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Biomedical subjects

G M Raghoebar

Publications and source records attributed to G M Raghoebar.

At least 55 records · Page 3Linked to original sources
PubMed2000

A comparison of labial and crestal incisions for the 1-stage placement of IMZ implants: a pilot study.

PURPOSE: The aim of this study was to compare the crestal incision with the labial flap design when inserting a 2-stage implant system in a nonsubmerged manner. PATIENTS AND METHODS: Ten consecutive edentulous patients with a severely resorbed mandible (Cawood Class V to VI) that resulted in reduced stability and insufficient retention of the lower denture were included. In all patients, 2 IMZ implants were inserted in a 1-stage procedure in the mandibular canine regions as part of an implant overdenture treatment. In 5 patients, the labial flap approach was used, and a crestal incision approach was used in the other 5 patients. Standardized evaluations were performed at 2, 6, and 12 weeks after implant placement and 12 months after placement of the new prosthesis. RESULTS: In the first postoperative weeks, more hyperplasia occurred around the implants inserted by the crestal incision than the labial flap. However, after 1 year of function, no striking differences between the 2 groups were present with regard to the clinical and radiographic parameters. CONCLUSIONS: From this pilot study, it was concluded that both the crestal incision and the labial flap approach are reliable procedures for insertion of IMZ implants in a 1-stage procedure. However, because of the smaller risk of soft tissue overgrowth, there is a preference for the labial flap approach.

Adult↗
PubMed2000

Etiology and management of mandibular fractures associated with endosteal implants in the atrophic mandible.

Mandibular fractures can occur with the insertion of endosseous implants. Four patients whose mandibles were fractured with the removal or insertion of mandibular endosseous implants are described. Three of the patients required an autogenous bone graft to repair the fracture, and 1 patient was managed with a reconstruction plate. Strategies for prevention and treatment of this uncommon complication are discussed.

Aged↗
PubMed2000

Vertical distraction of the severely resorbed mandible. The Groningen distraction device.

In this paper, both the surgical procedure and the clinical results of a novel distraction device to augment a severely resorbed anterior edentulous mandible are described. The distraction device is non-voluminous, and consists of two distraction screws and one guide screw. Two months after the last day of distraction, both distraction screws are replaced by endosseous implants and the guide screw is removed. Three months after implantation, the prosthetic treatment can be started. So far three patients have been treated. In all patients, the severely resorbed mandible (mandibular height in the canine region: 5, 6 and 7 mm, respectively) could be sufficiently enlarged to enable reliable insertion of endosseous implants with a length of at least 12 mm. No complications occurred. Biopsies taken from the distraction site revealed formation of lamellar bone parallel to the distraction vector. From this preliminary study it is concluded that the Groningen vertical distraction device has the potential for reliable augmentation of the anterior segment of a severely resorbed edentulous mandible to enable insertion of endosseous implants with adequate length and primary stability.

Aged↗
PubMed2000

[Interface between dentistry and otorhinolaryngology].

In this paper some relevant pathological aspects on the interface of dentistry and ENT surgery are discussed. A major part of the field of ENT surgery is not available for direct inspection and/or evaluation. Therefore, ENT pathology is often overseen or not detected at an early stage. Because of frequent patient-dentist contact, also in healthy patients, dentists can play an important role in early detection of ENT pathology. The combination of specific anatomic knowledge of the ENT region and a proper anamnesis are potent tools for a dentist to suspect ENT pathology, even in not easily accessible areas like the hypopharynx and oesophagus.

Dentistry↗
PubMed1999

Morbidity and complications of bone grafting of the floor of the maxillary sinus for the placement of endosseous implants.

