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PubMed2004

The conversion partial denture: a clinical report.

The treatment alternative described maximizes the benefit of remaining teeth while allowing simplified alteration of the prosthesis if abutments are lost during the life span of the removable partial denture (RPD). A conversion partial is an RPD whose tooth-frame assembly components are individually fabricated and then joined with an acrylic resin major connector. The conversion RPD optimizes retention and stabilization of a terminal dentition and can be easily converted to an immediate complete denture.

Aged↗
PubMed1991

Endosseous implant placement immediately following dental extraction and alveoloplasty: preliminary report with 6-year follow-up.

The philosophy of retaining natural teeth as long as possible for the preservation of alveolar bone has been a fundamental concept of dental treatment. With the introduction of predictable osseointegrated implant-supported prostheses, placement of an implant immediately after dental extraction can be considered. This paper discusses the technique of implant placement immediately following dental extraction. Clinical experience including 61 patients with follow-up of 1 to 6 years is reported.

Alveolar Bone Loss↗
PubMed1984

Interim dentures and treatment dentures.

Improvement in the interim denture procedure in the past decade has been one of the significant advancements in prosthodontic practice. The interim denture approach is only slightly more time-consuming and expensive than the conventional immediate denture approach, yet it has many advantages. Among those advantages are the following: (1) allows rapid results; (2) results in a higher quality definitive denture; (3) allows the surgical treatment to be performed during one appointment; (4) permits duplication of the natural tooth position; and (5) provides the patient with a spare denture after the definitive denture is completed. An interim denture technique was described that utilized a flexible layered silicone mold to form the replaced teeth. The interim denture procedure is flexible and lends itself to many variations in technique to meet unusual clinical situations. An interim removable partial denture technique was described that involves block-out of undesirable undercuts and duplication of the master cast for fabrication of the partial denture. This technique results in an interim partial denture that can be placed with little or no adjustment and that will provide better service for those who require it. Three simple procedures for fabricating treatment dentures were described and the indications for each were discussed. Although treatment dentures are not often used, they are essential for the dentist who is treating difficult patients who require complete dentures.

Dental Casting Investment↗
PubMed1991

The immediate implant: a treatment alternative.

The safety and efficacy of placing endosseous implants into the anterior mandible at the time of dental extractions with appropriate radical alveolectomies ("immediate implants") is reported. The results were compared to a control group of patients. The success of the immediate group was 92.7%; that of the control group was 98.1%. The difference in success rates was not significant at the P less than .05 level.

Adult↗
PubMed1978

The immediate overdenture. A case history.

A case is described of application of the immediate overdenture technique to restore function, speech and aesthetics in a patient with extreme resorption of the maxillary anterior residual ridge. In the opinion of the authors, retention of the roots of the remaining teeth most definitely contributed to the retention, stability and overall success of the denture (Figs. 9, 10).

Denture, Complete, Immediate↗
PubMed2004

Immediate restoration and loading of dental implants: clinical considerations and protocols.

The use of dental implants to assist in the treatment of partial and complete edentulism is well documented. Most of the implant literature, however, reports results associated with implant survival and success when there has been adherence to rigid placement and loading protocols. Conventionally, these protocols call for the undisturbed healing of the implant-3 months in the mandible and 4 to 6 months in the maxilla. This article evaluates the literature and develops protocols for clinical procedures for the early or immediate restoration or loading of dental implants. Criteria are established for defining immediate loading, immediate restoration, early loading, and early restoration as compared to conventional protocols. The review assesses factors that influence accelerated loading and restoration decisions, including bone quality and quantity, implant design, splinting of implants, and prosthetic design. Conclusions and recommendations are made based on the experience of the consensus group charged with considering these procedures and on the current literature published on these protocols.

Bone Density↗
PubMed2005

Simplified treatment of the atrophic posterior maxilla via immediate/early function and tilted implants: A prospective 1-year clinical study.

BACKGROUND: Posterior maxillae are often difficult to treat owing to the sinus antrum. Placing implants in remaining bone regions in the atrophic maxilla, without performing sinus grafting, is a challenge. Immediate function adds to this challenge. PURPOSE: The purpose of this study was to suggest and evaluate a simplified treatment concept for the rehabilitation of the atrophic maxilla using tilted implants subjected to immediate/early function. MATERIALS AND METHODS: Eighteen patients were included in the study. Sixty implants were placed to support 19 fixed partial or full-arch prostheses. Immediate/early function was applied. The patients were followed for a minimum of 1 year after prosthesis connection. Stability measurements and radiographic evaluation of the change of the marginal bone level were performed. RESULTS: One axial and one tilted implant failed in one patient, giving a cumulative survival rate of 96.7%. No failure of provisional prostheses occurred. The mean marginal bone resorption recorded after 1 year was low (0.82 mm for axial implants and 0.34 mm for tilted implants). CONCLUSION: The results of the present study suggest that tilted implants placed in immediate function may be a viable treatment approach for the rehabilitation of the atrophied maxilla. Simplified treatment procedures, reduced surgical invasion, shorter treatment time, and reduced costs constitute some of the benefits for the patient and the clinician.

