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At least 163 records · Page 9Linked to original sources
PubMed2003

Clinical complications with implants and implant prostheses.

The purpose of this article is to identify the types of complications that have been reported in conjunction with endosseous root form implants and associated implant prostheses. A Medline and an extensive hand search were performed on English-language publications beginning in 1981. The searches focused on publications that contained clinical data regarding success/failure/complications. The complications were divided into the following 6 categories: surgical, implant loss, bone loss, peri-implant soft tissue, mechanical, and esthetic/phonetic. The raw data were combined from multiple studies and means calculated to identify trends noted in the incidences of complications. The most common implant complications (those with a greater than a 15% incidence) were loosening of the overdenture retentive mechanism (33%), implant loss in irradiated maxillae (25%), hemorrhage-related complications (24%), resin veneer fracture with fixed partial dentures (22%), implant loss with maxillary overdentures (21%), overdentures needing to be relined (19%), implant loss in type IV bone (16%), and overdenture clip/attachment fracture (16%). It was not possible to calculate an overall complications incidence for implant prostheses because there were not multiple clinical studies that simultaneously evaluated all or most of the categories of complications. Although the implant data had to be obtained from different studies, they do indicate a trend toward a greater incidence of complications with implant prostheses than single crowns, fixed partial dentures, all-ceramic crowns, resin-bonded prostheses, and posts and cores.

Alveolar Bone Loss↗
PubMed1995

Masseter muscle fatigue before and after rehabilitation with implant-supported prostheses.

To establish whether different implant-supported prosthetic reconstructions influence jaw muscle resistance to clenching efforts, sustained submaximal (50%) clenching was performed in two groups of patients who were edentulous in one or both jaws. One group consisted of patients who were rehabilitated by means of an overdenture on two to four implants connected by a bar; the other group consisted of patients who were rehabilitated with an implant-supported fixed prosthesis on four to seven implants in either the maxilla or the mandible. Results indicated that after rehabilitation with implant-supported fixed reconstructions, the myoelectric output level increased over time, which was parallel to a higher bite force level. For the other group, such a time-dependent change in electromyographic amplitude did not occur. On the other hand, power spectrum analysis revealed a significant downward shift of the mean power frequency during sustained clenching after rehabilitation with implant-supported overdentures but not with implant-supported fixed prostheses. The absence of a spectral shift in the latter group probably expressed a fear of biting too hard and fracturing the prosthesis.

Adult↗
PubMed1995

Prosthodontic treatment of patients receiving implants by predoctoral students: five-year follow-up with the IMZ system.

Twenty-four patients were treated with 71 IMZ implants between 1987 and 1991 at Tufts University School of Dental Medicine by senior dental students. Soft tissue, marginal bone height, and prostheses were evaluated. Inflammation was noted around 70% of the implants, and marginal bone loss around 13% of the implants exceeded 2 mm. Prosthodontic complications included broken screws, broken dentures, broken intramobile elements (IMEs), porcelain fracture, and IMZ clip replacement. All 71 implants were immobile.

Adult↗
PubMed1996

Treatment results with immediate overdentures: an evaluation of 4.5 years.

In a controlled clinical trial, 74 patients who required complete immediate dentures were randomly treated with immediate mandibular overdentures on two mandibular canines with or without magnetic attachments or with complete immediate dentures. All were borderline situations for overdenture therapy. The patients were evaluated for 4.5 years after denture insertion. The results demonstrated that 50% of the dentures had been renewed or had required replacement; in this respect, no differences were found among the three groups. In the overdenture groups, 15% of the abutments were extracted; most abutment restorations were replaced or had to be replaced. Two thirds of the magnets were lost or in bad condition. No significant differences were found in relation to patient satisfaction; most patients were satisfied with their dentures. It is the authors' opinion that even though the abutment conditions were disappointing after 4.5 years, mandibular overdenture therapy is indicated in borderline situations because of the 50% reduction in mandibular bone loss found.

Alveolar Bone Loss↗
PubMed1997

Preliminary results of a multicenter study evaluating a chemically enhanced surface for machined commercially pure titanium implants.

PURPOSE: This report presents the preliminary results of a prospective multicenter study to evaluate the efficacy of a chemically etched pure titanium surface on screw-type dental implants. MATERIAL AND METHODS: The results of 147 implants placed in 75 patients were evaluated and followed for up to 3 years, using clinical and radiographic examinations. The implants were inserted to support single crowns, overdentures, and fixed prostheses, as dictated by the individual patient's need. RESULTS: Of the 147 implants placed, 5 were lost and the remaining implants were followed throughout, to the end of the study period. Crestal bone levels adjacent to each implant were monitored and the amount of total bone loss was calculated. Clinically healthy peri-implant gingival tissues were observed on 95% of the implants, whereas 88.3% demonstrated no bleeding on probing and no recession during the follow-up period. According to the criteria used in this study, the total success rate was calculated to be 96.6%.

