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At least 37 records · Page 2Linked to original sources
PubMed2002

The effect of bruxism on treatment planning for dental implants.

Bruxism is a potential risk factor for implant failure. Excessive force is the primary cause of late implant complications. An appreciation of the etiology of crestal bone loss, failure of implants, failure to retain implant restorations, and fracture of components will lead the practitioner to develop a treatment plan that reduces force on implants and their restorations. The forces are considered in terms of magnitude, duration, direction, type, and magnification. Once the dentist has identified the source(s) of additional force on the implant system, the treatment plan is altered to contend with and reduce the negative sequelae on the bone, implant, and final restoration. One viable approach is to increase the implant-bone surface area. Additional implants can be placed to decrease stress on any one implant, and implants in molar regions should have an increased width. Use of more and wider implants decreases the strain on the prosthesis and also dissipates stress to the bone, especially at the crest. The additional implants should be positioned with intent to eliminate cantilevers when possible. Greater surface area implant designs made of titanium alloy and with an external hex design can also prove advantageous. Anterior guidance in mandibular excursions further decreases force and eliminates or reduces lateral posterior force. Metal occlusal surfaces decrease the risk of porcelain fracture and do not require as much abutment reduction, which in turn enhances prosthesis retention. The retention of the final prosthesis or super-structure is also improved with additional implant abutments. Night guards designed with specific features also are a benefit to initially diagnose the influence of occlusal factors for the patient, and as importantly, to reduce the influence of extraneous stress on implants and implant-retained restorations.

Bite Force↗
PubMed2002

[Treatment of infected total knee arthroplasty].

OBJECTIVE: To investigate the treatment of infected total knee arthroplasty (TKA). METHODS: Between 1983 and 2000, 6 patients with infection after TKAs were treated, including 2 men and 4 women, aged on average 63 years (44 - 75 years). Initial knee arthroplasty was performed for osteoarthritis in 4 patients and for rheumatoid arthritis in 2 knees. The timing of diagnosis of infection after knee arthroplasty averaged 50 months (range, 1 month-11 years). Simple debridement and antibiotic treatment were prescribed for 3 patients, debridement and one-stage reimplantation for 1, debridement and two-stage reimplantation for 1, and athrodesis for 1. RESULTS: Of the 3 patients with simple debridement, one was cured, one failed but underwent athrodesis later, and one lost to follow up. Two patients with reimplantation were cured and had good function recovery. All of the 6 patients were followed up on average for 4 years. No infection recurred except one who lost to follow-up. CONCLUSIONS: Management of infection after total knee arthroplasty includes antibiotic suppression and debridement with prosthesis retention, insertion of another prosthesis as a one-stage or two-stage exchange technique, knee arthrodesis and amputation. These treatments have specific indications. To treat infection after total knee arthroplasty, suitable method should be taken according to patient's condition. Arthrodesis is the best salvage operation, though it may handicap patients' daily life. Reimplantation of another prosthesis could maintain a functional joint.

Adult↗
PubMed2000

Implant position record and implant position cast: minimizing errors, procedures and patient visits in the fabrication of the milled-bar prosthesis.

This article describes a new rationale and method involved in the fabrication of a patient detachable prosthesis supported by a milled bar. This simple procedure improves prosthesis retention. The overdenture is processed directly over a milled bar, which provides an intimate relation between the bar and the acrylic resin denture base to create resistance against rotational and lateral forces acting on the prosthesis. Incorporating simple and predictable attachments, with low maintenance needs, controls resistance to dislodgment along the path of insertion of the prosthesis. The concepts used in the fabrication of the milled bar include an implant position record (IPR) and an implant position cast (IPC) to reduce the need for time-consuming procedures, such as sectioning the cast bar and soldering it to make it fit the abutments. This procedure also reduces the number of patient visits required of the completion of the prosthesis.

Dental Abutments↗
PubMed2006

[Patient satisfaction with removable implant-supported prostheses in the edentulous mandible].

The aim of the present study was to investigate patients' satisfaction with removable implant restorations with two or four implants compared to a complete denture (CD) in the edentulous mandible. 20 patients in each group were asked to fill out a questionnaire ("Patient satisfaction related to the prosthetic restoration") before treatment, after six months and three years. With implant restorations, either implant-retained (IRET) or implant-supported (ISUP), greater improvements in prostheses retention and pain reduction were achieved in comparison to complete dentures. In addition, restrictions related to food selection were resolved for most implant patients. Despite great inter-individual differences, there was a tendency for larger improvements of almost all parameters with IRET, except chewing ability, which was rated best with ISUP. Long-term results revealed that patients with ISUP (four implants) assessed prostheses retention with the highest ratings compared to those with IRET and CD (p = 0,0147). These results indicate that an improvement in functional and psychological parameters can be achieved with two implants, whilst stabilization with four implants improves prosthesis retention, chewing ability and pain reduction in the long term. Maintenance efforts were more complex for implant restorations than for CD and imply a recall at least once a year.

