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Biomedical subjects

T von Arx

Publications and source records attributed to T von Arx.

At least 19 recordsLinked to original sources
PubMed2000

Basic surgical principles with ITI implants.

The basic surgical principles governing the placement of ITI implants are based on research-oriented developments in harmony with evidence-based and outcome-oriented clinical procedures. In the past 15 years, the range of implant indications has been significantly widened, and partially edentulous patients clearly represent the majority of patients seeking treatment with dental implants today. An important aspect of the successful rehabilitation of patients with ITI implants is the careful selection of implant candidates with respect to systemic and local risk factors. These factors are presented based on current knowledge. Today, solid-screw implants in various screw dimensions and neck configurations comprise the ITI Dental Implant System. These different implant types are necessary to handle the full range of implant indications, in particular in partially edentulous patients. The main clinical factors are presented for the selection of the appropriate implant type, length and diameter. These implants are utilized both in a non-submerged and in a submerged approach. The main goal of surgical therapy is low trauma and the least demanding surgical procedure for patient and clinician to optimize the cost-effectiveness of implant therapy. Hence, a non-submerged approach is preferred in all sites without esthetic priority, such as in fully edentulous patients or in posterior sites of partially edentulous patients. These indications clearly represent the majority of implant patients. In esthetic sites, a submerged approach is utilized to satisfy the specific esthetic demands. The possibility to successfully utilize short implants (6 and 8 mm) and a reduced healing period of 3 months are further advantages of ITI implants due to favorable properties of the rough TPS surface. With the introduction of the microrough SLA surface, a reduction of the healing period to 6 weeks facilitates further progress towards simplification of implant therapy. In summary, the ITI Dental Implant System represents a scientifically well-documented, complete implant system for the treatment of fully and partially edentulous patients, offering straightforward surgical concepts based on predictable treatment outcome and excellent cost-effectiveness.

Antibiotic Prophylaxis↗
PubMed2000

Surgical procedures in partially edentulous patients with ITI implants.

Today, partially edentulous patients represent the majority of patients seeking treatment with implant-supported prostheses. This chapter presents the specific aspects of the surgical handling of partially edentulous patients with either single-tooth gaps, extended edentulous spaces or distal extension situations. Due to differences in treatment objectives, a distinction is made between sites without esthetic priority (non-esthetic sites) and with esthetic priority (esthetic sites). In non-esthetic sites, the primary goal of the surgical therapy is to achieve a predictable hard and soft tissue integration of the implant to re-establish function with the implant-supported prosthesis. In esthetic sites, the goal of surgical therapy is to achieve successful tissue integration and to obtain esthetic soft tissue contours to re-establish both function and esthetics. Therefore, the surgeon must have a clear understanding of the specific needs in a given situation, and must master the necessary surgical techniques concerning a correct implant placement and a correct soft tissue handling to achieve the treatment objectives. In non-esthetic sites, a non-submerged approach is clearly preferred, thus avoiding a second-stage procedure for abutment connection. If a soft tissue correction is necessary to re-establish keratinized peri-implant mucosa, this is done at the time of implant placement with mucogingival surgery. In esthetic sites, a submerged implant placement is preferred to achieve esthetically pleasing soft tissue contours. If a soft tissue augmentation is necessary, this is done at the time of implant placement with connective tissue grafts. Thus, the second surgical procedure after 8-10 weeks of healing is reduced to a mucosaplasty like a punch biopsy, avoiding an open flap procedure. Based on favorable properties of the TPS surface, short implants (6 or 8 mm) and short healing periods of 3-4 months have been successfully utilized in partially edentulous patients in the last 14 years. The introduction of the SLA surface allows a further reduction of the healing period to 6 weeks of healing in all sites with normal bone density (class I-III). In summary, the ITI philosophy offers straightforward surgical concepts to predictably achieve the treatment objectives with the least demanding surgical protocol, reducing the related chairtime and costs for the patient and the clinician.

Dental Abutments↗
PubMed1999

Root-end cavity preparation after apicoectomy using a new type of sonic and diamond-surfaced retrotip: a 1-year follow-up study.

PURPOSE: This study evaluated the outcome of periradicular surgery using a new set of retrotips for root-end cavity preparation. PATIENTS AND METHODS: Forty-three patients who had 50 consecutively treated teeth with periradicular pathology were enrolled in this prospective study. After apicoectomy, root-end cavity preparation was performed, using diamond-surfaced retrotips driven by a sonic handpiece; EBA-cement was used as the root-end filling material. Healing assessment was based on clinical and radiographic criteria. RESULTS: At the 1-year follow-up, 82% of the reexamined surgical cases presented with successful healing. Fourteen percent of the treated teeth were deemed as improved (partial healing), and 4% were classified as failures. CONCLUSION: The new retrotips were found to be ideal for root-end cavity preparation. They simplify the surgical approach to root ends where the working space is limited by restricted access. Root-ends prepared with this new sonoabrasive technique yielded excellent results at the 1-year follow-up examination.