Acid Etching, Dental↗
PubMed1997

Implant placement in prosthodontics practice: a five-year retrospective study.

UNLABELLED: Dental implants have revolutionized dentistry in every aspect of treatment including surgery, restorative dentistry, and orthodontic treatment planning. PURPOSE: This retrospective study analyzes the treatment of completely and partially edentulous patients in a prosthodontics practice and the Edmonton Implant Seminar. MATERIAL AND METHODS: All implant surgery was performed by the prosthodontist. The majority of implants (336) were restored by the prosthodontist (71%). A total of 135 restorations were provided by 12 different general practitioners (29%) in a study group environment. RESULTS: Of 471 implants that were placed, 453 (96.2%) integrated successfully. Treatment groups were divided into single implant restoration (19.3%), fixed partial dentures (51%), overdentures (12.3%), and mandibular fixed partial denture cantilever (17.6%). Retention of final prosthesis was 99.4%. Of 18 failures, four occurred between Stage I and II surgeries, 11 occurred between Stage II surgery and final impressions, and three occurred after placement of final restorations. All three restorative failures were single implants. CONCLUSION: The results indicated that implant placement by a prosthodontist is comparable to the success of previous studies.

Adolescent↗
PubMed1998

Photoelastic stress patterns produced by implant-retained overdentures.

STATEMENT OF PROBLEM: When 2 implants are used to support a removable overdenture, optimal stress distribution to minimize forces to the implants is desired. PURPOSE: This study used photoelastic analysis to compare the stress patterns generated around implants with 2 retention mechanisms. MATERIAL AND METHODS: Two root form implants were anchored in a photoelastic mandible and a removable overdenture was fabricated. The denture was lined with a resilient layer of impression material to simulate oral mucosa. Attachment of the denture to the implants was varied by using ball/O-ring and bar-clip attachments. Vertical and oblique occlusal forces from 10 to 200 lb were applied unilaterally to the right and left first molars. Resultant stress distributions in the photoelastic mandible were photographed and evaluated. RESULTS: With vertical forces, the ball/O-ring attachment transferred minimal stress to both implants. Vertical forces applied to the bar-clip overdenture created immediate stress patterns of greater magnitude and concentration on both implants. A posterior oblique load resulted in similar stress patterns to both systems with slightly greater stress to the bar-clip overdenture. CONCLUSIONS: Within the limits of this study, ball/O-ring attachments transferred less stress to implants than the bar-clip attachments when the photoelastic model was subjected to a posterior vertical load.

Bite Force↗
PubMed1998

The decade of overdentures: 1970-1980.

Jaw bones resorb when teeth are lost. People cannot function as well with complete dentures compared with their natural teeth. As more people are living longer and these cumulative effects become increasingly documented, dentists in the 1970s attached more importance to keeping teeth. The concept of overdentures developed as a simple and economic alternative to prolong the retention and function of the last few teeth in a compromised dentition. The previous option was extensive fixed prosthodontics. An overdenture is a complete or removable partial denture that has one or more tooth roots to provide support. Rather than extracting all compromised teeth, the crowns, and pulpal tissue of selected teeth (usually two anterior teeth) are removed. The remaining root projecting through the mucosa is restored and/or contoured. With the crown removed, there is space to cover the area with a denture. The root has less mobility, and its retention retards bone resorption. Overdentures with roots are more stable, and patients can chew better than with dentures supported on residual alveolar bone and mucosal tissue alone. Keeping even a few teeth has a strong psychological value for some patients. Patients who have lost teeth, adjacent tissue, and bone need replacement of more oral structures than tooth crowns alone can provide. A complete denture with flange contours can restore tissue and appearance. The conventional tooth-supported overdenture concept continues to be an accepted treatment modality and has now been adapted to implants.

Alveolar Bone Loss↗
PubMed1999

New telescopic crown design for removable partial dentures.

