SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
A procedure for the creation of a custom, anatomic implant abutment copy milled with digitally scanned information has been described. The definitive restoration was a custom-machined abutment with a ceramic crown that had an aluminous oxide core.
The objective of this study was to investigate the clinical performance of: (1) adhesively placed Cerec crowns with reduced stump preparations, and (2) Cerec endo crowns. The crowns were examined at baseline using modified USPHS criteria in 20 patients with 10 Cerec crowns with reduced stump preparations and 10 Cerec endo crowns. All crowns had been produced chairside with the Cerec 3 CAD/CAM method using the function mode. The crowns were machined from Vita Mk II feldspathic ceramic blocks, polished manually, and placed with dual-curing composite luting agent using a functional adhesive. After 1 year, a follow-up examination of the crowns was conducted; all 20 Cerec crowns were rated with a clinically acceptable A or B rating. Fractures or loss of retention were not observed. The method of producing and placing all-ceramic crowns with reduced stump preparations and endo crowns chairside in one appointment can be implemented successfully in private practice.
Immediate placement of dental implants into tooth extraction sites is an effective treatment option. When immediate placement procedures are performed with a round implant, a void is often evident between the implant and the orifice of the socket. Previous treatment focused on the use of membranes or special closure techniques to induce bone growth into the void. Anatomically shaped dental implants provide a predictable alternative to previous filling techniques since the anatomical implants decrease or completely fill the void at the socket opening. This article describes a surgical technique developed for the immediate placement of these implants in extraction sites.
PURPOSE: Non-vital endodontically treated posterior teeth with complete loss of coronal hard tissues were prepared with a circular equigingival butt margin and central retention cavity of the entire pulp chamber ("endo-preparation"). Computer-generated ceramic corono-radicular restorations (Cerec endo-crowns) were bonded to these preparations. The purpose of this study was to evaluate the survival rate and the clinical quality of CAD/CIM endo-crowns after 2 years. MATERIALS AND METHODS: 19 Cerec endo-crowns (4 premolars and 15 molars) in 13 patients were examined using modified USPHS criteria at baseline and after an average time of 26 months. The ratings of the two examinations were compared. RESULTS: The service time of the 19 endo-crowns was 14 to 35.5 (mean +/- SD: 26 +/- 6) months. One molar endo-crown failed after 28 months because of recurrent caries. CONCLUSION: The overall clinical quality of the Cerec endo-crowns was very good, and so far, the clinical concept appears feasible.
Explore the source record for details and available documents.
Implant dentistry has evolved into one of the most predictable treatment alternatives in all of medical science. Advances in the surgical and prosthetic components, implant designs and surface technologies, and imaging techniques have allowed for significant modifications to occur with respect to one- and two-stage surgical protocols, accelerating treatment times to the benefit of patient and clinician. This article presents a technique to improve surgical and restorative accuracy, allowing for predictable placement and immediate loading of implants through use of CT imaging, stereolithographic models, and CT-derived surgical templates.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Thirty routine patients, provided with fixed prostheses supported by osseointegrated Brånemark implants in edentulous lower jaws, were arranged into three different groups with regard to design of the metal framework. Ten patients received cast gold alloy frames and the other two groups were provided with two different designs of welded titanium frames. The fit of the completed prostheses was measured in three dimensions (3-D) in relation to the master cast, by means of a photogrammetric technique, prior to insertion. Mean 3-D distortion of the centre point of the gold cylinder was 42 (s.d. 8) microns for the cast framework. The corresponding mean distortion for the two designs of titanium frameworks was 43 (s.d. 16) and 36 (s.d. 10) microns, respectively. Least distortion was observed in vertical direction for all three designs. None of the different designs of metal frames showed a significantly better fit (P > 0.05), but the cast and oldest titanium framework design presented a much wider range of distortion. This indicated a higher risk of sectioning and resoldering during the fabrication of the prostheses as compared to the more consistently fabricated prostheses, with a new titanium framework design.
Soft and hard tissue defects of the cranio- and maxillofacial area, especially after an avulsion injury, are challenging to reconstruct. Sophisticated soft and hard tissue transfer techniques have allowed satisfactory reconstruction of the gross anatomic structure. However, these methods do not allow optimal restoration of fine anatomic detail or function. The advent of dental implants and modified dental implants for craniofacial applications has allowed maximization of cosmetic and functional restoration. Prosthodontists are capable of fabricating subunits of the cranio- and maxillofacial area with fine detail, reproducing the coloring, texture, and idiosyncrasies of a patient's native skin. Dental implant technology has allowed these prostheses to be bone anchored, yielding a reproducible and stable attachment. This method of attachment in turn allows flexibility in the design of the prosthesis, to maximize restoration, and imparts an increased sense of confidence to the patient. Illustrated are six examples demonstrating the versatility of dental implants in the reconstruction of avulsion injuries of the cranio- and maxillofacial complex.