Placement of endosseous implants in the atrophic maxilla is often limited because of a lack of supporting bone. A technique to augment the floor of the maxillary sinus with autogenous bone graft seems to be a new reliable treatment modality. The morbidity and complication rate of augmentation of the maxillary sinus floor was studied in 75 patients. The sinus floor was augmented with iliac crest (n = 65, 128 sinuses, 276 implants), mandibular symphysis (n = 8, ten sinuses, 21 implants), or maxillary tuberosity grafts (n = 2, two sinuses, two implants). The width of the alveolar crest had to be reconstructed in 52 patients, while in the other 23 patients augmentation and implantation were performed simultaneously. Perforation of the sinus membrane occurred in 45 patients, but this did not predispose them to the development of sinusitis. Loss of bone particles and sequesters were observed in one (diabetic) patient only, in whom a mucosal dehiscence occurred. A second augmentation procedure was successful. Symptoms of transient sinusitis were observed in two of the seven patients with a predisposition for sinusitis. These symptoms were successfully treated with decongestants and antibiotics. One patient developed a purulent sinusitis which resolved after a nasal amrostomy. The bone volume was sufficient for insertion implants in all patients. Twenty of 299 patients (6.7%) in whom Brånemark implants had been inserted were lost to follow-up (mean, 32 months); no sinus pathology was observed. The patients received implant-supported overdentures (58 patients) or fixed bridges (17 patients) and experienced no complaints with regard to the grafts or implants. We conclude that the morbidity and complication rate of bone grafting of the floor of the maxillary sinus floor with autogenous bone is low.

Adolescent↗
PubMed1999

Results of intentional replantation of molars.

PURPOSE: This study evaluated the treatment outcome of intentional replantation of molars. PATIENTS AND METHODS: Twenty-nine patients were treated with intentional replantation because conventional apicoectomy was not possible. The success rate was judged by clinical and radiographic parameters. RESULTS: One molar (3%) had to be removed because of pain and mobility 4 weeks postsurgery, and three molars (11%) had to be removed during the first year because of periodontal problems. Four molars (14%) showed periodontal problems or root resorption, but are still in function and causing no obvious problems to the patients. Twenty-one molars (72%) were successfully treated. CONCLUSION: Intentional replantation is a reliable and predictable treatment for those cases in which conventional apicoectomy is hampered because of anatomic limitations or patient factors.

Adult↗
PubMed1999

Implant-retained mandibular overdentures compared with complete dentures; a 5-years' follow-up study of clinical aspects and patient satisfaction.

The aim of this prospective randomized controlled clinical trial was to evaluate and compare clinical aspects and satisfaction during the first year following treatment and consecutively the change in treatment during the next 4 years of follow-up. Patients were allocated to one of the following treatment modalities: an implant-retained overdenture (IRO-group, 2 endosseous implants, n = 61) or a complete denture (CD-group, n = 60). One year after placement of the denture, unsatisfied patients of the CD-group got the opportunity for a retreatment including an implant-retained overdenture. In the IRO-group 4 implants were lost during the first year and again 4 implants were lost during the next 4 years (survival rate: 93%). All patients could be re-operated successfully. In the CD-group 14 patients (23%) chose an implant-retained overdenture after 1 year. Patients of the IRO-group were significantly more satisfied than patients of the CD-group after 1 year (satisfaction score 8.3 versus 6.6, scale 1-10) and after 5 years (7.4 versus 6.4). From this study it can be concluded that endosseous implants have a high survival rate after 5-years' follow-up. Satisfaction score of the IRO-group is diminishing in time, probably because patients get used to an improved situation. After 5 years, the mean satisfaction score of the CD-group (including patients who got implants) was still lower than of the IRO-group, in spite of the opportunity to a retreatment and have implant-retained overdentures.

Alveolar Bone Loss↗
PubMed1999

Bone grafting of cleft lip and palate patients for placement of endosseous implants.