STATEMENT OF PROBLEM: Special technical skills and experiences are required to fabricate a telescopic crown to provide adequate retention with precise frictional retention ("conus friction force") between coping and telescope. It is also difficult to control clinically alterations of retentive forces after prolonged usage. PURPOSE: This study examined an innovative telescopic crown system for removable partial dentures that can be fabricated without special technical skill or experience and readily adjusted retentive forces. The retention of telescopic crowns was investigated after repeated insertion/separation tests. MATERIAL AND METHODS: Ten telescopic crowns were constructed to evaluate retentive forces. Each telescopic crown was adjusted to provide a retentive force of approximately 9.8 N. Each telescopic crown was then subjected to 10,000 insertion/separation cycles, and retentive force of each telescopic crown was recorded initially and after every 1,000 cycles. The retentive force of each telescopic crown was re-adjusted after these measurements to provide a retentive force of approximately 9.8 N. The retentive force was recorded a second time after each 1,000 insertion/separation cycles up to 10,000 cycles. RESULTS: Retention of the telescopic crowns gradually diminished, depending on the number of insertion/separation cycles. The mean retentive force after 10,000 insertion/separation cycles was over 2 N. All 10 telescopic crowns were re-adjusted to exert a retentive force of 9.8 N after the initial 10,000 cycles, and the retentive force also diminished on the second 10,000 cycles. CONCLUSIONS: Reduction of retention was dependent on insertion/separation cycles. This new telescopic crown with reduced retention could be easily readjusted. Readjusted retentive forces were at least equivalent to the initial retention.

Analysis of Variance↗
PubMed1999

Treatment plan for restoring the edentulous maxilla with implant-supported restorations: removable overdenture versus fixed partial denture design.

STATEMENT OF PROBLEM: Restoring the edentulous maxilla with a fixed complete denture or a removable overdenture is a complex and challenging procedure. PURPOSE: This article presents and discusses the crucial factors involved in deciding whether a fixed or removable implant prosthesis should be planned in fulfilling the patient's preference for optimal esthetics, phonetics, comfort, and function. METHODS AND MATERIAL: A concept for treatment planning is presented that enables the practitioner to check the decisive parameters during the first examination and to make the final decision with the help of the reformatted computerized tomography scan. CONCLUSION: If this treatment plan is followed, implants can be placed to comply with the selected prosthetic solution and compromised solutions can be avoided. The fixed design for implant prosthesis is only appropriate for patients with minimal resorption of the alveolar bone and an optimal maxillomandibular relationship. The removable overdenture may be indicated from the outset and is no longer restricted to patients with a compromised situation in which fixed implant prostheses are not feasible.

Alveolar Bone Loss↗
PubMed1999

Clinical complications of osseointegrated implants.

STATEMENT OF PROBLEM: There is no comprehensive review of the literature that identifies the complications reported in clinical dental implant studies. PURPOSE: This article attempted to determine the types of complications that have been reported and to provide data regarding their frequency. METHODS: All available clinical studies from 1981 to 1997, published in English or with English abstract, that presented success/failure data regarding implant treatment were evaluated to determine the types of reported complications and to quantify implant loss as it relates to type of prosthesis, arch, time, implant length, and bone quality. RESULTS: Greater implant loss occurred with overdentures than with other types of prostheses. There was greater loss in the maxilla than mandible with fixed complete dentures and overdentures, whereas little arch difference was noted with fixed partial dentures. Implant loss increased with short implants and poor bone quality. The time of implant loss (preprosthetic vs postprosthetic) varied with type of prosthesis. Surgical complications included neurosensory disturbance, hematoma, mandibular fracture, hemorrhage, and tooth devitalization. Initial and long-term marginal bone changes were identified. Peri-implant soft tissue complications included dehiscence, fistulas, and gingival inflammation/proliferation. Mechanical complications were screw loosening/fracture, implant fractures, framework, resin base and veneering material fractures, opposing prosthesis fractures, and overdenture mechanical retention problems. Some studies also presented phonetic and esthetic complications. CONCLUSIONS: Although the literature presents considerable information on implant complications, variations in study design and reporting procedures limited the available data and therefore precluded proper analysis of certain complications.

Dental Arch↗
PubMed1999

Use of a flexible cast for fabrication of multiple post-coping overdenture restorations.

Direct intraoral fabrication of multiple post-coping restorations for an overdenture in the same arch can be a time-consuming chairside clinical procedure. In addition, accurate intraoral fabrication of resin patterns with intracrevicular margins is not always possible as a result of limited access. This article presents a direct-indirect method that uses an elastic cast for fabrication of multiple post-coping restorations with intracrevicular margins. Custom post patterns are fabricated directly in the root canal with autopolymerizing resin (Duralay). An impression is made of the remaining tooth structure, which also includes the post patterns, and a flexible cast is poured chairside. The cast is available within 6 to 8 minutes of impression making and can be trimmed similar to a stone die. The procedure also provides flexibility that allows separation of the cast from the impression without fracture of the custom post pattern or cast. The fabrication of the post-coping restoration can be completed in the laboratory, or if necessary, completed chairside and verified intraorally, before dismissing the patient.

Dental Abutments↗