STATEMENT OF PROBLEM: It has been suggested that a precise fit between the implant and the framework cylinder is necessary to ensure a satisfactory long-term clinical outcome. PURPOSE: The purpose of this study was to compare the precision of fit between implant abutments and framework cylinders in frameworks fabricated by the Procera system and those fabricated from cast gold-alloy. MATERIAL AND METHODS: A total of 19 frameworks, 14 made with the Procera system (type 1) and 5 made of a cast gold-alloy (type 2), were fabricated. A total of 95 implants, 70 type 1 and 25 type 2 frameworks, were evaluated. Three replicas of the space between the implant abutments and the framework cylinders of the master cast were made for each test specimen. The replicas were cut with a scalpel in 2 axial directions: buccal-lingual and right-left. For the purpose of measurement, a microscope with a precision of +/- 0.5 microm was used at original magnification x30. The Student t test was used to determine whether there were significant differences between the framework designs. RESULTS: The buccal-lingual measurements for the type 1 and type 2 frameworks showed mean values of 28.1 microm (SD 9.8) and 42.0 microm (SD 1.8) on the buccal side, respectively, and 25.6 microm (SD 11.2) and 51.6 microm (SD 10.9) on the lingual side, respectively. For the right-left view, the mean measurements were 26.6 microm (SD 8.4) and 49.2 microm (SD 11.4) on the right side, respectively, and 27.4 microm (SD 8.5) and 44.4 microm (SD 6.5) on the left side, respectively. The total mean value for type 1 frameworks was 26.9 microm (SD 9.3); that for type 2 frameworks was 46.8 microm (SD 8.8). CONCLUSION: Within the limitations of this experiment, it was demonstrated that the fit of frameworks made with the Procera system was significantly better than that of the frameworks made with cast gold-alloy (P<.01).
The purpose of this article is to identify the incidence of complications and the most common complications associated with single crowns, fixed partial dentures, all-ceramic crowns, resin-bonded prostheses, and posts and cores. A Medline and an extensive hand search were performed on English-language publications covering the last 50 years. The searches focused on publications that contained clinical data regarding success/failure/complications. Within each type of prosthesis, raw data were combined from multiple studies and mean values calculated to determine what trends were noted in the studies. The lowest incidence of clinical complications was associated with all-ceramic crowns (8%). Posts and cores (10%) and conventional single crowns (11%) had comparable clinical complications incidences. Resin-bonded prostheses (26%) and conventional fixed partial dentures (27%) were found to have comparable clinical complications incidences. The 3 most common complications encountered with all-ceramic crowns were crown fracture (7%), loss of retention (2%), and need for endodontic treatment (1%). The 3 most common complications associated with posts and cores were post loosening (5%), root fracture (3%), and caries (2%). With single crowns, the 3 most common complications were need for endodontic treatment (3%), porcelain veneer fracture (3%), and loss of retention (2%). When fixed partial denture studies were reviewed, the 3 most commonly reported complications were caries (18% of abutments), need for endodontic treatment (11% of abutments), and loss of retention (7% of prostheses). The 3 most common complications associated with resin-bonded prostheses were prosthesis debonding (21%), tooth discoloration (18%), and caries (7%).
BACKGROUND: Most implant treatment is performed with a two-stage surgical procedure. A disadvantage of these implant treatments is that they are time-consuming. PURPOSE: The aim of the present study was to evaluate the results of early loading in the edentulous mandible and to compare those results with treatment results of one-stage surgery followed by a healing period and with two-stage surgery. MATERIAL AND METHODS: The material comprises four treatment groups with a total of 108 patients with edentulous lower jaws and 432 implants. All patients were treated with Brånemark implants (Nobel Biocare AB, Gothenburg, Sweden) with a turned surface and fixed prostheses in the lower jaw, supported by four implants. The patients in group A were treated with a one-stage procedure, a two-piece implant, and a 3-month healing period before loading. Group B (control group) had a two-stage procedure, a two-piece implant, and a 3-month healing period. Group C had a one-stage procedure, a one-piece implant, and a 3-month healing period. Group D was treated with a one-stage surgical procedure, a two-piece implant, and early loading (within 3 weeks). All patients were provided with a Procera Implant Bridge (Nobel Biocare) with a framework made by computer-assisted milling of one piece of pure titanium. All patients have been followed up for 1 year. RESULTS: The survival rates were 93.2 to 93.3% in the experimental groups and 97.5% in the control group. The difference was not statistically significant. The measurements of the marginal bone level demonstrated a mean bone loss of 0.8 mm between fixture insertion and the 1-year examination in patients with early loading (group D) whereas the bone loss in patients who underwent a healing period before loading was 1.3 to 1.6 mm. The difference between the control group and the group with early loading was significant. CONCLUSIONS: Survival rates for patients treated with a one-stage procedure were lower than survival rates for patients treated according to a "classical concept," but the differences were not statistically significant. There was no difference between treatment results with one-piece and two-piece implants. The implant loss in patients with early loading was probably caused by overloading, and careful supervision of occlusal loading is recommended. Early loading gave significantly less marginal bone loss when compared with two-stage surgery.
