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Biomedical subjects

Ofer Mardinger

Publications and source records attributed to Ofer Mardinger.

4 recordsLinked to original sources

Use of dental implants to improve unfavorable removable partial denture design.

This study aimed to determine whether the use of a limited number of dental implants, with no rigid connection between implants and teeth and as few as possible prosthetic element requirements, is a viable solution for improving unfavorable removable partial dentures (RPD) design. Fifteen partially edentulous patients with an unfavorable number and distribution of abutment teeth were treated, each with a limited number of implants, from 1997 to 2004, resulting in an improved RPD design. Implant survival rate was 100%, and prosthetic complications were minor. All patients reported great satisfaction with the partial dentures and good chewing efficiency. The results indicate that the use of dental implants to improve unfavorable RPD design is a viable and cost-effective treatment modality.

Dental Abutments↗

Temporomandibular joint involvement in malignant external otitis.

OBJECTIVE: The purpose of this study was to present 6 patients with malignant external otitis (MEO) that resulted in temporomandibular joint (TMJ) involvement and to discuss the incidence, clinical presentation, and treatment modalities. STUDY DESIGN: All patients diagnosed with MEO between 1994 and 2002 were reviewed for cases in which the TMJ was invaded by the infectious process. Only patients in whom TMJ involvement was documented radiographically and in whom the clinical course was well documented were included in this study. RESULTS: MEO was diagnosed in 42 patients over an 8-year period; TMJ involvement was recorded in 6 patients (14%). The medical history revealed controlled type 2 diabetes mellitus in 4 of the 6 patients. All patients reported early ear symptoms, mainly otalgia and otorrhea. Local signs included an ear canal filled with granulation material, edematous overlying skin, and sensitivity to palpation. Cultures taken from the external ear were positive for either Pseudomonas aeruginosa, Staphylococcus epidermidis, Aspergillus, or Proteus mirabilis. TMJ symptoms developed between 1 and 5 months after admission and included painful periauricular swelling and trismus. In 3 patients, healing was uneventful; 3 also died of the disease. CONCLUSIONS: TMJ involvement in MEO is associated with a resistant disease process, often with several recurrences. Prolonged administration of antibiotics is the treatment of choice. Surgical debridement of the TMJ is necessary for the positive identification of the pathogenic organism, in cases of abscess formation, or when osteomyelitic bone destruction of the condyle and glenoid fossa develop.

Aged↗

Peripheral giant cell granuloma associated with dental implants.

BACKGROUND: Peripheral giant cell granuloma (PGCG) is a well-circumscribed lesion confined to the alveolar and gingival mucosa. PGCG is considered a reactive lesion caused by local irritation or trauma. The objectives of the present study were to evaluate the incidence of PGCG in peri-implant lesions submitted for histologic examination, to establish its correlation with implant failure, and to discuss its pathogenesis. METHODS: The study was conducted on 25 periimplant biopsy specimens submitted for histological examination between 1999 and 2001. Sections (5 microm) of paraffin embedded tissues were cut and stained with hematoxylin and eosin. RESULTS: From the 25 specimens, three (two males and one female, ranging in age from 31 to 69 years) were identified as peripheral giant cell granuloma. The posterior mandible was affected in two cases and the anterior maxilla in one. The clinical appearance was an exophytic mass with a bleeding surface. The time interval between implantation and lesion development was from several months to 6 years. Recurrence following curettage was found in all cases. The implants were stable; however, two were removed either because of bone loss around the implant or because of several recurrences. In all cases healing was uneventful. CONCLUSIONS: Peripheral giant cell granuloma can develop in association with dental implants. Clinically, the lesions are similar to the classical PGCG. In the present study, the precise incidence could not be concluded because of the small number of selected cases. Due to the aggressive nature of the lesion and the high recurrence rate, implants can fail unless the lesion is detected early and proper surgical removal is performed. Tissue removed from the peri-implant area should always be submitted for histologic examination for accurate diagnosis.

Adult↗

Marginal bone loss pattern around hydroxyapatite-coated versus commercially pure titanium implants after up to 12 years of follow-up.

PURPOSE: The purpose of this study was to compare the marginal bone loss (MBL), complications, and 12-year survival rates of commercially pure titanium (cpTi) and hydroxyapatite (HA)-coated implants placed in the maxilla. MATERIALS AND METHODS: The study group consisted of 120 patients (77 women, 43 men) treated from 1988 to 1997. A total of 388 implants (156 cpTi and 232 HA-coated) were placed in the maxilla. There were 126 immediate (32.5%) and 262 (67.5%) nonimmediate implants. Patients were evaluated annually. Mean follow-up was 60 +/- 32.3 months. MBL was measured on radiographs using the implant threads as the dimensional reference. MBL, complications, and 12-year survival and success rates were correlated with implant coating, time of implantation, implant dimensions, and position in arch. RESULTS: Total mean MBL was 1.07 +/- 2.16 mm. MBL was significantly lower with cpTi implants (0.55 +/- 1.04 mm) compared to HA-coated implants (1.51 +/- 2.71 mm) (P < .001). No statistical difference in regard to MBL was found between immediate and nonimmediate implants (0.86 +/- 1.8 mm vs 1.16 +/- 2.3 mm). The total 12-year survival rate was 91.4%. HA-coated implants had a significantly higher 12-year survival rate than cpTi implants (93.2% vs 89%; P < .03). Nonimmediate implants had a significantly higher failure rate (8.2%) than the immediate implants (1.3%) (P < .009). No correlation was found between type of implant coating and late implant failure. DISCUSSION: Immediate implants can serve as a predictable option, providing higher survival and success rates. HA-coated implants tended to fail less during the surgical phase, but had higher mean MBL compared to cpTi implants. CONCLUSIONS: HA-coated implants had greater MBL than cpTi implants but a higher 12-year survival rate. Immediate implants had a lower failure rate than the nonimmediate implants in this study population.

Adolescent↗