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PubMed2005

Obturators for acquired palatal defects.

UNLABELLED: The developing role of the prosthodontist in the head and neck cancer team is discussed and a sequence of care given for patients who will require the restoration by prosthetic means of surgically created palatal defects. Various styles of definitive obturators are described. CLINICAL RELEVANCE: A knowledge of the care of patients with palatal defects is of value to GDPs and to members of the head and neck cancer team.

Dental Prosthesis Design↗
PubMed2004

Immediate loading of dental implants in the edentulous mandible.

BACKGROUND: The authors review the literature regarding immediate implant loading in the anterior edentulous mandible, demonstrate the technique they currently use, review preliminary results and present an illustrative case. MATERIALS AND METHODS: The authors conducted a literature search using PUBMED and Ovid databases. They considered for review 31 articles in English from 1969 to 2003 that pertained to immediate loading of the anterior mandible. The authors developed a technique to provide a bar-supported prosthesis on the day of surgery. They treated five patients and followed them up for at least six months. The preliminary results are presented. RESULTS: This literature review demonstrated that immediate loading of anterior mandibular implants is an acceptable method, with predictable results. This case series demonstrates the potential for delivering a final bar on the day of surgery, based on the current evidence and clinical application. CONCLUSIONS AND PRACTICE IMPLICATIONS: The method described provides patients with immediate prosthetic restorations and a decreased treatment time compared with that for the traditional two-stage implant approach.

Dental Implantation, Endosseous↗
PubMed2005

Oral implants.

Explore the source record for details and available documents.

Dental Implants↗
PubMed2005

Application of oral implants to the general dental practice.

BACKGROUND: The use of dental implants has become a management strategy for replacing missing teeth. As new implant surface technologies develop and prosthetic options increase, the field of dental implantology continues to change. General dentists con sidering the use of this treatment modality in their practices should understand the vital role treatment planning plays in achieving predictable outcomes. OVERVIEW: This article reviews specific issues the general dentist typically faces when considering patients for single-tooth, partially-edentulous-arch and full-arch tooth replacement using dental implants. The author analyzes patient-based assessments, as well as diagnostic criteria and steps, to help practitioners predict patient-specific issues that may signal complications. He also discusses approaches for resolving complications. The article emphasizes the importance of careful evaluation in predicting patient-specific issues that can lead to gingival recession and suggests approaches to manage these situations. CONCLUSIONS AND CLINICAL IMPLICATIONS: Dental implants have become an increasingly common treatment option for missing dentition. Because innovations in implant surfaces continue to promote faster bone growth with better predictability, general dentists should be aware of the importance of treatment planning, assessment and teamwork in achieving successful outcomes.

Dental Implantation, Endosseous↗
PubMed2004

An esthetic technique to fill screw-retained fixed prostheses.

Currently, many composite materials have been used in the filling of access openings for screw-retained implant prosthesis. The main disadvantage of these materials is the compromise in esthetics that they place on the implant crown. An additional disadvantage is leakage of bacterial contaminants around traditional light-cured composites placed in the screw access hole. This article introduces a technique that uses opaqueing composites and the expansion properties of panacea (Zeza Inc, Chester, NY) resin to help remedy these problems. The fabrication of the silicone obturator is explained in previous literature. By following this technique, the dentist can use resin to decrease microleakage and opaqueing composite to improve esthetics.

Composite Resins↗
PubMed1998

Assessment of prosthetic restorations on bone-lock implants in patients after oral tumor resection.

