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Biomedical subjects

P A Schnitman

Publications and source records attributed to P A Schnitman.

14 recordsLinked to original sources
PubMed1990

Dental implants. State of the art, state of the science.

Analysis of epidemiologic studies reveals that even with advances in preventive dentistry, edentulism continues to be a pressing problem especially in a rapidly expanding senior population. As an alternative to traditional removable dentures, dental implants can provide fixed support for crowns and bridges. A recent National Institutes of Health Consensus Development Conference revealed significant growth in implant technology and established that, although a complex treatment alternative, implants can function for 10 years or more. Continued development in basic and clinical research, federal regulations, professional education, public awareness, insurance, and marketing will shape the future of the field.

Biocompatible Materials↗
PubMed1990

Education in implant dentistry.

Currently, relatively few dentists are qualified to practice implant dentistry; the demand for dental implants may soon exceed the profession's capacity to deliver this type of treatment. Accordingly, there is a salient need for national standards of education in the field. Implant education varies widely for practicing dentists, postdoctoral students, and predoctoral students. Although many schools are starting to teach implant dentistry in their predoctoral curricula, clinical and laboratory experience is limited. There are not enough trained professors, funding for new departments is limited, and change is often met with resistance. It is anticipated that within the decade, schools will establish departments, divisions, or sections dedicated to education in implant dentistry, despite these obstacles.

Curriculum↗
PubMed1990

Monitored anesthesia care for dental implant surgery: analysis of effectiveness and complications.

The optimal method of providing safe and effective sedation for outpatients undergoing lengthy dental operations is unclear. We provided monitored anesthesia care (conscious sedation) for 102 consecutive dental implant procedures, using intravenous midazolam and fentanyl as primary pharmacologic agents. Midazolam was administered by multiple, intermittent injection or via continuous infusion. The dose of midazolam required for the induction of sedation ranged from 3.4 +/- 1.6 mg to 4.0 +/- 2.0 mg. Maintenance of adequate sedation required a mean midazolam administration rate of 4.0 +/- 2.1 mg/h to 5.1 +/- 2.1 mg/h, and a mean fentanyl administration rate of 54 +/- 29 mcg/h to 60 +/- 27 mcg/h. Continuous monitoring allowed for rapid detection and treatment of 40 separate hemodynamic and respiratory problems. There was no evidence of patient injury, and all patients returned home on the day of surgery. A post-operative telephone survey revealed that 65% of patients had complete amnesia for operative events, 96% were satisfied with monitored anesthesia care, and 94% would desire a similar anesthetic technique for future procedures.

Anesthesia, Dental↗
PubMed1990

Immediate fixed interim prostheses supported by two-stage threaded implants: methodology and results.

Restoring patients with implant-supported fixed-detachable bridges according to the protocol established by Brånemark necessitates a period of several months when complete dentures must be worn to allow for a stress-free healing period of the implants. For many patients, especially when they still have some natural teeth remaining, this is unacceptable. An approach was developed that overcomes these limitations, offering an alternative to the transitional removable approach. Five or six Nobelpharma fixtures were placed between and two additional fixtures were placed distolingual to the foramina. Abutments were connected at implant insertion to these two fixtures and to one fixture in the symphyseal region. The remaining fixtures were allowed to heal in the conventional manner. A previously constructed mandibular denture was converted to a fixed bridge supported by these three implants. This method was successfully applied in seven patients who were reconstructed with mandibular fixed-detachable bridges without ever wearing a removable prosthesis. The overall, long-term implant therapy was not adversely affected by this technique.

Aged↗
PubMed1990

General discussion.

Explore the source record for details and available documents.

Clinical Trials as Topic↗
PubMed1979

Bone maintenance: implant versus transplant.

Bone maintenance based on various attachment mechanisms is the key to tooth-root replacement safety and efficacy. The dental implant has broad applicability based on design, but demonstrates progressive peri-implant bone loss. The allogeneic tooth transplant, significantly less applicable because of size, is antigenic and rejected by bone-replacement root resorption. Since the predictability and survival times of these implant and transplant modalities are similar and there is less residual bone loss with the transplant, it is suggested that for clinical situations such as the fresh extraction socket, where there is room, the allotransplant, rather than implant, is the root-replacement of choice.

Alveolar Process↗
PubMed1975

Alumina and zirconia coated vitallium oral endosteal implants in beagles.

The purpose of this study was to assess the addition of a ceramic coating upon a Vitallium implant to increase the implant's biologic acceptability in the oral environment. The mandibular premolar teeth in 9 adult beagle dogs were removed bilaterally and these areas allowed to heal for 6 weeks. Ceramic coating with either Al2O3 or ZrO2 was carried out by flame spray deposition upon Vitallium anchor implants (9 of each), and the implants placed into the 18 healed premolar areas. Clinical and radiographic evaluation was conducted by 2 independent investigators over a 32 week period. Implants which exhibited mobility greater than II on a scale of 0 to III, at intervals of one-half, were judged unsatisfactory. After 19 weeks, all 9 Al2O3 coated implants and 5 ZrO2 coated implants were rated unsatisfactory. After 32 weeks, 4 ZrO2 coated implants were in situ with 0 or I mobility. Radiographically the width of the peri-implant space increased in direct proportion to both time and mobility. Histologic sections demonstrated encapsulating dense fibrous connective tissue which was oriented parallel to both ZrO2 and Al2O3 implants. Results suggest the zirconia used is a superior ceramic coating to the alumina. Neither seemed to increase biologic acceptability over uncoated Vitallium implants.

Aluminum↗