Aged↗
PubMed2005

Immediate occlusal loading of Brånemark System TiUnite implants placed predominantly in soft bone: 4-year results of a prospective clinical study.

BACKGROUND: Immediate occlusal implant loading has been documented as a viable treatment option for various indications. However, most of the available studies reported on the short-term outcome of this treatment modality. PURPOSE: The purpose of this prospective clinical study was to document, on a long-term basis, the outcome of immediate occlusally loaded Brånemark System Mk IV TiUnite (Nobel Biocare AB, Göteborg, Sweden) implants placed to support fixed reconstructions in various regions of the jaws. MATERIALS AND METHODS: Thirty-eight patients received a total of 51 fixed prosthetic reconstructions, all of which were connected on the day of implant insertion. Twenty restorations replaced single teeth, 30 were fixed partial dentures, and 1 was a full-arch fixed lower restoration. These prostheses were supported by 102 Brånemark System Mk IV TiUnite implants (38 maxillary and 64 mandibular), the majority of which were placed in posterior regions (88%) and mainly in soft bone (76%). Resonance frequency measurements and marginal periimplant soft tissue evaluations were conducted during the course of the study. Furthermore, radiographic examinations were performed at the time of prosthesis delivery and at the 1- and 6-month and 1-, 2-, 3-, and 4-year follow-up visits. This report summarizes the results after 4 years of loading. RESULTS: Three maxillary implants were removed, although stable, in one patient at the 8-week follow-up owing to postoperative infection in the adjacent guided bone regeneration area. No implants were lost further on. This resulted in a cumulative implant success rate of 97.1% after 4 years of prosthetic loading. The mean marginal bone remodeling after 4 years of function was 1.3 +/- SD 0.9 mm. At 4 years, absence of marginal plaque and bleeding on probing was reported for 87% and 69% of the sites, respectively, thereby remaining unchanged since the 1-year follow-up. On average, the interproximal soft tissue fill increased for both mesial and distal papillae from scores of 1.4 +/- 1.1 and 1.0 +/- 1.1, respectively, at the preoperative assessment to 2.0 +/- 0.8 and 1.7 +/- 0.8, respectively, at the 4-year assessment. CONCLUSION: The applied immediate loading protocol, in combination with a slightly tapered implant design and a modified implant surface texture, was shown to be a successful treatment alternative in regions exhibiting soft bone.

Adult↗
PubMed1993

[Jawbone reduction in immediate prostheses. A comparison between overdentures and complete dentures].

In a randomized controlled clinical trial 74 patients who required immediate dentures were randomly treated with immediate overdentures on 2 lower canines or immediate complete dentures. Mandibular bone reduction was measured using oblique lateral cephalometric radiographs made at base-line and the results compared with those of one year and two years after denture treatment. Analysis of the data showed that the average bone reduction in the lower canine regions in the first year was 0.75 in the immediate overdenture group and 1.90 mm in the immediate complete denture group. In the posterior parts of the mandible the bone reduction was respectively 0.77 and 1.77 mm. The differences were statistically significant in all measured regions. The differences in the first two years were significant in all regions except the molar region. Retention of roots of canines beneath a mandibular denture in immediate denture patients, even when they were in poor condition, reduced the collapse of the alveolar processes in all region of the mandible.

Alveolar Bone Loss↗
PubMed2003

Immediate functional loading of Brånemark System implants with enhanced initial stability: a prospective 1- to 2-year clinical and radiographic study.

BACKGROUND: The interest in the benefits of immediate loading of titanium implants has recently involved fixed prostheses for partially edentulous areas. The advantages of this approach well justify the need for extending the procedure to all regions of the mouth. Current available clinical literature on this subject is incomplete. PURPOSE: The purpose of this study is to investigate the clinical outcome of the immediate loading of Brånemark System implants (Nobel Biocare AB, Gothenburg, Sweden) inserted with enhanced initial stability principally in posterior sites (78%). MATERIALS AND METHODS: The present study was conducted in 26 consecutively treated patients. A total of 50 Brånemark System machined surface implants were placed supporting 30 fixed temporary partial dentures in light occlusion. All implants were followed up for a minimum of 1 year of function. Minimum requirements for immediate loading were proposed. Bone quality and quantity were classified according to Lekholm and Zarb's criteria. Stability of the marginal bone level, both mesial and distal, was measured on the basis of radiographic analysis. Implant survival rate was calculated according to Kaplan-Meier analysis. The peak insertion torque employed during fixture placement was between 40 and 72 Ncm, except in the case of one implant that was lost. RESULTS: Overall survival rate was 98%. An unpaired t-test revealed bone remodeling conforming to biologic width establishment (p <.005). CONCLUSIONS: Within the limit of this study, immediate loading appears to be a viable procedure in posterior sites and for a growing number of clinical indications. Enhanced implant stability and light occlusion seem to be security factors. In spite of unfavorable conditions such as the presence of quality 4 bone and a lack of splinting, all implants with enhanced primary stability survived.

