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Histologic evaluation of 2 human immediately loaded and 1 titanium implants inserted in the posterior mandible and submerged retrieved after 6 months.

Immediate loading can be successfully used in implant dentistry. Many factors are thought to be of importance in obtaining mineralized tissues at the interface. One such factor is the implant surface characteristics. The authors retrieved, after a 6-month loading period, 2 immediately loaded implants and 1 submerged implant, each of which had been inserted in posterior mandibles. Histology showed that, in both immediately loaded implants, mineralized tissue was present at the interface, and the bone-implant contact percentage was about 65% to 70%. No gaps, fibrous tissue, or inflammatory infiltrates were present at the interfaces. In the submerged (control) implant, the bone-implant contact percentage was much lower (about 35%). Our results showed that immediate loading of dental implants, even in the posterior regions of the jaw bones, hadn't caused untoward effects on the formation of mineralized tissues at the interface, producing, on the contrary, a higher bone-implant contact percentage than in the control implant, and thus, immediate loading can be a possible alternative procedure in implant dentistry.

Bone Marrow↗

Immediate function in the edentulous mandible: replacement of a lost implant using prefabricated guides.

This article describes a technique for replacement of a lost implant. The procedure involves the use of templates, drill guides, and drills of the system to replace a 4.5-mm-wide lost implant with a 5.0-mm-wide implant. The surgical procedure was simplified to optimize the healing process and to be more comfortable for the patient. The accuracy of the templates and guides allowed for ideal position of the implant and the immediate use of the original fixed implant-supported prosthesis.

Dental Implantation, Endosseous↗

Presurgical implant-supported prosthesis: technique for cementation of a definitive prosthesis immediately after surgery.

A fixed prosthesis, supported by implants, was fabricated prior to surgery and cemented with passive fit immediately after placement of 14 implants in the mandible. The prosthesis was constructed before implant surgery on a plaster cast that precisely reproduced the patient's hard and soft tissues. The cast was built using a method that allowed the transfer of hard and soft tissue anatomy from computerized tomograms. A rigid surgical stent, cast in gold, was used to place the implants into prosthetically ideal positions under three-dimensional control. The prosthesis was placed immediately after implant placement, using an occlusion-driven method, which avoided the need for occlusal adjustments to the prosthesis.

Cementation↗

[Late results of immediately loaded interforaminal implants].

The aim of this retrospective study was to evaluate the late results of immediately loaded implants in the interforaminal area of edentulous mandibles treated with implant-supported overdentures. the study initially included 44 patients who received a total of 176 ITI implants (4 interforaminal implants per patient) of which 233 patients with 89 implants were controlled (drop out of 21 patients). Immediately after the operation a bar was fixed to the implants and loaded with a retained overdenture. The patients were followed from a minimum of 8 to a maximum of 18 years (average of 12.2 years). Three implants were lost. Five implants didn't pass the criteria of success. The results of this study show that the success rate of immediately loaded implants in the interforaminal region is similar to secondarily loaded implants. According to these data, the often demanded healing phase of four months is not necessary.

Adult↗

The use of a custom template for immediate loading with the definitive prosthesis: a clinical report.

A new approach to implant dentistry for the fully edentulous arch is presented. Using a conventional computer tomography scan and specialized surgical planning software, a fixed final prosthesis is fabricated before the surgical procedure so the prosthesis may be delivered immediately after the implants are placed. Initial prospective studies of 10 patients with observation times of up to 24 months have shown all patients to have a functional prostheses. Long-term studies are being performed to validate this new procedure.

Computer-Aided Design↗

Extractions, implant placement, and immediate loading of mandibular implants: a case report of a functional fixed prosthesis in 5 hours.

The purpose of this report is to present a reliable surgical and prosthodontic protocol for immediate loading of implants, allowing patients to receive a fixed implant-supported prosthesis in a matter of hours. The surgical, prosthodontic, and laboratory steps for this protocol of immediate functionally loading the implants are described for the treatment of a 51-year-old woman who presented with a hopeless mandibular dentition and an edentulous maxillary arch. It is possible to decrease the treatment time in successfully restoring the patient's oral function by means of immediate functional loading of dental implants and immediately placing a fixed implant-supported prosthesis. Compared with the traditional implant protocols, this protocol of a one-visit approach for patient treatment 1) decreases the number of office visits; 2) decreases the treatment time; 3) reduces the patients' costs; 4) allows the patient to avoid wearing a removable interim prosthesis; and 5) increases the patients' acceptance of treatment while maintaining predictability in treating mandibular edentulism.

Dental Implantation, Endosseous↗

Brånemark Novum: prosthodontic and dental laboratory procedures for fabrication of a fixed prosthesis on the day of surgery.