With the latest developments of the Procera system, all-ceramic crowns have become an attractive solution to provide functional and esthetic rehabilitation on teeth and dental implants. The Procera AllCeram crown and Procera Abutment embrace the concept of computer-assisted design and computer-assisted machining (CAD/CAM) and can be used together for optimal esthetic result. The purpose of this case report was to illustrate the advantages of these new components for complex anterior rehabilitation. Three natural teeth and a Procera Abutment were restored using four Procera AllCeram crowns. Treatment planning and esthetic benefits are discussed.
PURPOSE: The purpose of this clinical pilot study was to describe a photogrammetric technique to determine implant positions in the oral cavity, and to test and compare this technique to conventional impression/master cast procedures for fabrication of titanium frameworks with a computer numeric-controlled (CNC) milling technique. MATERIALS AND METHODS: Implant positions were recorded by means of conventional impressions/master casts as well as intraoral 3-dimensional photogrammetric measurements in 2 patients who were provided with 5 Brånemark implants each in the edentulous mandible. For each patient 2 titanium frameworks were made by means of a CNC milling technique (All-in-One). Both frameworks had an identical design, but the orientations of the framework cylinder fit surfaces were machined either from measurements from the master casts or from the intraoral photogrammetric measurements. The frameworks were tried for fit in the oral cavity and on the master casts. RESULTS: Both cases showed different precision of fit when comparing the 2 frameworks on the master casts. One of the 2 photogrammetric frameworks was not considered acceptable when tried on the models. In the oral cavity, however, all 4 frameworks presented comparable fit, and all were accepted for clinical use. CONCLUSION: The clinical experiences with try-in of the 4 different frameworks indicated that the photogrammetric technique could be a valid option for conventional impressions when using CNC milling fabrication in implant dentistry. The different results from the model and oral examinations also imply the difficulties of assessing clinical fit when testing fit at the master cast level only.
Explore the source record for details and available documents.
An extensive discussion of bar patterns is presented, including historical background, current bar designs, and precision milling concepts. Research that has been done on different bar configurations is discussed along with technical and clinical considerations for various bar pattern designs.
STATEMENT OF PROBLEM: There is some question about whether implant abutment selection affects the transfer of load between connected implants and natural teeth. PURPOSE: The purpose of this study was to compare stress transfer patterns with either 1 or 2 posterior implants connected to a single anteriorly located simulated natural tooth with either 1 or 2 segmented and nonsegmented implant abutments under relevant functional loads by use of the photoelastic stress analysis technique. MATERIAL AND METHODS: A model of a human left mandible, edentulous posterior to the first premolar, with two 3.75-mm x 13-mm screw-type implants embedded within the edentulous area, was fabricated from photoelastic materials. The implants were in the first and second molar positions. Two fixed partial denture prosthetic restorations were fabricated with either segmented conical abutments or nonsegmented UCLA abutments. Vertical occlusal loads were applied at fixed locations on the restorations. The photoelastic stress fringes that developed in the supporting mandible were monitored visually and recorded photographically. The stress intensity (number of fringes), stress concentrations (closeness of fringes), and their locations were subjectively compared. RESULTS: Loading on the restoration over the simulated tooth generated apical stresses of similar intensity (fringe order) at the tooth and the first molar implant for both abutment types. Low-level stress was transferred to the second molar implant. Loading directed on the implant-supported region of the restoration demonstrated low transfer of stress to the simulated tooth. Nonvertical stress transfer with slightly higher intensity was observed for the nonsegmented abutment. CONCLUSION: Within the limitations of this simulation study, stress distribution and intensity for the 2 implant conditions was similar for segmented and nonsegmented abutment designs. Magnitude of stresses observed for both abutment designs was similar for the single implant condition. Vertical loading produced more nonaxial stresses away from the force applied for the 1 implant condition with the nonsegmented abutment. Direct loading results were similar for both abutment designs. Specific recommendations for selection of implant abutment and application should be based on clinical criteria.