Adolescent↗
PubMed1999

Implant placement and simultaneous ridge augmentation using autogenous bone and a micro titanium mesh: a prospective clinical study with 20 implants.

This prospective clinical study evaluated bone regeneration around 20 dental implants placed in 15 patients (mean age 39.7 years). Peri-implant bone defects were augmented with autogenous bone grafts harvested intraorally from the mandible (chin or retromolar area). Augmented sites were covered with an individually trimmed micro titanium mesh which was rigidly affixed with microscrews to the residual jaw bone. Height of implant exposure (mean 6.5 mm), i.e. dehiscencies (80%) or fenestrations (20%), and graft height (mean 6.2 mm) were measured in an apico-coronal direction using a periodontal probe. At re-entry (mean interval 6.6 months) the titanium mesh and microscrews were removed and bone regeneration assessed. The mean height of the integrated bone graft was 5.8 mm corresponding to a mean bone fill of 93.5%. The overall postop healing course was excellent with only one site developing a soft tissue dehiscence with subsequent mesh exposure (complication rate 5%). This study demonstrated that a micro titanium mesh in combination with autogenous bone grafts is effective for treatment of peri-implant bone defects.

Adolescent↗
PubMed1998

Autotransplantation for treatment of regional odontodysplasia. Case report with 6-year follow-up.

Regional odontodysplasia is an uncommon dental malformation with characteristic clinical and radiographic findings. Affected teeth appear discolored with irregularly shaped surfaces. Radiographically wide pulp chambers and thin poorly defined hard tissue outlines are typical features. This report describes a 9-year-old girl with recurrent and recalcitrant periapical infections as a result of unilateral mandibular odontodysplasia. With a 6-year follow-up, this is the longest documented case of regional odontodysplasia treated by tooth autotransplantation.

Bacterial Infections↗
PubMed1998

Localized ridge augmentation using a micro titanium mesh: a report on 27 implants followed from 1 to 3 years after functional loading.

The present paper describes the clinical and radiographic healing results of 27 implants followed from 1 to 3 years after functional implant loading. Prior to implant placement, alveolar ridges with insufficient bone volume were augmented using autogenous bone grafts and a micro titanium mesh for graft stabilization. After a mean interval of 5.2 months implants were installed. Following an osseointegration period of on average 7.2 months, implants were supplied with suprastructures. The mean loading period for the 27 implants was 21 months. All implants exhibited ankylotic stability and healthy peri-implant soft tissues. The detailed analysis of clinical parameters (probing depth, level of mucosal margin, attachment level, modified plaque and sulcus bleeding indices) and radiographic measurements (crestal bone level), revealed findings similar to those at implants placed into non-augmented bone. Peri-implant bone resorption was calculated to be 1.0 mm for the 1st year after implant loading and 0.1 mm for the following year. Pain, suppuration or semilunar bone defects were absent at all implants. It was concluded that loaded dental implants which have been inserted into an augmented alveolar ridge using autogenous bone grafts and a micro titanium mesh for graft stabilization, demonstrate clinical and radiographic findings similar to those of implants placed into a pristine ridge.

Adult↗
PubMed1998

Implant placement and simultaneous peri-implant bone grafting using a micro titanium mesh for graft stabilization.

This article reports the surgical technique and outcome of simultaneous bone grafting and implant placement. A new treatment philosophy different than the principle of guided bone regeneration is presented. The technique is characterized by grafting autogenous bone into a peri-implant bone defect rather than by regenerating bone in a secluded space. Stabilization of the autogenous bone graft is achieved with a micro titanium mesh. The study sample comprised 10 implant sites in six patients. All sites were successfully treated, and postoperative healing was uneventful. The autogenous bone grafts demonstrated perfect integration upon reevaluation when the implants were recovered. The micro titanium mesh proved to be highly biocompatible, exhibited excellent mechanical properties, and avoided graft displacement and contour collapse.

Adult↗
PubMed1997

Treatment of severe peri-implant bone loss using autogenous bone and a resorbable membrane. Case report and literature review.

Clinical case reports and animal studies have demonstrated that the principle of guided bone regeneration can be applied for surgical treatment of moderate to profound peri-implant bone loss (peri-implantitis). However, the degree of bone regeneration within the peri-implant osseous defect was reported to be variable depending on different clinical factors and on the postoperative course. Most papers dealing with surgical treatment of peri-implantitis advocate the use of a non-resorbable ePTFE membrane for secluding the peri-implant bone defect enabling bone regeneration. Additionally some surgeons fill the defects with allografts or alloplasts. The present case report demonstrates another surgical approach by using autogenous cancellous bone for grafting into the peri-implant bone defect and placing a bioresorbable polylactide membrane as a matrix barrier. The successful outcome of this modified surgical approach enabled the patient to maintain the implant for prosthetic reconstruction after early but severe bone loss.

Absorption↗