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Biomedical subjects

Kitichai Rungcharassaeng

Publications and source records attributed to Kitichai Rungcharassaeng.

12 recordsLinked to original sources

Bilaminar subepithelial connective tissue grafts for immediate implant placement and provisionalization in the esthetic zone.

Immediate implant placement and provisionalization has been considered as a preservative procedure when replacing failing teeth, especially in the esthetic zone. Nevertheless, an average facial gingival tissue recession of 1 mm is still common after one year of function. Furthermore, facial gingival recession of thin periodontal biotype seems to be more pronounced than that of thick biotype. Biotype conversion around both natural teeth and implants with subepithelial connective tissue graft has been advocated, and the resulting tissues appear to be more resistant to recession. A technique combining subepithelial connective tissue graft and immediate implant placement and provisionalization is devised to achieve a more stable peri-implant tissue in thin biotype situations. This article describes the surgical and prosthodontic approach of this procedure as well as its clinical rationale.

Adult↗

Implants as absolute anchorage.

Anchorage control is essential for successful orthodontic treatment. Each tooth has its own anchorage potential as well as propensity to move when force is applied. When teeth are used as anchorage, the untoward movements of the anchoring units may result in the prolonged treatment time, and unpredictable or less-than-ideal outcome. To maximize tooth-related anchorage, techniques such as differential torque, placing roots into the cortex of the bone, the use of various intraoral devices and/or extraoral appliances have been implemented. Implants, as they are in direct contact with bone, do not possess a periodontal ligament. As a result, they do not move when orthodontic/orthopedic force is applied, and therefore can be used as "absolute anchorage." This article describes different types of implants that have been used as orthodontic anchorage. Their clinical applications and limitations are also discussed.

Bone Plates↗

Immediate functional load of mandibular implant overdentures: a surgical and prosthodontic rationale of 2 implant modalities.

Classic guidelines in osseointegration for root-form dental implants include a long healing period, during which functional load should be avoided. However, the long healing period might impose an intolerable situation on some patients, especially in the completely edentulous situation. Subperiosteal dental implant guidelines demonstrate that the implant upon insertion can be put into immediate function and be restored with the final prosthesis soon after surgery. Studies on immediately functional loaded implant-supported prostheses in patients who are completely edentulous have been reported, exhibiting high success rates comparable with conventionally loaded implants. This article describes the surgical and prosthodontic procedure for the immediately functional loaded mandibular implant overdentures in 2 different dentalimplant modalities, as well as its clinical rationale.

Dental Implantation, Endosseous↗

Prophylactic root resection and periapical grafting for anterior implant aethetics: an integration of tissue-reconstruction and tissue-preservation concepts.

The presence of active infections involving the labial bony plate of a failing maxillary anterior tooth presents a challenging situation for aesthetic implant replacement. Not only would the septic state of an abscess be detrimental for immediate implant placement and bone augmentation, but the accompanying bony destruction would also increase the likelihood and magnitude of gingival recession, making this a bioaesthetic challenge. This article describes a technique that integrates tissue-reconstruction and tissue-preservation concepts to achieve peri-implant tissue aesthetics as well as its clinical rationale.

Adult↗

Clinical complications with implants and implant prostheses.

The purpose of this article is to identify the types of complications that have been reported in conjunction with endosseous root form implants and associated implant prostheses. A Medline and an extensive hand search were performed on English-language publications beginning in 1981. The searches focused on publications that contained clinical data regarding success/failure/complications. The complications were divided into the following 6 categories: surgical, implant loss, bone loss, peri-implant soft tissue, mechanical, and esthetic/phonetic. The raw data were combined from multiple studies and means calculated to identify trends noted in the incidences of complications. The most common implant complications (those with a greater than a 15% incidence) were loosening of the overdenture retentive mechanism (33%), implant loss in irradiated maxillae (25%), hemorrhage-related complications (24%), resin veneer fracture with fixed partial dentures (22%), implant loss with maxillary overdentures (21%), overdentures needing to be relined (19%), implant loss in type IV bone (16%), and overdenture clip/attachment fracture (16%). It was not possible to calculate an overall complications incidence for implant prostheses because there were not multiple clinical studies that simultaneously evaluated all or most of the categories of complications. Although the implant data had to be obtained from different studies, they do indicate a trend toward a greater incidence of complications with implant prostheses than single crowns, fixed partial dentures, all-ceramic crowns, resin-bonded prostheses, and posts and cores.

