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Immediate and early function of Brånemark System implants placed in the esthetic zone: a 1-year prospective clinical multicenter study.

BACKGROUND: Immediate/early implant function means great benefits for patients and therapists because treatment time and cost can be substantially reduced. This concept has become an accepted alternative for complete arch fixed restorations in the mandible, and clinical documentation is emerging for other indications. PURPOSE: The purpose of this prospective clinical multicenter study was to evaluate the outcome of implants placed in incisor, canine, and premolar regions in maxillas or mandibles. Implants were loaded with provisional crowns and bridges on the same day or within a few days and were followed up for 1 year during function. MATERIALS AND METHODS: Four centers treated 76 patients each in need of an implant-retained prosthesis in the anterior and premolar regions in the maxilla or mandible. A total of 116 titanium implants with machined surfaces (Brånemark System , Nobel Biocare AB, Gothenburg, Sweden) were placed: 74 in maxillas and 42 in mandibles. Eighty-seven prostheses were made, of which 63 were single crowns and 24 were bridges (supported by 53 splinted implants). Twenty-two implants in 14 patients were placed in fresh extraction sites. The goal with the preparation and insertion technique was to achieve good primary implant stability and a minimum implant insertion torque of 30 Ncm before the implant was completely seated. The occlusion was adjusted to eliminate direct contact with the provisional prostheses. After 6 months, the patients received their permanent prostheses. Sixty-seven patients were followed for 1 year. RESULTS: Five implants were lost in five patients, three in the maxilla and two in the mandible. Four of the lost implants were single-tooth replacements and one was splinted. The cumulative survival rate (CSR) was 95.7% for all implants after 1 year and 93.7% and 98.1% for single-tooth and splinted implants, respectively. There were no implant losses in the extraction sites. CONCLUSIONS: The CSR of 96% at 1 year indicates that immediate function of Brånemark System implants placed in incisor to premolar regions in both jaws is a viable concept. More failures occurred with single-tooth replacements (6.3%) than with splinted implants (1.9%).

Adolescent↗

The use of hypnosis in hemophilia dental care.

The influence of emotional stress on the onset and control of bleeding episodes is a well-known fact. Oral surgical procedures are a common cause of severe states of anxiety in hemophiliacs. Anxiety has been shown to trigger and/or complicate an existing hemorrhagic episode in hemophiliacs. This is true in adults as well as children. Hypnosis, when applicable, has been found to be an excellent adjunct for the control of anxiety. It has been observed that in a relaxed and tranquil hemophiliac, his hemorrhagic tendency during and after surgery is considerably decreased. Induction to a hypnotic state depends on each individual's susceptibility, and therefore different approaches are used depending on the patient's knowledge of hypnosis. In addition to the control of fear, salivary secretions, pain, and capillary bleeding can well be brought under control during surgery and postoperatively by means of posthypnotic suggestions. Good oral hygiene habits such as daily brushing and flossing, so important as preventive measures for the prevention of caries and periodontal disease, can be reinforced through hypnotic suggestions. Preventive dentistry in hemophiliacs is of paramount importance.

Dental Restoration, Permanent↗

Materials and techniques for achieving clinical excellence with indirect composite restorations.

Indirect resin restoration technology continues to grow at an unbelievable rate. This article has outlined some of the materials available within this category. There are others that the author has not had the opportunity to work with. At this time, the author believes the primary indication for the use of this class of material is esthetic inlays and onlays as well as a well-planned conservative [figure: see text] fixed partial denture in a low stress area. If unclear about the best material to use in a given situation, the dentist should consult the laboratory technician to discuss the technician's experience and confidence with the different systems. Many times the physical properties of the material are not as important as the ability of the technician and his or her experience with the different handling properties of the available systems when examining the short-term and long-term success of the restoration.

Cementation↗

Pretreatment wax-ups and provisionals for restorative dentistry.

One of the most important factors in restorative success is the preparation of a case prior to treatment. Case planning, constructing the wax-up and provisional restorations, and understanding the potential problems with a case prior to beginning can only ensure a higher degree of success than would be achieved by not employing these basic restorative steps. Although it is not utilized generally, the wax-up can be of immense value to any restorative dentist for cases of all kinds, ranging from a single tooth to full-mouth reconstruction.

Composite Resins↗

Predictable provisionalization: achieving psychological satisfaction, form, and function.

UNLABELLED: The dentition is the foundation of the human face and is far more than just a masticatory apparatus. The smile, which is the definition of humankind, crosses all gender, age, cultural, and religious boundaries to express emotion. When enhancing or restoring a smile with aesthetic dentistry, the provisionalization phase is critical in conveying information regarding function, occlusion, phonetics, and the patient's expectations among the members of the restorative team. This presentation details a predictable process for rapidly fabricating provisional restorations with optimal fit and performance. LEARNING OBJECTIVES: This article describes the role of provisionalization and a protocol for fabrication of temporary prostheses for optimal results. Upon reading this article, the reader should: Understand the role of provisionalization on the surrounding soft and hard tissue structures. Recognize the role provisionalization plays in patient education and communication.

Dental Restoration, Temporary↗

Allergic contact gingivostomatitis from a temporary crown made of methacrylates and epoxy diacrylates.

Occupational allergic contact dermatitis caused by (meth)acrylates is common in dental personnel, whereas dental acrylic fillings and crowns have rarely been reported to cause problems in dental patients. Here we report on a 48-year-old woman who developed gingivitis, stomatitis, and perioral dermatitis after a temporary crown made of restorative, two-component material had been inserted. The manufacturer stated that the temporary crown base paste and catalyst contained three (meth)acrylates, namely, a proacrylate, which is a modification of 2,2-bis[4-(2-hydroxy-3-methacryloxypropoxy)phenyl]propane (BIS-GMA); a tricyclate, which is a saturated, aliphatic, tricyclic methacrylate; and urethane methacrylate. The manufacturer refused to give more exact information on the (meth)acrylates. Patch testing revealed that the patient was highly allergic to BIS-GMA, other epoxy diacrylates, and (meth)acrylates, as well as to the base paste and catalyst of the temporary crown. Accordingly, it was concluded that the allergic reaction was caused by BIS-GMA, or a cross-reacting (meth)acrylate, or other (meth)acrylates in the temporary crown.

Bisphenol A-Glycidyl Methacrylate↗