OBJECTIVE: Fixation of a prosthesis or single tooth replacement using osseointegrated implants has the potential to overcome functional and psychological inconveniences that many patients experience from such appliances. However, the dimensions of the recipient site are relatively often inadequate for implant placement. This study assessed grafting of this site with autogenous bone as a solution for the latter problem. METHODS: Ten cleft lip and palate patients had bone grafts; six had iliac crest grafts to the maxillary sinus floor (31 implants), and four had chin bone grafts to the local defect in the anterior maxilla (six implants). Implants were inserted during the grafting procedure (one patient) or after 3 months (nine patients). RESULTS: No inflammation of the bone grafts or the maxillary sinus occurred. One implant was lost during the healing phase. Four single tooth restorations, one fixed bridge, and five implant-supported overdentures were made. During the follow-up, which was 47 months (range, 28 to 65 months) in the anterior maxilla group and 56 months (range, 28 to 68 months) in the posterior maxilla group, no loss of implants was observed, and all prosthetic appliances functioned well. CONCLUSIONS: It is concluded that bone grafting followed by placement of dental implants can serve as a reliable alternative for conventional prosthetic rehabilitation of cleft patients.

Adolescent↗
PubMed1999

[Local bone augmentations for the use of implants].

Placement of endosseous implants is often restricted because of lack of supporting bone, limiting placement of implants of adequate length in a prosthodontically optimal position. Several surgical procedures have been described to create sufficient volume of bone for placement of implants. In this paper, various techniques are described for harvesting intraoral bone grafts for augmentation of a localized defect of the alveolar ridge.

Alveolar Bone Loss↗
PubMed1998

[Dental implants: a better anchor for dentures].

Loss of teeth results in resorption of the jaws. As a consequence the denture bearing area progressively reduces, eventually causing loss of retention and stability of the conventional denture. In three patients, two women aged 36 and 37 and a man aged 46, suffering from severe problems with their conventional dentures endosteal implants were inserted in the jawbone. After the healing period the dentist fabricated an implant-retained overdenture. The patients were very satisfied with the final result. Endosteal implants are, especially in the mandible, a reliable treatment modality for a stable implant-retained denture in case of patients suffering from retention problems with their conventional dentures.

Adult↗
PubMed1998

[Fixation of facial and auricular prosthesis with osseous implants in cranial bone].

OBJECTIVE: To evaluate the use of osseointegrated implants to fix facial and auricular prostheses. DESIGN: Retrospective. SETTING: University Hospital Groningen, the Netherlands. METHODS: Thirty patients were treated with Brånemark implants for fixation of auricular (21 patients) and orbital (9 patients) prostheses during May 1988-December 1995. The complications during the procedure, the success rate of the implants, skin reactions around the implants and patient satisfaction were recorded. RESULTS: A total of 97 implants were placed. One implant had to be removed after the healing period because it was loose. No other implants were lost during the follow-up period (mean 36 months; range: 12-91). The skin around the implants sometimes showed a mild reaction which could be adequately treated. In most of the cases no inflammation of the skin was observed. Retention, ease of handling and wearing comfort of the facial prostheses were excellent. CONCLUSION: Fixation of facial and auricular prostheses can be improved by osseointegrated implants resulting in high patient satisfaction.

Adolescent↗
PubMed1998

Reconstruction of the extremely resorbed mandible with interposed bone grafts and placement of endosseous implants. A preliminary report on outcome of treatment and patients' satisfaction.

During recent decades many surgical techniques have been developed to enlarge the denture-bearing area of the mandible. Most of these techniques improved retention and stability of the lower dentures only temporarily. Since the advent of endosseous implants to stabilize overdentures, combinations of augmentation procedures and placement of endosseous implants have been introduced to restore the severely resorbed mandible. In this study we describe the preliminary results of such a combined approach using sandwich osteotomy with an autogenous bone graft (iliac crest) followed by placement of four endosseous implants in the interforaminal region in 10 women. After a mean follow-up period of 31 months (range 19-57) several variables were measured including condition of the peri-implant tissues, radiographic bone changes and patient satisfaction. The first results indicate that the technique described offers a solid base for implant-stabilized overdentures: no implants were lost, the peri-implant tissues were in good condition, bone loss was limited, and patients were satisfied. Future studies will evaluate the permanence of these results.