The feasibility of implant treatment in patients after oral ablative tumor surgery has not yet been investigated with consideration of the requisite high periodontal standards. A report on this topic has to deal not only with implant survival but also with implant health, bone response, soft tissue health, failure pattern, time of failure, and ease of restoration. For the assessment of an implant system, an overview must be accomplished that takes into account the different restorations used and their interaction with the implant system that was used. This study presents the Bone-Lock implant system (Howmedica Leibinger GmbH, Freiburg, Germany) in a retrospective investigation after 5 years of follow-up with special emphasis on the prosthetic restorations used following resection of oral malignancies. From early in 1990 through June 1996, we inserted 210 dental endosteal Bone-Lock implants (58 patients) after oral tumor resectioning. Included in the study were 45 patients with 162 implants and prosthetic restorations that had been loaded for 1 year (dentures retained by telescopic or bar-clip or ball attachments, implant-supported prostheses, tooth-to-implant connected bridges). Regular follow-up consisted of evaluation of the Plaque Index (Silness and Löe) and of the Sulcus Bleeding Index (Löe), measurements of pocket probing depth, implant mobility (by means of the Periotest method), bone resorption (according to X-ray findings), and a questionnaire that registered patient satisfaction. The results were evaluated for each restoration and were compared with baseline standards. The overall 5-year survival rate was 83.2%. For implants that had been in place for over 365 days, the survival rate was 93%. The investigation showed that after resection of oral malignancies, patients could be treated with dental implants and superstructures with long-term efficacy similar to that found in healthy subjects considering internationally accepted standards. Implant treatment in tumor patients appeared to offer the most positive periodontic results when use of bar-clip or telescope-retained overdentures was involved. The patient satisfaction level with the described prosthodontic treatment was satisfactory.

Alveolar Bone Loss↗
PubMed1998

Use of new magnetic attachments for implant-supported overdentures.

A newly designed magnetic attachment system for external hexed implants with a standard abutment platform has been developed. This system has certain definite advantages over bar attachments and ball attachments, which are frequently utilized for implant-supported overdentures. Especially, it can be applied to cases with reduced vertical dimension of occlusion because the total height of the magnet and the keeper is only 2.3 mm when assembled. In addition, detrimental lateral stresses to the fixture are greatly alleviated due to very low attractive forces horizontally. Favorable clinical results using this new magnetic attachment system have been obtained, and it may be considered a useful addition to overdenture therapy using any external hexel implant with a standard abutment platform, such as the Brånemark implant system.

Aged↗
PubMed2000

Fixed prosthodontics for the edentulous patient.

A case report is used to demonstrate the prosthetic treatment to restore a fully edentulous patient with fixed partial dentures. A rationale for the use of adequate foundations, connections, fixed prostheses, and occlusion is described for this patient.

Bone Transplantation↗
PubMed2001

The effect of implant diameter, restoration design, and occlusal table variations on screw loosening of posterior single-tooth implant restorations.

The purpose of this study was to (1) determine in vitro the effect of narrowing the buccolingual width of the occlusal table on the untightening torque required to loosen gold prosthetic screws after subjecting implants and implant-supported restorations to occlusal loads, and (2) to compare the incidence of screw loosening and values of untightening torque of the screws among crowns supported by 1 wide-diameter as opposed to 2 standard implants after loading in vitro. The restorations were divided into 4 groups (group 1, a narrow crown supported by one 5-mm wide-diameter implant; group 2, a narrow crown supported by 2 standard 3.75-mm-diameter implants; group 3, a wide crown supported by one 5-mm wide-diameter implant; and group 4, a wide crown supported by 2 standard 3.75-mm-diameter implants). A custom-designed chewing machine was used to simulate the grinding phase of the masticatory cycle and lateral excursions. The crowns were subjected to a 6-kg load for 16660 cycles over 5.5 hours and were loaded at the outer and inner inclines and cusp tips with an untightening loading pattern. The untightening torque was measured for the gold screws in the different groups before and after loading at 4 different locations for 8 cycles on the simulated chewing machine. A 1-way analysis of variance indicated a significant difference (P < .001) among the test groups. Pairwise multiple comparison tests (Scheffe) were carried out on mean "change scores." Group 3 was significantly different from the other groups, which were not significantly different from each other. Restoring missing molars with 1 wide-diameter implant had a greater incidence of screw loosening as compared with 2 implants. Narrowing the occlusal table of the restoration is critical when using 1 implant to support a missing molar. The untightening torque of gold screws was not affected by changing the width of the occlusal table of crowns supported by 2 implants.

Analysis of Variance↗
PubMed2001

Management of an implant case that required retreatment: a case report.

The presented case represents how the lack of a preoperative panoramic radiograph or any radiograph contributed to incorrect case planning, poor implant selection, and the careless surgical placement of an implant into or dangerously close to the lower left mental foramen, resulting in a paresthesia of 9 months duration. Two implants were surgically removed and the bone defects were grafted with a mixture of irradiated cancellous bone plus Biogran. One implant was sectioned and intentionally "put to sleep." The case was successfully completed with a lower bar overdenture supported by 4 screw implants placed in alternate sites, opposing a custom fabricated maxillary denture with a lingualized occlusal scheme.

