used in free-standing as well as hybrid types of implant supported prostheses. The materials used and techniques of fabrication are described.
A method for restoring the posterior portion of the maxilla with a simultaneous composite alloplastic sinus lift graft and placement of press-fit implants is presented. Sinus grafting is needed because of minimal remaining alveolar bone. The composite graft material uses a combination of demineralized freeze-dried cortical bone and Interpore 200 hydroxyapatite. Since 1987, 45 sinus grafts with simultaneous placement of 111 root-form implants have been performed for 27 patients. None of the 76 restored implants have been lost. Complications were encountered in 2 patients (4 sinuses) who were heavy smokers. Antibiotics were administered, symptoms subsided, and the implants integrated.
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A method of preparing teeth to accommodate intracoronal attachments is presented. The resulting prosthesis incorporates a fixed partial denture with physiologically contoured crowns and a removable partial denture with a precisely determined path of insertion. These techniques stress the importance of surveyed diagnostic casts and coordinated tooth preparations for artificial crowns to facilitate treating complex cases.
The marginal adaptation of Renaissance crowns is compared with that of the widely used metal ceramic and Dicor crowns. This investigation shows that Dicor and metal ceramic crowns fit better than Renaissance crowns. Clinical implications of all three restorations are discussed.
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Various combination fixed-removable prostheses have been presented. The construction of the combined provisional prostheses permits the clinician to establish the desired occlusal harmony, esthetics, and jaw relationships, as well as optimal management of the patient. The provisional template allows the clinician to determine patient reaction and response prior to construction of the definitive prostheses. This leads to better clinician-patient rapport and patient satisfaction. Also, it minimizes postinsertion adjustments.
An overview has been presented of the prosthodontic procedures used prior to the first stage of implant surgery, the procedures used between the first and second stages of surgery, and the prosthetic appliances fabricated prior to insertion of the definitive implant prosthesis. In addition, the need for suggestions to the surgeon for optimal implant fixture placement using surgical templates has been discussed. The design and fabrication of a preferred mandibular surgical template has been presented. In addition, it has been recommended that the surgeon and restorative dentist should employ a team approach to implantology for the best results.
The understanding of the theories and applications of fixed prosthodontics utilized in conjunction with intracoronally attached removable partial dentures is vital to full-mouth combined reconstructions. Required objectives of fixed full coverage retainers include elimination of pathology, restoration of form and function, as well as enhancement of aesthetics. These topics are discussed in terms of design of full-coverage preparations and tissue management.
This study compared the margin opening of cemented porcelain-fused-to-metal crowns of three different casting designs: 80-degree bevels with metal collars, 80-degree bevels with porcelain applied to the labial collars, and 45-degree labial bevels with metal and porcelain to a common margin termination. There were no statistically significant differences between the margin opening of the three groups. Porcelain application and firing did not distort the facial margin. The 45-degree bevel with porcelain to the margin has greater esthetic potential and the same margin adaptation as the 80-degree bevel with an all-metal collar.
The utilization of intracoronal or extracoronal removable partial denture attachments in conjunction with a fixed retainer applies additional stresses to the structural durability of the fixed retainer and its integrity with the underlying abutment. Therefore, the utilization of this attachment with a fixed retainer requires understanding and diligent application of the basic principles of fixed prosthodontics.The primary objective of prosthodontics must be the preservation and health of the remaining existing tissues and structures: teeth, periodontal tissues, temporomandibular joint, and oral facial muscles. This must be of primary importance as we achieve our goals of (1) eliminating existing pathology, (2) restoring morphology and function, and (3) improving esthetics and thereby heightening self-esteem and the psychological well-being of the individual. These objectives make us sensitive to the considerations we have discussed in preparation design and the tissue management required in the fabrication of fixed retainers.
This article indicates that the gingival opening of a two-surface cast restoration after cementation is minimized by the use of a preparation with proximal grooves.
The inaccuracies of the casting and fitting processes associated with semiprecision intracoronal attachment systems may compromise the fit of the completed prosthesis. The objective of using metal prefabricated intracoronal semiprecision attachments is to improve the adaptation between the matching attachment surfaces used in the fabrication of removable partial dentures. In milled dovetail or waxed dowel rests, the attachment of one side is completed and the other is cast to match. The prefabricated attachment system presented uses a matching component cast directly against the precast metal rest-mandrel. This reduces the inaccuracies resulting from waxing, investing, and casting.
The tensile strength of connectors joining bars of palladium-silver alloy and formed using hydrogen/oxygen flame soldering was compared to those formed using conventional gas/oxygen soldering. As-cast specimens served as the control. No significant differences were found between the as-cast, hydrogen/oxygen flame soldered, or the natural gas/oxygen flame soldered specimens.
The various clinical and laboratory procedures for use of auxiliary prefabricated metal screw retention, castable plastic telescopic, and custom laboratory-fabricated systems are presented as adjuncts to implant-supported restorative procedures. These devices aid in the fabrication of predictable and retrievable screw-retained, fixed-detachable implant-supported prostheses for various conditions and combinations of support. Ancillary screw systems are also useful in solving cosmetic problems when implant placement compromises this goal.