Management of the posterior maxilla in the compromised patient: historical, current, and future perspectives.
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Animals↗
Biomedical subjects
Thomas J Balshi
Publications and source records attributed to Thomas J Balshi.
Quadruple zygomatic implant support for retreatment of resorbed iliac crest bone graft transplant.
PURPOSE: The purpose of this report is to present a reliable surgical and prosthodontic protocol for the treatment of the atrophic maxilla by placing four zygomatic implants. MATERIALS AND METHODS: The surgical and prosthodontic procedures are described for the retreatment of a 63-year-old woman who had previously undergone an iliac crest bone graft transplant, which had resorbed. RESULTS: It is possible to place double zygomatic implants bilaterally, in addition to conventional implants in the anterior maxilla. Bone grafting procedures can be avoided, resulting in a fixed implant-supported maxillary prosthesis. CONCLUSION: A logical treatment solution is four zygomatic implants for the atrophic maxilla, especially because the previous iliac crest bone graft had resorbed.
Alveolar Ridge Augmentation↗
Teeth in a day for the maxilla and mandible: case report.
BACKGROUND: A growing body of evidence indicates that successful osseointegration of dental implants can take place in the wake of immediate loading, providing that bone quality and quantity are adequate, and patients follow postsurgical instructions carefully. PURPOSE: The goal of this report is to demonstrate the efficient treatment protocol based on immediate loading for both the maxilla and mandible, including extraction site locations. MATERIALS AND METHODS: Following extraction of the remaining anterior mandibular teeth, 18 Brånemark implants (Nobel Biocare AB, Gothenburg, Sweden), including two zygoma and two pterygoid implants, were installed in both arches in accordance with the Teeth in a DayTM protocol developed by the authors 9 years ago. This protocol uses an acrylic screw-retained prosthesis, with steel prosthetic copings embedded, supported by full-size Brånemark implants to prevent micromotion at the bone-to-implant interface. RESULTS: Only 1 of the 18 immediately loaded implants failed to osseointegrate. Three years after completion of treatment, the patient reported functioning well with no complications. CONCLUSIONS: When appropriate subjects are selected, the Teeth in a Day protocol offers patients a number of significant advantages, including condensed treatment time, reduced postsurgical discomfort, and almost instantaneous improvement in speech and masticatory function, esthetics, and patient self-image.
Acrylic Resins↗
Immediate loading of dental implants in the edentulous maxilla: case study of a unique protocol.
Although immediate loading of dental implants is increasingly gaining recognition as an important option for certain categories of implant patients, the maxillary arch has historically posed difficulties that have limited the number of immediate loading applications. To address the needs of patients who cannot tolerate maxillary removable complete dentures, an immediate loading protocol we call "Teeth in a Day" uses a conversion prosthesis that has been expanded to include complete-arch maxillary reconstruction. Use of a large number of implants to prevent micromotion at the bone-to-implant interface is a critical element in this protocol. A patient treatment is reported.
Clinical Protocols↗
Treatment of congenital ectodermal dysplasia with zygomatic implants: a case report.
Dental abnormalities associated with ectodermal dysplasia (ED) can result in severe functional and esthetic problems. To correct these problems, dental implants have increasingly become the treatment of choice. This patient study illustrates the use of implants to rehabilitate a 20-year-old ED patient who initially presented with only 2 permanent and 6 primary teeth in the maxilla. Along with conventional endosseous implants, 2 specially designed zygomatic implants were utilized to avoid the need for bone grafting in the patient's severely resorbed maxilla. This expedited achievement of the final satisfactory result.
Adult↗
Implants are a prosthesis.
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Dental Implantation, Endosseous↗
Immediate placement and implant loading for expedited patient care: a patient report.
This patient report concerns etiologic factors leading to a failed natural dentition, masticatory function, and poor dental esthetics in a 30-year-old woman. The surgical and restorative treatment provided for the patient was designed to address her dental phobia, location of residence, and debilitated oral condition. While the following case report details an example of the clinical success that can be achieved through advances in dental implant treatment, the most satisfying event was not necessarily the procedure itself, but the profound change that the generosity of the osseointegration community has made on the life of a needy individual. Through the active leadership of the Osseointegration Foundation Charitable Grant Program, the patient, whose complex treatment is described here, was able to take advantage of treatment that otherwise would not have been available to her. This complex treatment was enabled by the Osseointegration Foundation and other caring donors.
Adult↗
Immediate functional loading of Brånemark system implants in edentulous mandibles: clinical report of the results of developmental and simplified protocols.
PURPOSE: This report evaluates the 5-year results of 9 of 10 patients in a clinical investigation of immediate functional loading of Brånemark System implants in edentulous mandibles, and of 24 patients treated with a simplified protocol for the same indication. The purpose of the paper is to suggest a simple, reliable, and documented method for immediate implant loading of complete-arch mandibular prostheses. MATERIALS AND METHODS: Ten healthy patients in need of full-arch mandibular implant reconstruction (development group) were treated between December 1993 and December 1994 with 130 Brånemark System standard Implants, placed in fresh extraction and healed sites. Four implants per patient were immediately loaded with acrylic resin fixed prostheses. The prostheses were replaced by metal-framework conversion prostheses approximately 6 weeks later, and definitive metal-reinforced prostheses incorporating all implants were placed after second-stage surgery. An additional 24 patients were treated with a simplified protocol using a total of 144 implants placed between March 1997 and October 2000. In these patients, the acrylic resin prostheses were not disturbed for 3 months, and fewer implants were used with an increasing ratio of implants loaded. Eventually, all Implants were loaded immediately for the last patients treated. RESULTS: The prosthesis survival rate was 100% for the total material. In the developmental group, the implant cumulative survival rate was 80% for the immediately loaded implants after 5 years, while the 2-stage implants reached 96%. Bone level measurements showed no differences between immediate and 2-stage protocols for this group. The implant cumulative survival rate was 97% for the simplified treatment group. DISCUSSION AND CONCLUSION: A predictable and simple concept for loading of immediate implant prostheses in edentulous mandibles was demonstrated. Results from the development of this technique suggest that it may be essential to maintain the initial implant splinting over a healing period of about 3 months and that implant placement between the mental foramina provides optimal support.
Aged↗