Adaptation, Psychological↗
PubMed2003

[Clinical value of cast post-core porcelain fused to metal crown in restorating residual root and crown of molars].

OBJECTIVE: To investigate the effect of cast post-core porcelain fused to metal crown on the restoration of residual root and crown of molars. METHODS: One hundred and sixty-four residual roots and crowns of molars were treated with root canal therapy and restored by cast core porcelain fused to metal crown. The restoration effect was assessed at the 3rd, 6th, 12th and 24th month. RESULTS: The strength of dental prosthesis retention, marginal fitness, and strength of crowns were satisfactory. The effective rate reached 95.12% during the 2 year follow-up. CONCLUSION: The cast post-core porcelain fused to metal crown is a better method in treating the residual root and crown of molars.

Adult↗
PubMed2004

The mandibular complete overdenture.

Mandibular complete overdenture treatment has been available for decades, but its use was limited when the treatment relied on retained teeth as overdenture abutments. This treatment, however, is currently experiencing more popularity than ever before. In fact, dentistry may be experiencing a philosophical shift, in which mandibular implant overdenture treatment may become the new standard of care for the treatment of the edentulous mandible. Practitioners are looking for simplified treatments that can provide cost-effective alternatives to more complex implant prosthodontic procedures. Implant overdentures provide a strong return for the investment in treatment time and expense and are a treatment suited to the lower socioeconomic status of many edentulous patients. The clinical outcome of this treatment is significantly better than that achieved with conventional mandibular dentures, especially when patients are experiencing technical problems because of compromised prosthesis retention or stability.

Dental Abutments↗
PubMedDate not supplied

Prosthetic aspects and patient satisfaction with two-implant-retained mandibular overdentures: a 10-year randomized clinical study.

PURPOSE: This study aimed to compare the prosthetic aspects and patient satisfaction with prosthetic care in two-implant-retained mandibular overdentures, whether implants were splinted with a bar or left with magnets or ball attachments. MATERIALS AND METHODS: Thirty-six completely edentulous patients had two Brånemark implants placed in the mandibular canine area. A randomized procedure allocated patients into three groups of equal size, each with a different attachment system: bars, magnets, or balls. Prosthesis retention and mechanical as well as soft tissue complications were recorded in addition to patient satisfaction. A linear mixed model was fitted with attachment type and time as classification variables and adjusted by Turkey's multiple range test. RESULTS: Ball-retained overdentures showed at year 10 the greatest vertical retention force (1,327 g), followed by bars (1,067 g) and magnets (219 g). In the ball group, need for tightening of abutment screws was the most common mechanical complication; in the magnet and bar groups, respectively, the most common complications were wear and corrosion, and the need for clip activation. Prosthesis stability and chewing comfort for the overdenture were rated significantly lower for the magnet group compared to the ball and bar groups. Prosthesis stability of the maxillary denture was rated significantly lower in the bar group compared to ball and magnet groups. CONCLUSION: The ball group scored best in relation to retention of the overdenture, soft tissue complications, and patient satisfaction at year 10. The bar group scored lower for comfort and stability of the maxillary denture. Magnets offered patients the least comfort.

Adult↗
PubMed2006

Conservative treatment of staphylococcal prosthetic joint infections in elderly patients.

BACKGROUND: We report the outcome of debridement and prosthesis retention plus long-term levofloxacin/rifampicin treatment of prosthetic joint infections. METHODS: Staphylococcal prosthesis joint infections were defined by positive culture of joint aspirate, intraoperative debridement specimens, or sinus tract discharge in the presence of clinical criteria. Patients received long-term oral levofloxacin 500 mg and rifampicin 600 mg once per day. Sixty patients (age 74.6+/-8.4 years) were included. RESULTS: Coagulase-negative staphylococci were significantly more frequently isolated in the knee (78.6%; P=.00001). Of the Staphylococcus aureus isolates, 33.3% were methicillin-resistant. Time from arthroplasty to symptoms onset was higher (P=.03) in coagulase-negative staphylococci infections. Global failure was 35% (higher for the knee) and ranged from 16.6% to 69.2% (P=.0045) in patients with symptoms duration of less than 1 month to more than 6 months. A shorter duration of symptoms (P=.001) and time to diagnosis (P=.01) were found in cured patients versus patients showing failure. Among those with S. aureus infections, a higher failure rate was found with methicillin-resistance. CONCLUSIONS: Efficacy was higher in patients with shorter duration of symptoms, earlier diagnosis, hip infections, and methicillin susceptibility.