Adult↗
PubMed2005

Immediate loading in oral implants. Present situation.

The earliest antecedents of immediate loading were introduced by Ledermann in 1979. He placed overdenture in four interforaminal implants on the same day the surgery was carried out. In the original implantological protocol of Brånemark the immediate loading did not appear indicated, currently, it is being presented as a predictable alternative in several studies. We revised different articles on immediate loading from 1997 to 2002. We analysed different variables and concluded that immediate loading produces a success rate in posterior maxilla similar to the differed loading (90-100%). The characteristics of the implant, favourable to immediate loading, are: screw-shaped, with a rough surface, sand blasted and acid etching processed and a minimum length of 10 mm. The initial stability and a micro movement of the implant, inferior to 150 microm and a marginal to the insertion equal or superior to 32 N/cm are defined as a proper osseous. The bruxism stands out as an adverse factor according to several authors.

Crowns↗
PubMed2005

Immediate loading dental implants: overview and rationale.

Brånemark established the concept of osseointegrated dental implants as a predictable modality for treatment of edentulous patients. He defined osseointegration as bone-to-implant contact at the microscopic level. Osseointegration was a revolutionary concept in implant dentistry. While earlier pioneers never considered direct bone anchoring of the implant, and even established interposition of fibrous tissue between implant and bone as desirable to mimic periodontal ligament function, Brånemark et al. demonstrated that direct bone apposition at the implant surface was not only possible, but long lasting.

Aged↗
PubMed2003

Critical review of immediate implant loading.

BACKGROUND: Implant dentistry has become successful with the discovery of the biological properties of titanium. In the original protocol, studies have advocated a 2-stage surgical protocol for load-free and submerged healing to ensure predictable osseointegration. However, the discomfort, inconvenience, and anxiety associated with waiting period remains a challenge to both patients and clinicians. Hence, loading implant right after placement was attempted and has gained popularity among clinicians. Issues/questions related to this approach remain unanswered. Therefore, it is the purpose of this review article to (1). review and analyze critically the current available literature in the field of immediate implant loading and (2). discuss, based on scientific evidence, factors that may influence this treatment modality. MATERIAL AND METHODS: Literature published over the past 20 years was selected and reviewed. Findings from these studies were discussed and summarized in the tables. The advantages and disadvantages associated with immediate implant loading were analyzed. Factors that may influence the success of immediate implant loading, including patient selection, type of bone quality, required implant length, micro- and macrostructure of the implant, surgical skill, need for achieving primary stability/control of occlusal force, and prosthesis guidelines, were thoroughly reviewed and discussed. RESULTS AND CONCLUSION: Various studies have demonstrated the feasibility and predictability of this technique. However, most of these articles are based on retrospective data or uncontrolled cases. Randomized, prospective, parallel-armed longitudinal human trials are primarily based on short-term results and long-term follow-ups are still scarce in this field. Nonetheless, from available literature, it may be concluded that anatomic locations, implant designs, and restricted prosthetic guidelines are key to ensure successful outcomes. Future studies, preferably randomized, prospective longitudinal studies, are certainly needed before this approach can be widely used.

Bite Force↗
PubMed1998

Immediate loading of titanium plasma-sprayed implants: an histologic analysis in monkeys.

Aim of this study was to evaluate peri-implant tissue reactions to immediately loaded titanium plasma-sprayed implants in Macaca fascicularis monkeys. A total of 48 titanium plasma-sprayed implants were inserted (24 in the posterior maxilla and 24 in the posterior mandible). A metal superstructure was cemented 3 days after implant insertion on 24 implants (12 in the maxilla and 12 in the mandible) (test implants). The remaining 24 implants (12 in the maxilla and 12 in the mandible) were left unloaded (control implants). Nine months after implant placement a block section was carried out, the defect filled with non-resorbable hydroxyapatite, and all 48 implants retrieved. The implants were treated to obtain thin ground sections. Three slides were cut for each implant and examined under normal and polarized light and a morphometrical analysis done. All implants were covered by bone under light microscopy. The histomorphometrical analysis demonstrated that in test implants, the bone-implant contact percentage was 67.3% (+/-7.6%) in the maxilla, and 73.2% (+/-5.9%) in the mandible; in control implants the percentages were, respectively, 54.5% (+/-3.3%) and 55.8% (+/-6.5%). In the test implants the bone around the implants tended to have a more compact appearance. In conclusion, our study demonstrated that in test implants the bone-implant contact percentage was significantly greater than in the controls (P < 0.01) and no fibrous connective tissue was present at the interface.

Alveolar Process↗
PubMed1975

The use of natural teeth in overlay dentures.

A method has been described for the construction of tooth-supported dentures where the natural tooth was utilized and the acrylic resin for the denture base processed directly to the prepared cast. Based on the 112 dentures that were made, this technique is economical, provides support and stabilization, and has full patient acceptance.

Dental Abutments↗