Alveolar Bone Loss↗

Clinical complications in fixed prosthodontics.

The purpose of this article is to identify the incidence of complications and the most common complications associated with single crowns, fixed partial dentures, all-ceramic crowns, resin-bonded prostheses, and posts and cores. A Medline and an extensive hand search were performed on English-language publications covering the last 50 years. The searches focused on publications that contained clinical data regarding success/failure/complications. Within each type of prosthesis, raw data were combined from multiple studies and mean values calculated to determine what trends were noted in the studies. The lowest incidence of clinical complications was associated with all-ceramic crowns (8%). Posts and cores (10%) and conventional single crowns (11%) had comparable clinical complications incidences. Resin-bonded prostheses (26%) and conventional fixed partial dentures (27%) were found to have comparable clinical complications incidences. The 3 most common complications encountered with all-ceramic crowns were crown fracture (7%), loss of retention (2%), and need for endodontic treatment (1%). The 3 most common complications associated with posts and cores were post loosening (5%), root fracture (3%), and caries (2%). With single crowns, the 3 most common complications were need for endodontic treatment (3%), porcelain veneer fracture (3%), and loss of retention (2%). When fixed partial denture studies were reviewed, the 3 most commonly reported complications were caries (18% of abutments), need for endodontic treatment (11% of abutments), and loss of retention (7% of prostheses). The 3 most common complications associated with resin-bonded prostheses were prosthesis debonding (21%), tooth discoloration (18%), and caries (7%).

Adult↗

Dimensions of peri-implant mucosa: an evaluation of maxillary anterior single implants in humans.

BACKGROUND: Attempts have been made to evaluate the biologic dimension of osseointegrated implants, however, most are histologic studies in animals, and the effect of soft tissue support from adjacent teeth on the interproximal dimension of the peri-implant mucosa for anterior single implants has not been addressed. This study clinically evaluated the dimensions of the peri-implant mucosa around 2-stage maxillary anterior single implants in humans after 1 year of function. The influence of the peri-implant biotype was also examined. METHODS: Forty-five patients (20 males and 25 females) with a mean age of 47.3 years were included in this study. A total of 45 maxillary anterior single implant crowns with a mean functional time of 32.5 months (range, 12 to 78) were evaluated. The dimensions of peri-implant mucosa were measured by bone sounding using a periodontal probe at the mesial (MI), mid-facial (F), and distal (DI) aspects of the implant restoration and the proximal aspects (MT, DT) of adjacent natural teeth. In addition, the peri-implant biotype was evaluated and categorized as thick or thin. Statistical analysis was performed using an independent t test (P<0.05). RESULTS: The means and standard deviations of the dimensions of peri-implant mucosa at MT, MI, F, DI, and DT were 4.20 +/- 0.77 mm, 6.17 +/- 1.27 mm, 3.63 +/- 0.91 mm, 5.93 +/- 1.21 mm, and 4.20 +/- 0.64 mm, respectively. The dimensions of peri-implant mucosa in the thick biotype were significantly greater than the thin biotype at MT, MI, and DT (P<0.05). CONCLUSIONS: The mean facial dimension of peri-implant mucosa of 2-stage implants is slightly greater than the average dimension of the dentogingival complex. The level of the interproximal papilla of the implant is independent of the proximal bone level next to the implant, but is related to the interproximal bone level next to the adjacent teeth. Greater peri-implant mucosal dimensions were noted in the presence of a thick peri-implant biotype as compared to a thin biotype.

Adult↗

Interimplant papilla preservation in the esthetic zone: a report of six consecutive cases.

Simultaneous removal of multiple adjacent teeth in the anterior maxilla often leads to collapse of the labial bony plate as well as flattening of the interproximal bony scallop, resulting in long implant restorations with missing interimplant papillae. An interimplant papilla preservation technique involving alternate immediate implant placement and provisionalization, one following the osseointegration healing period of the other, was introduced. All 14 implants placed in six consecutive patients maintained osseointegration after a mean functioning time of 22.6 months (range 12 to 34 months). A highly satisfactory esthetic outcome and a papilla index score of 3 was observed in all patients.

