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Biomedical subjects

M Nevins

Publications and source records attributed to M Nevins.

At least 37 records · Page 2Linked to original sources
PubMed1997

The use of replicate resin models in the treatment of maxillary sinus augmentation patients.

The elevation of the floor of the maxillary sinus is becoming a routine surgical procedure to develop the site for dental implants. This delicate procedure is best performed with diagnostics of the highest magnitude. To this point, computer tomographic scans provide valuable information, especially when defining the location and extension of septae transversing the sinus. Additional useful information is provided by a replicate resin model that is constructed from a magneto-optical disk compatible with a personal computer. The image data is then converted to a DOS format. Bone structures of interest are thresholded in each slice based on single-pixel gray levels. Object profiles with linear interpolation and their elaboration generate the three-dimensional surface of the object. Finally, the physical resin model is fabricated.

Alveolar Ridge Augmentation↗
PubMed1997

Localized bone reconstruction as an adjunct to dental implant placement.

Advances in bone reconstructive techniques, including the potential of barrier membrane usage for osteogenesis, have increased the indications for implant placement. This review discusses the critical biologic and clinical criteria involved in achieving a predictable success with barrier membranes. Experimental and clinical findings have shown that the type of adjunctive grafting material used, healing time of the membrane site, type and size of bone defect, and membrane exposure all influence the end result. Small bony defects like implant fenestrations and intact extraction sites seem not to depend on the application of membranes to regenerate bone membranes. Large bone grafts used for ridge reconstruction purposes might benefit from membranes, because they reduce the inevitable resorption of bone grafts when used alone. New developments in material and tissue engineering have introduced the use of resorbable membranes, xenografts, and osteoinductive proteins, such as recombinant human bone morphogenic protein, that are likely to play a role in the treatment of localized ridge deficiencies.

Alveolar Bone Loss↗
PubMed1996

Long-term periodontal maintenance in private practice.

Adult periodontitis is a chronic disease suffered by the mainstream of the world's population. To date, its treatment consists of providing support, control, and stabilization of the disease rather than a cure. Although treatment modalities rely upon a maintenance program to preserve a controlled environment that has been established, it is painstakingly evident that total patient compliance does not exceed 40% in private practice. In addition, there is little evidence that any society is populated by plaque-free patients. The important variables in private practice are the end point goals of treatment, manpower availability, patient behavior, the size of the treatment facility and the economic pressures of the geographic location. Each of these has to be considered in its entirety to appreciate the difficulties encountered in managing this significant issue in a periodontal practice.

Adult↗
PubMed1996

Bone formation in the goat maxillary sinus induced by absorbable collagen sponge implants impregnated with recombinant human bone morphogenetic protein-2.

This study assessed the efficacy, safety, and technical feasibility of inducing bone formation in an animal model of maxillary sinus floor augmentation using recombinant human bone morphogenetic protein-2 (rhBMP-2) impregnated on an absorbable collagen sponge (ACS). Bilateral antral maxillary sinus floor elevation procedures were surgically performed in six adult female Alpine-Saanen goats. Bone formation in response to the implant was evaluated using sequential radiographs, computerized tomography, and gross pathologic and histologic analysis performed at necropsy. Computerized tomographic scans documented nonosseous radiopacity in both sinuses postimplantation. Sinuses implanted with the rhBMP-2/ACS subsequently demonstrated increasing radiopacity local to the implant site, while radiopacity of the negative control sinuses remained unchanged or decreased. The results demonstrated the ability of an rhBMP-2/ACS implant to induce substantive new bone formation within the maxillary sinus of goats without adverse sequelae. The rhBMP-2/ACS composite implant may represent an acceptable alternative to traditional bone grafts and bone substitutes for maxillary sinus floor augmentation procedures in humans.

Animals↗
PubMed1996

The relationship of the guided gingival frame to the provisional crown for a single-implant restoration.

This article discusses and defines the use of the provisional crown to encourage gingival growth to provide an ideal frame for a single-tooth implant prosthesis. Both the rationale and the technique are presented. The successful use of an osseointegrated implant to support a fixed prosthesis is an accepted treatment modality in both the biologic and clinical dental communities. The clinical examination, the radiographic survey, and diagnostic casts all contribute to achieving an optimal esthetic result, but the final image may continue to be elusive until the healing of the second-stage surgery when the gingiva can be evaluated. The gold standard of success is providing an inconspicuous result.

Crowns↗
PubMed1995

The successful use of osseointegrated implants for the treatment of the recalcitrant periodontal patient.

This study reports the successful use of osseointegrated implants to replace teeth in patients whose periodontal disease has been categorized as recalcitrant. It includes partially and totally endentulous jaws. A total of 309 implants placed by two periodontists practicing in traditional office settings were included in the survey. Of the 132 mandibular implants, 4 failed, for a success rate of 97%; and 3 of the 177 maxillary implants failed, for a success rate of 98%. There were 21 implants placed in 1985; 38 in 1986 and 1987; 185 from 1988 to 1990; 42 in 1991; and 23 in 1992. The report includes 42 mandibular and 50 maxillary prostheses, none of which has failed. One female mandibular case was converted from 2 posterior free-standing to a full arch prosthesis when the anterior teeth failed periodontally. These results demonstrate that individuals with a strong susceptibility to periodontal disease can be treated successfully with osseointegrated implants.

Adult↗
PubMed1995

Bone formation utilizing titanium-reinforced barrier membranes.