Aged↗
PubMed1991

[The coronoid-maxillary space in denture retention].

The coronoid-maxillary space defines the distal maxillary rims, and it is usually tightened during mouth opening. It has been reported that its adequate filling or its overfilling is helpful in prosthesis retention. There are two types of individual anatomical variations, that can affect the size of this space. In fact, the coronoid process can be vertical or lateral. In the first case, the coronoid-maxillary space is reduced in oral opening, therefore the prosthesis edge must be thin. In the latter case, the space increases or does not vary during mouth opening, therefore the prosthesis must be thicker in order to obtain its adequate retention.

Denture Retention↗
PubMed1990

Keratoprosthesis. II. Results obtained after implantation of 27 dismountable two-piece prostheses. A retrospective, follow-up study.

During the years 1974-1987 a total of 27 two-piece keratoprostheses were implanted in 25 eyes of 22 different patients with bilateral blinding anterior segment disease with no possibility for a successful corneal transplantation. The prosthesis design and the surgical procedures used are described. The healing in and fixation of the prostheses were initially good in all cases, but 9 prostheses were lost or removed because of complications during the postoperative period of observation. The prosthesis retention time was significantly longer than that earlier achieved by the use of a one-piece prosthesis. In 18 of 27 cases a visual acuity of 6/60 or better was obtained. Postoperative complications included necrosis of the tissues covering and supporting the prosthesis, infection around the prosthesis, overgrowth of the surrounding tissues and the development of dense retroprosthetic membranes. Despite the obvious risks, keratoprosthesis surgery in a small number of patients with severe corneal disease represents the only potential hope for a visual rehabilitation, and should therefore be considered.

Adult↗
PubMed2001

Clinical effectiveness and cost-effectiveness of 2 management strategies for infected total hip arthroplasty in the elderly.

Optimal management of infected total hip arthroplasty poses a major challenge to clinicians. Exchange arthroplasty is usually advocated but has high rates of surgical morbidity and is expensive. Debridement with prosthesis retention is associated with less morbidity, but high rates of relapsed infection have been described. To estimate the effectiveness and cost-effectiveness of these 2 strategies among older patients, we used a Markov model to simulate patients' projected lifetime clinical course in hypothetical cohorts of 65-year-old and frail 80-year-old men and women. Initial debridement and retention increased life expectancy 2.2-2.6 quality-adjusted life months and had a favorable cost-effectiveness ratio in all cohorts. Results were most sensitive to the annual rate of relapse after debridement and age at initial diagnosis of infection. In the absence of prospective clinical trials, debridement and retention is a reasonable strategy for treatment of older persons with staphylococcal or streptococcal infection and a nonloosened prosthesis.

Age Factors↗
PubMed2006

Prosthodontic rehabilitation after traumatic tooth and bone loss: a clinical report.

Traumatic injuries from motor vehicle accidents may cause anatomic deficiencies in soft and hard tissues. Successful treatment of patients with such deficiencies may include preprosthetic surgery using osseointegrated implants to increase prosthesis retention and stability. This article describes the treatment of a motor vehicle accident victim whose anterior teeth and supporting tissues were lost.

Accidents, Traffic↗
PubMed1982

Surgical treatment of the denervated or sagging lower lid.

Paralytic ectropion of the lower eyelid and increased curvature of the lower eyelid associated with anophthalmos both cn be optimally treated by use of an autogenous fascia lata sling. Some patients also have problems with prosthesis retention due to lower eyelid deformity with a shortened inferior fornix. In some instances, it is also necessary to perform a horizontal shortening operation on the lower eyelid. In anophthalmic patients, the relationship between prosthesis size and weight and a sagging lower lid is discussed. In some patients when the lower eyelid is elevated, the patient then has an upper lid ptosis for which it is necessary to perform an appropriate levator shortening operation. Surgical technique and illustrative pre- and post-operative photographs are shown.

Blepharoptosis↗