PURPOSE: The purpose of this report is to describe a new technique to fabricate and deliver an implant-supported fixed prosthesis to the patient on the day of surgery, and to propose a protocol for the prosthodontic and dental laboratory procedures. MATERIALS AND METHODS: The development of the Brånemark Novum prosthodontic protocol is reviewed, and clinical and dental laboratory assessments and methods are described. RESULTS: The total treatment time to fabricate a permanent implant-supported fixed prosthesis in the mandible can be reduced to 1 day with the Brånemark Novum technique. The new method includes a precise surgical technique using drilling templates for predetermined implant positions, a rigid splinting of the implants immediately after placement, the use of a prefabricated titanium framework, and elimination of implant impression procedures. CONCLUSION: With the technique described in this report, it is possible to provide patients with a permanent implant-supported fixed prosthesis in the mandible on the day of implant surgery. Patient benefits are obvious, with drastically reduced total treatment time, lower cost, and fewer clinical visits.

Dental Implantation, Endosseous↗

A system for definitive restoration of single-stage implants in one day.

While the Novum system does not offer a solution for immediate loading and restoration of mandibular implants in all patients, it is a valuable treatment option for many individuals. Although the surgery is precise and labor intensive, the fact that no additional (stage 2) surgery is necessary, and that a definitive restorative outcome is possible in a single working day, makes this an appealing treatment option. Current results with this technique in the United States are favorable but short term. Experience in Europe, however, appears to validate this technique, with results that are comparable with the well-documented 2-stage approach.

Dental Implantation, Endosseous↗

Immediate loading of mandibular implants in compromised patients: preliminary results.

To minimize the number of implant surgical procedures, a total of 72 single-stage, transgingival Frialoc implants (Friadent) were placed in the mandibles of 18 patients who required implant restoration. The patients' ability to undergo surgical implant treatment was restricted because of either poor general medical health or psychologic conditions. All implants were immediately loaded with a bar-retained overdenture. Only 4 of the 72 immediately loaded Frialoc implants (in one patient) failed over a control period of 29 months. The cumulative implant survival rate was 94.4%. Apart from an initial increase in bone resorption at two posterior implants supporting a cantilever bar (the cantilevers were removed 13 months after delivery of the prosthesis) and serious lip swelling in one patient, there were no further serious surgical, prosthetic, or general medical problems during the treatment period. The initial results of the study indicate that the single-stage Frialoc System allows fast prosthetic mandibular restorations. Because there is only one operation, the risk of local or general health complications in compromised patients is reduced.

Adolescent↗

A surgical stent for the Brånemark Novum bone reduction procedure.

BACKGROUND: The Brånemark Novum concept (Nobel Biocare AB, Göteborg, Sweden) was introduced to load implants immediately with a definitive fixed prosthesis in the edentulous mandible. This concept is based on the use of prefabricated templates to allow precise placement of three implants and a prefabricated bar structure for the prosthetic procedure. To obtain three-dimensional stability in these prefabricated templates, surgical bone reduction may be necessary to obtain a stable adaptation between the templates and the recipient bone site. PURPOSE: The aim of this work was to design a surgical stent for predictable reduction of the residual alveolar crest prior to the implant placement procedures. MATERIALS AND METHODS: A predetermined alveolar crest platform based essentially on a lateral cephalometric radiographic evaluation was simulated on a cast in order to design a transparent resin surgical guide. The predictability potential of the procedure was then evaluated in 10 patients. The prosthetic outcomes were compared with those of a similar group of 10 patients treated without the presented stent by evaluating two factors, namely, the anterior dimensions of the prostheses and the required posterior adjustments of the upper bar. RESULTS: Correlation analysis of our series suggested a good predictability potential for this procedure (r = 0.9215). The mean anterior prosthetic dimension was 32% lower and was more predictable (narrow range of 8-12 mm vs broad range of 8-21 mm) when the stent was used. Furthermore, since half as many posterior adjustments of the upper bar were required, the laboratory procedure was facilitated. CONCLUSION: This individualized guide allows appropriate bone reduction for obtaining a predictable surgery and prosthetic stage.

Adult↗

[Immediate denture and bar retention denture: two solutions of choice to re-establish function and improve esthetics].

Possibilities given by our technics concerning immediate denture and contra-mucosal retention bar mandibular complete denture, allow, at present time, in five clinical steps, an esthetical improvement and a functional rehabilitation, realizing dental prosthesis with all the standard characteristics of classical removal dentures. Any transitional treatment may be suppressed, temporary prosthesis giving often rise to para-functions and resorptions. Finally, these technics give to the patient perfect conditions for a functional integration of prosthesis, as well on psychological as on physiological point of view.

Dental Impression Technique↗