Alveolar Ridge Augmentation↗
PubMed2002

Restoration of divergent free-standing implants in the maxilla.

Divergent implants in the maxilla can make restoration with removable prosthetics difficult when the implants will not be splinted with a superstructure. Attachments to be used with individual implants require that the implants be within 10 degrees of divergence. This article will address a new angled male designed to fit the locator attachment (female component) that can accommodate up to a 40 degrees divergence.

Dental Abutments↗
PubMed2003

Use of magnetic abutments for short endosseous implants following a fibula bone graft in an oral cancer patient: a case report.

Dental implant treatment is an indispensable portion of oral rehabilitation in patients who are to undergo reconstructive surgery following the removal of an oral cancerous lesion. However, ideal dental implant treatment cannot be achieved easily in patients who have undergone mandibular reconstruction with a free vascularized flap, usually because of the limited length, height, and width of the bone graft. Shorter implants (< 10 mm in length) therefore are occasionally used in vascularized fibula graft sites. In such cases, however, shorter implants tend to be overloaded, thereby endangering its longevity. In this article, we discuss how a magnetic abutment system was introduced for such a patient. This was designed to discourage overloading of the mandatory short implants. The outcome was successful without overloading 1.5 years after the placing of the mandibular overdenture.

Bone Transplantation↗
PubMed2005

Screw- vs cement-implant-retained restorations: an experimental study in the Beagle. Part 1. Screw and abutment loosening.

The causes of implant failures can be biological or mechanical. The mechanical causes include fracture of the implant, fracture of the abutment, and loosening of the abutment. Numerous studies show that abutment loosening constitutes one of the marked implant postsurgery complications requiring clinical intervention. The aim of the present study was to evaluate the incidence of the screw loosening in screwed or cemented abutments. Six adult male Beagles were used. In each dog, the first molars and 2 premolars were extracted. The sutures were removed after 7 days. After 3 months, 10 implants were placed in each dog, 5 in the right mandible and 5 in the left mandible. The abutments either were screwed in (n=30) by applying a total strength of 30 N/cm or were cemented (n=30). After 12 months, 8 (27%) loosened screws were present in screwed abutments, whereas no abutment loosening was observed in cemented abutments (P = .0001). Screwed abutments are often submitted to nonaxial loads that determine screw and abutment loosening.

Animals↗
PubMed2005

The use of prefabricated titanium tissue abutments for the construction of a maxillary subperiosteal implant.

This article presents a bimodal procedure for a patient with an implant-supported fixed partial denture (FP2 class of Misch) where endosteal implants (EOIs) and a subperiosteal implant (SPI) were indicated in different sections of the same arch. In edentulous patients, heterogeneous bone volume and density may be encountered in different regions of the same arch. When the available bone is favorable, the use of EOIs is simpler and less time consuming. An SPI is indicated when the available bone is severely resorbed, as in the type I division C, type II divisions C and D, and type III divisions C and D. The main advantage of the described combined technique is that it offers an alternative to invasive surgeries such as iliac crest bone grafts or various surgical augmentation procedures. The second advantage is the very brief healing period after insertion of the SPI before prosthetic loading. Planning, design, laboratory construction, surgical application, and prosthetic rehabilitation for bimodal implant treatment are described. Prefabricated titanium tissue abutments are used in the fabrication of the posts of the anterior titanium SPI. Titanium tissue abutments are placed in the waxup stage of the SPI before the casting of the titanium SPI. Posterior fixtures are EOIs. An anterior SPI with 4 posts and 4 posterior EOIs provides a combination of support for the screw-retained fixed maxillary denture of Misch's FP2.

Alveolar Bone Loss↗
PubMed2006

The relevance of a new generation of monobloc posts and impression copings for implant-supported fixed partial dentures: a 2-year clinical prospective study with the FM-Clip system on EVL implants (SERF).

The use of monobloc posts for implant-supported fixed partial dentures is interesting for biomechanical and biological reasons, but it suffers from a lack of precision during the impression phase. The use of a new generation of monobloc posts associated with individual impression copings with a piston offers a simple and efficient impression procedure for small and medium implant-supported fixed partial dentures. This article presents the FM-Clip system for EVL implants composed of new straight monobloc posts and small impression copings with a piston for precise impressions and easy production of implant-supported fixed partial dentures.

Dental Abutments↗