Biomedical subjects
Publications and source records attributed to I D Zinner.
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.
Often, the posterior region of the maxilla lacks the alveolar bone necessary to maintain an implant-supported prosthesis. The authors outline a procedure to augment the maxillary ridge using a composite alloplastic bone graft. The procedure also enables the practitioner to place implants at the time of the graft, reducing the surgical and healing time for the patient. Within six to 12 months of the bone graft, the patient can wear a fixed, implant-supported prosthesis. The authors report that patients who have been treated with this procedure have maintained stable implant prostheses for over five years.
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.
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.
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A prefabricated Thompson dowel rest semiprecision attachment system for distal-extension removable partial dentures deserves consideration in the treatment planning of periodontally involved dentitions. It is a system that provides for rotation and therefore stress-breaking with controlled movement. Many other stress-breaking systems provide for rotation without specific control. In addition, the Thompson dowel rest system is the only stress-breaker that is intracoronal not extracoronal. This prefabricated system offers facilitation of laboratory procedures, eliminates the need for utilization of gold for dowels, reduces the size of the rest seats, and aids in the preservation of the integrity of the hard and soft supporting tissues.
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Concepts and techniques for fabrication of various types of provisional fixed restorations have been described. The problems created by less than optimal construction are presented. The clinician must decide which type of fixed provisional appliance is desirable or required in various situations. The same fixed provisional restoration cannot be suitable in every situation. The dentist must be able to evaluate and select which type of interim fixed prosthesis should be constructed for the various cases that present in their offices.
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.
This article presents an overview of the techniques and rationale of the various impression procedures employed in the fabrication of the removable portion of a combination fixed and removable reconstruction.
Several impression techniques for the removable component have been presented to help the dentist select impression procedures and materials appropriate to individual intraoral conditions confronted when constructing intracororonally retained removable partial dentures in combination fixed--removable reconstructions.
An overview of the various locking types of semiprecision rests was presented along with several methods for their use in partial denture construction. By using the attachments selectively, the dentist should be able to direct the technician in their construction. All the types and systems presented serve the functions of retention, bracing, and support, which are the requirements for any removable partial denture retainer system.
The history of the nonlocking type of intracoronal semiprecision rest has been traced from its origins with Neurohr in 1930, up to its present use as the Thompson dowel rest. The advantages of the use of this deep rest design and the clasp arm design for primary retention have been discussed. The Blatterfein modification of the lingual clasp arm has been introduced to overcome the problems of breakage and lack of stabilization that are present with the Thompson, Van Dam, and Wands designs. Several clinical situations have been illustrated demonstrating the variety of applications of the Thompson dowel rest type of semiprecision prostheses.
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Explore the source record for details and available documents.