Adult↗
PubMed1998

The mandibular staple bone plate: a long-term retrospective evaluation.

PURPOSE: Clinical and radiographic parameters and denture satisfaction were evaluated in a long-term retrospective study of patients treated with the mandibular staple bone plate. PATIENTS AND METHODS: Fifty-six edentulous patients were treated with the mandibular staple bone plate to stabilize their lower denture. The mean evaluation period was 103 months (range, 84 to 139 months). Peri-implant mucosa and bone height were scored, together with quality of the prosthesis and prosthodontic maintenance care. Denture satisfaction was assessed by using two questionnaires. RESULTS: Four staple bone plates were removed during the evaluation period, and one appeared to be fractured. The remaining 51 staple bone plates were functional without any signs of major complications (survival rate, 91%). No further alveolar resorption in the interforaminal region of the mandible took place during the evaluation period. Patients were very satisfied with the prosthetic construction. CONCLUSIONS: The mandibular staple bone plate is a good modality to stabilize the lower denture. However, endosseous implant systems are preferred because of comparable success rates with a more simple operative procedure.

Adult↗
PubMed1998

Mandibular overdentures supported by two or four endosteal implants. A prospective, comparative study.

The aim of this prospective study was to evaluate the effect of the number of implants supporting a mandibular overdenture on the condition of the peri-implant tissues. Sixty edentulous patients (Cawood class V VI) participated in this study. After randomization, thirty patients were treated with an overdenture supported by two IMZ implants (group A) and thirty patients with an overdenture on four IMZ implants (group B). The implants were inserted in the anterior region of the mandible. After three months overdentures were constructed, supported by round bar and clip attachments. A standardized clinical and radiographic evaluation was performed 0, 6 and 12 months after insertion of the denture. One implant was lost (group A) during the healing period. There were no significant differences with regard to any of the studied clinical or radiographic parameters of the peri-implant tissues, neither were significant differences found between the lateral and central implants in group B. None of the patients reported a sensory change in lip or chin region. From this study it is concluded that there seems to be no need to insert more than two endosteal implants to support an overdenture, however, long-term prospective studies are needed to support this notion.

Adult↗
PubMed1998

Mandibular overdentures supported by two Brånemark, IMZ or ITI implants. A prospective comparative preliminary study: one-year results.

The aim of this prospective comparative study was to evaluate the condition of the peri-implant tissues of three different implant systems supporting a mandibular overdenture. Ninety edentulous patients (Cawood class V-VI) participated in this study. After randomization, 30 patients were treated with 2 Brånemark implants, 30 patients with 2 IMZ implants and 30 patients with 2 ITI implants. The implants were inserted in the canine region of the mandible. After 3 months overdentures were fabricated supported by a round bar and clip attachment. A standardized clinical and radiographic evaluation was performed 0,6 and 12 months after insertion of the denture. The intraoral radiographs were made, using the long-cone technique with an aiming device. Two implants were lost (1 Brånemark, 1 IMZ) during the healing period. None of the patients showed any sensory change in lip or chin region. The pocket depth in the Brånemark group decreased significantly whereas the mucosa recession increased significantly in both the Brånemark as well as in the IMZ group. After 12 months, there was significantly less bone loss in the ITI group. From our study it was concluded that 2 (Brånemark, IMZ or ITI) implants placed in the interforaminal region connected with a bar supply a proper base for the support of a mandibular overdenture in the (Cawood V-VI) edentulous patient. The ITI implant appears to be the implant of choice for mandibular overdenture therapy, because only one operation is required for a comparable result.

Adult↗
PubMed1998

[Relapse after endodontic treatment: endodontic retreatment or apex resection?].

In many cases, unsuccessful endodontic treatment is followed by apicoectomy. Endodontic retreatment, however, could be an appropriate alternative for apicoectomy more frequently. In this paper indications, specific problems and treatment methods are presented for endodontic retreatment, apicoectomy and intentional replantation.

Apicoectomy↗