Advances in bone reconstructive techniques have increased the indications for implant placement in sites previously thought to be unsuitable. This clinical study evaluated a new surgical technique for the treatment of a variety of localized bone defects in four patients utilizing a titanium-reinforced membrane. The membrane material was developed to maintain a large protected space between the membrane and the bone surface without the need for a supportive device. Healing was uneventful in all sites, and the membranes were retrieved after 6 to 12 months. No residual defects were noted, resulting in an average change of implant exposure of 8.2 +/- 2.3 mm for sites with buccal dehiscences and from 5 to 6 mm ridge enlargement in localized bone defects. The quality of the regenerated tissue under the titanium-reinforced membrane appeared as bone structure with a superficial fibrous layer. This fibrous layer was more pronounced in sites treated with a membrane alone but was more than compensated by the quantity of new bone under the soft tissue. The results demonstrated that the use of a reinforced membrane appears to be a viable alternative for the clinical treatment of non-space-maintaining implant/bone defects. Further clinical and experimental investigations are recommended.

Adult↗
PubMed1995

Guided bone regeneration of bone defects associated with implants: an evidence-based outcome assessment.

Guided bone regeneration is a new technique that evolved following the guided tissue regeneration procedure for regeneration of lost periodontium. The objective of guided bone regeneration is to promote bone formation in osseous deformities either before or in conjunction with endosseous implant placement. Osseous defects consist mainly of extraction sites, dehiscences or fenestrations, and localized ridge deformities. In addition, bone defects may either provide natural spacemaking or be nonspacemaking. A plethora of publications indicate that the guided bone regeneration technique can be used successfully in all types of defects. Nonspacemaking defects usually require bone graft materials to assist in space maintenance and enhance bone formation. Fixation pins are also used, either with or without graft materials, in this regard. The scientific literature on guided bone regeneration was reviewed by a task force to determine techniques proven to increase predictability relative to successful patient outcomes and to develop specific evidence based diagnostic and treatment decision trees.

Alveolar Bone Loss↗
PubMed1995

Osseointegration and nerve transposition after mandibular resection to treat an ameloblastoma: a case report.

This case report demonstrates the use of osseointegrated implants to replace the mandibular left second premolar and first and second molars removed during a surgical resection of a walnut-sized ameloblastoma. The first-stage surgery was performed 2 years after the oncologic surgery, and it was necessary to laterally reposition the inferior alveolar nerve prior to placement of implants. The patient has been restored to full dental function. There was no occurrence of paresthesia at any time. The treatment plan and the treatment were a collaboration of an oral surgeon, a periodontist, and a restorative dentist, located in Sweden, the United States, and Italy, respectively, and is an indication of what can be accomplished to the benefit of the patient when teamwork is exercised.

Adolescent↗
PubMed1995

The implant periapical lesion: etiology, prevention, and treatment.

A classification of implant periapical lesions that separates them into inactive and infected has been suggested. The inactive form is likely to be an apical scar, resulting from a residual bone cavity created by placing an implant that was shorter than the prepared drill site. The infected focus probably occurs when an implant apex is placed in proximity to an existing infection or when a contaminated implant is placed. Bone necrosis caused by overheating during preparation may also be a causative factor. Suggested preventions of implant periapical lesions include careful management of contaminants and heat generation during implant surgery. Treatment varies according to the type of lesion. The inactive type is observed and monitored. The infected type requires surgical intervention, elimination of the infection, and an implant apical resection or implant removal depending on the extent of the infection and the stability of the implant.

Bacterial Infections↗
PubMed1994

The advantages of localized ridge augmentation prior to implant placement: a staged event.

This paper demonstrates the successful reconstruction of alveolar bone destroyed by advanced periodontitis and endodontic failure. It offers a staged approach that is predictable and is superior to extracting the tooth and not performing a ridge enhancement procedure. Four cases using guided tissue regeneration in combination with bone grafts prior to the placement of endosseous dental implants are discussed.

Alveolar Ridge Augmentation↗
PubMed1993

Histologic investigations on 33 retrieved Nobelpharma implants.

Thirty Nobelpharma implants were retrieved from 17 patients despite a remaining clinical stability, after between 1 and 16 years of clinical function. The reasons for implant removal were bone resorption in combination with soft tissue disorders, psychological causes, implant fracture and post mortem cases. When measured at the cortical passage, there was an average of 84.9% direct bone-to-implant contact and 81.8% average surface bone area in individual threads as evaluated in a computerized morphometric system at the light microscopic level.

Adult↗
PubMed1993

The successful application of osseointegrated implants to the posterior jaw: a long-term retrospective study.

This long-term study has demonstrated the successful use of osseointegrated implants to replace posterior teeth in the partially dentate patient. A total of 1,203 Nobelpharma implants placed by two periodontists practicing in traditional office settings were included in the survey. Of the 551 implants placed in the mandible, 25 failed, for a success rate of 95.5%. Of the 247 mandibular prostheses fabricated for 200 mandibles, 8 failed, for a prosthesis stability rate exceeding 97%. Of the 652 implants placed in the maxilla, 31 failed, for a success rate of 95.2%. Of the 250 maxillary prostheses fabricated for 193 maxillae, 2 failed, for a success rate exceeding 99%. The results compare favorably to previous reports in terms of implant survival and stability.

Adolescent↗
PubMed1993

Periodontal considerations in prosthodontic treatment.

This paper reviews the relationship of periodontics to restorative dentistry. Specific emphasis is placed on the relationship of the restorative margin to the periodontium and the frequent need to alter the placement of the gingival margin so that the restoration will be constructed on sound tooth structure. The prognosis of the sectioned multirooted tooth and other alternatives of treating a shortened dental arch are considered. However, all treatment modalities conclude that a compliant patient and a strong periodontal maintenance program are integral to success, which, with a coordinated effort by the periodontist and the restorative dentist, best assures a successful long-term dental treatment.

Crown Lengthening↗