Biomedical subjects
G J Wolfinger
Publications and source records attributed to G J Wolfinger.
A new protocol for immediate functional loading of dental implants.
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Dental implants in the diabetic patient: a retrospective study.
It has become increasingly common for controlled diabetic patients to be considered as candidates for dental implants. This study reports on the results of placing implants in 34 patients with diabetes who were treated with 227 Brånemark implants. At the time of second-stage surgery, 214 of the implants had osseointegrated, a survival rate of 94.3%. Only one failure was identified among the 177 implants followed through final restoration, a clinical survival rate of 99.9%. Screening for diabetes and trying to ensure that implant candidates are in metabolic control are recommended to increase the chances of successful osseointegration. Antibiotic protection and avoidance of smoking should also be considered.
Immediate loading of Brånemark implants in edentulous mandibles: a preliminary report.
A study involving the immediate loading of Brånemark implants in the edentulous mandibles of 10 patients is reported. The design involved the immediate loading of four widely distributed implants with a transitional fixed implant-supported prosthesis at first-stage surgery, avoiding the need for a removable prosthesis. A sufficient number of additional implants are allowed to heal in the conventional manner to provide sufficient support for a definitive fixed prosthesis even if all of the immediately loaded implants fail. Preliminary results have been favorable, with all patients functioning with a fixed implant prosthesis from the day of first-stage surgery.
Fabrication of acrylic resin copings for CeraOne provisional restorations.
A technique is described for fabricating autopolymerizing acrylic resin copings for CeraOne provisional restorations. This method has the advantage of providing a chemical bond rather than only a bond between the mechanical coping and the relined provisional crown, as is the case when using the provisional components supplied by the manufacturer. The technique describes provisionalization at the time of stage II surgery. This type of coping can also be used after a period of soft tissue healing when a healing abutment is employed. The benefits of the procedure include increased patient satisfaction and reduced chair time for repairs.
Two-implant-supported single molar replacement: interdental space requirements and comparison to alternative options.
Posterior single-tooth implant restorations are subjected to an increased risk of bending overload. A high incidence of implant fracture has been reported when using a single standard 3.75-mm-diameter implant to support a molar restoration. The purpose of this article is to demonstrate the clinical feasibility of placing two implants to support a molar restoration and to compare this treatment option to the use of a single standard implant or a wide-diameter implant. Two osseointegrated dental implants used to support a molar restoration in interdental spaces as small as 10 mm is shown to be effective and predictable in 60 restorations over the past 7 years. The use of two implants provides more surface area for osseointegration and spreads the occlusal loading forces out over a wider area, reducing the potential bending forces that would otherwise exist in a single-implant molar restoration.
Prosthodontic management of a combination transosteal/endosteal implant reconstruction: a clinical report.
This is a clinical report of a patient who was not referred for prosthodontic evaluation and treatment until after undergoing Bränemark endosseous implant placement to supplement the previously existing mandibular staple bone plate implant. This supplemental treatment was the surgeon's attempt to resolve the patient's complaint of loose dentures. Creativity with implant biomechanics and prosthodontic design were necessary to restore the patient, in a predictable manner, to normal function. A fixed, detachable cast overdenture bar rigidly connected to all the implants was constructed utilizing resilient attachments to retain the tissue-supported mandibular overdenture. A presurgical prosthodontic evaluation could have averted many of the problems encountered with treatment. More effective conventional prosthodontic treatment may have resolved the patient's complaints and eliminated the need for additional implant placement.
Analysis of 356 pterygomaxillary implants in edentulous arches for fixed prosthesis anchorage.
One thousand eight hundred seventeen implants were placed in the completely edentulous maxillae of 189 patients (122 female; 67 male). The patients' mean age was 60 years (range 28 to 91 years). Three hundred fifty-six of the 1,817 implants were placed in the pterygomaxillary area, and all patients were restored with complete-arch fixed detachable prostheses. The mean number of implants per maxillary prosthesis was 9.0 (range 6 to 15). During stage II surgery and before loading, 41 pterygomaxillary implants (11.5%) were not osseointegrated and were removed. After a mean loading period of 4.68 years (range 0.06 to 9.20 years), 1 additional pterygomaxillary implant was lost. Altogether, 42 of 356 pterygomaxillary implants (11.8%) were removed. Survival rates according to implant size, bone quality, and tooth position were also recorded. This study illustrates a cumulative survival rate of 88.2% for pterygomaxillary site implant placement in edentulous maxillary arches.
Conversion prosthesis: a transitional fixed implant-supported prosthesis for an edentulous arch--a technical note.
A technique for fabricating a provisional fixed prosthesis for an edentulous arch immediately following abutment connection, termed conversion prosthesis, is described in detail. Advantages of the restoration include the following: it provides a fixed prosthesis immediately following stage 2 surgery with improved function, stability, and distribution of load; it protects the sutured mucosa; it serves as a prototype for the final prosthesis; it can be used as a verification jig; it preserves the original vertical dimension of occlusion; it aids in obtaining and transferring the interocclusal record; it assists long-term patient maintenance; and it reduces treatment visits. The advantages of its use clearly outweigh the disadvantages.
Restoring lost vertical dimension of occlusion using dental implants: a clinical report.
The successful rehabilitation of a patient with severe vertical overlap resulting from the loss of posterior occlusal support and excessive wear of the mandibular incisors is described. The treatment plan necessitated extraction of the remaining periodontally compromised mandibular teeth and placement of eight implants. Lost occlusal vertical dimension and morphologic facial height were restored using a fixed detachable implant-supported mandibular prosthesis, and the maxillomandibular relationship was transformed from Class II to Class I.