Adult↗

Peri-implant tissue response of immediately loaded, threaded, HA-coated implants: 1-year results.

STATEMENT OF PROBLEM: Although high success rates have been reported with immediately loaded implants, the peri-implant tissue response has not been well documented. PURPOSE: This study evaluated implant success and peri-implant tissue response of immediately loaded, threaded, hydroxyapatite (HA)-coated root-form implants supporting mandibular bar overdentures with opposing conventional maxillary complete dentures in humans. MATERIAL AND METHODS: Five patients (3 men, 2 women; mean age 61 years) each received 4 HA-coated endosseous root-form implants in the interforaminal region in the mandible. The implants were rigidly splinted with a metal framework within 24 hours. The final EDS clip prosthesis was placed 1 to 2 weeks thereafter. The implants and peri-implant tissues were evaluated clinically and radiographically 0, 1, 3, 6, and 12 months after prosthesis placement. Data were analyzed with a repeated measures 1-way analysis of variance (P<.05). RESULTS: All implants were stable at the end of the observation period (mean Periotest value = -5.9 +/- 1.4). No peri-implant radiolucencies were noted, and no implants were lost. The mean marginal bone changes were -0.42 plus minus 0.34, -0.84 +/- 0.55, -1.14 +/- 0.80, and -1.16 +/- 0.89 mm at the 1-, 3-, 6-, and 12-month follow-ups, respectively (P<.001). Significant declines in the rates of marginal bone changes at each time interval were noted (P<.001). In addition, there were significant decreases in probing depth (P<.001) and plaque index (P<.001) but no significant difference in the frequency of bleeding upon probing (P=.64). CONCLUSION: Within the limitations of this study, the peri-implant tissue response of immediately loaded, HA-coated implants was favorable and comparable to that of conventional, delayed-loaded implants after 1 year.

Aged↗

Factors affecting the survival of implants placed in grafted maxillary sinuses: a clinical report.

Many factors affect the survival rate of osseointegrated implants placed in grafted maxillary sinuses. This clinical report describes the retrospective evaluation of 60 patients with 228 implants placed in 84 grafted maxillary sinuses at the Loma Linda University School of Dentistry. The factors used to determine the survival rates of these implants were implant type, simultaneous/delayed implant placement, pretreatment bone height, oral hygiene, and cigarette smoking habits. Out of the total 228 implants, 205 (89.9%) remained in function after a mean follow-up period of 41.6 months (range 0 to 60 months). A higher failure rate was associated with the use of non-threaded implants, poor oral hygiene, and smoking. This information may facilitate treatment planning and enhance communication between the dentist and patient regarding the risk/benefit ratio and outcomes of implants placed in grafted maxillary sinuses.

Adult↗

Immediate placement and provisionalization of maxillary anterior single implants: 1-year prospective study.

PURPOSE: This 1-year prospective study evaluated the implant success rate, peri-implant tissue response, and esthetic outcome of immediately placed and provisionalized maxillary anterior single implants. MATERIALS AND METHODS: Thirty-five patients (8 men, 27 women) with a mean age of 36.5 years (range 18 to 65) were included in this study. Thirty-five threaded, hydroxyapatite-coated implants were placed and provisionalized immediately after each failing tooth had been removed. The definitive restoration was placed 6 months later. The patients were evaluated clinically and radiographically at implant placement and at 3, 6, and 12 months after implant placement. RESULTS: At 12 months, all implants remained osseointegrated. The mean marginal bone change from the time of implant placement to 12 months was -0.26 +/- 0.40 mm mesially and -0.22 +/- 0.28 mm distally. No significant differences in the Plaque Index scores were noted at different time intervals. The mean midfacial gingival level and mesial and distal papilla level changes from pretreatment to 12 months were -0.55 +/- 0.53 mm, -0.53 +/- 0.39 mm, and -0.39 +/- 0.40 mm, respectively. All patients were very satisfied with the esthetic outcome and none had noticed any changes at the gingival level. DISCUSSION: Although marginal bone and gingival level changes were statistically significant from pretreatment to 12 months of follow-up, they were well within clinical expectations. CONCLUSION: The results of this study suggest that favorable implant success rates, peri-implant tissue responses, and esthetic outcomes can be achieved with immediately placed and provisionalized maxillary anterior single implants.

Adolescent↗