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Biomedical subjects

A K Garg

Publications and source records attributed to A K Garg.

At least 19 recordsLinked to original sources
PubMed2000

Immediate loading of titanium hexed screw-type implants in the edentulous patient: case report.

Histologic and histomorphometric studies in both animals and humans have shown that more rapid and greater bone-to-implant contact can be achieved with implants that incorporate certain surface characteristics compared with the original machined-surface implants. Such findings are significant because various implant designs may allow the fixtures to sufficiently resist functional loading sooner than originally thought. The case report presented here indicates that immediate loading of hexed titanium screw-type implants in the anterior mandible can lead to successful osseointegration and clinical outcome. The number of implants placed, their distribution, and the type of rigid connection are critical considerations for immediate loading. A bone height that can accommodate dental implants > or = 10 mm long is recommended. Biomechanically, the implants to be immediately loaded must be stable and resistant to macromovement to ensure good osseointegration.

Dental Implants↗
PubMed2000

The use of hydroxyapatite bone cement for sinus floor augmentation with simultaneous implant placement in the atrophic maxilla. A report of 10 cases.

BACKGROUND: Dental implant placement associated with sinus floor augmentation in a severely atrophic maxilla can be performed in a 1- or 2-stage surgical procedure, depending on the height of the residual alveolar bone. A minimum of 4 to 5 mm is recommended for a 1-stage procedure. METHODS: This clinical study describes the use of hydroxyapatite (HA) bone cement to stabilize HA-coated cylindrical implants placed simultaneously during sinus augmentation in 100 patients where insufficient bone volume did not allow primary implant stability. A total of 26 HA-coated dental implants were inserted in 100 grafted sinuses of 10 patients. RESULTS: None of the cases presented any difficulty in achieving initial stabilization and parallelism. No clinical complications of the sinuses were evident. Prior to exposure, radiographic evaluation revealed the implants embedded in a densely homogeneous radiopaque mass. At second-stage surgery, there was no clinical evidence of crestal bone loss around the implants. All implants were clinically osseointegrated. All patients received fixed implant-supported prostheses. Mean follow-up was 18 months (range 12 to 24 months). CONCLUSIONS: According to this preliminary study, the hydroxyapatite bone cement appears to hold great promise as a grafting alloplastic material for sinus floor augmentations. Its main advantage is its ability to provide initial stability required for osseointegration and proper implant location and parallelism. Further clinical and histological studies are required before it can be recommended for routine use in sinus lift procedures.

Adult↗
PubMed1999

Augmentation grafting of the maxillary sinus for placement of dental implants: anatomy, physiology, and procedures.

In patients with an inadequate amount of bone for implant placement, sinus lift surgery can be performed to restore a sufficient amount of alveolar bone to allow for successful implant placement and subsequent prosthetic reconstruction. In this article, the anatomy and physiology of the maxillary sinus, the mechanisms of bone grafting, bone grafting material, preoperative evaluation, surgical technique, and the grafting procedure, as well as intraoperative bleeding and postoperative complications, are discussed.

Alveolar Bone Loss↗
PubMed1999

Nine-year follow-up of successful placement of endosseous implants in a mandibular bone graft.

Facial trauma injuries secondary to gunshot wounds present a unique challenge. These wounds are avulsive and typically involve the destruction of soft tissue with bone loss. A technique in bone transplantation is that of particulate cancellous bone and marrow. Initial form and stability can be provided by a titanium mesh tray or reconstruction plates while the graft undergoes maturation and consolidation. Dental implants can then be placed in this grafted site to provide stabilization for a functional and comfortable prosthesis and for the support of the peri-oral soft tissues.

Bone Transplantation↗
PubMed1999

Depressed taste and smell in geriatric patients.

BACKGROUND: Geriatric patients have a number of dental care problems that younger patients do not encounter. The oral changes associated with aging can have a significant effect on the efficacy of dental treatment. TYPES OF STUDIES REVIEWED: The authors reviewed studies dealing with the causes of depressed sense of taste and smell; the causes included aging, disease, medications and dental problems. Based on their findings, the authors described the location and anatomy of taste buds and receptor cells for smell and explored appetite, saliva, food seasonings, nutrition and dietary recommendations. They also discussed the relationship of smoking and tongue cleaning to taste sensations. RESULTS: The authors found that considerable differences exist between elderly people and young people in regards to sensory perception and pleasantness of food flavors. Salt and bitter taste acuity declines with age, but sweet and sour perceptivity does not. Olfactory acuity also declines with age. The authors found that most of the studies reviewed suggested that the sense of smell is more impaired by aging compared with the sense of taste. Smoking diminishes the taste of food and makes flavorful foods taste flat, while tongue brushing can increase taste sensation for geriatric patients. CLINICAL IMPLICATIONS: Food can become tasteless and unappetizing for geriatric patients as the result of declining taste and smell perception. Geriatric patients should be encouraged to add seasonings to their food instead of relying on excessive consumption of salt and sugar to give their food flavor. Adequate nutrition, tongue cleaning and smoking cessation are recommended for geriatric dental patients.

Aged↗
PubMed1999

Clinical evaluation of the treatment of class II furcation involvements with bioabsorbable barriers alone or associated with demineralized freeze-dried bone allografts.

BACKGROUND: Class II furcation lesions are a challenging scenario for periodontal therapy and a serious threat for tooth prognosis. Guided tissue regeneration represents a viable treatment option, but some aspects remain to be clarified as to the efficacy of bone substitutes used in GTR procedures. The clinical efficacy of demineralized freeze-dried bone allografts (DFDBA) for regenerative procedures is presently under scrutiny. METHODS: This study evaluated the adjunctive clinical effects of DFDBA associated with a bioabsorbable (polylactic acid) barrier membrane in the regenerative treatment of human Class II furcation lesions as compared to the same type of barrier alone. Twelve patients with bilateral Class II furcation defects on lower first molars participated in the study. In each patient, one tooth was randomly assigned to treatment consisting of open surgical debridement followed by the placement of DFDBA (GTR+DFDBA, or test group) and a bioabsorbable barrier, while the contralateral side received the same flap surgery followed by use of the bioabsorbable membrane alone (GTR, or control group). The clinical efficacy of the 2 treatment modalities was evaluated at 6 and 12 months postoperatively. Measurements included vertical probing depth (VPD), horizontal probing depth (HPD), clinical attachment level (CAL), amount of gingival recession (GR), and change in class of clinically detectable furcation involvement (FC). RESULTS: Both treatments yielded significant improvements for all clinical parameters between baseline and 6 and 12 months (P<0.05). The comparison between test and control groups revealed significantly greater reduction in HPD (P=0.01) and higher values of GR (P=0.008) for the test group. The mean gain in HPD for test sites was 2.3 mm, while it amounted to 1.7 mm for controls. A significantly greater proportion of test sites could be classified postoperatively as Class I defects compared to controls (91% versus 50%, respectively). CONCLUSIONS: The results of this study indicate that significant improvements from baseline occurred in VPD, HPD, CAL, and clinically detectable furcation involvement after the treatment of Class II furcation lesions with a bioabsorbable membrane with or without the adjunctive use of DFDBA. In addition, the placement of DFDBA in the furcation defect under the bioabsorbable membrane resulted in a greater mean reduction of horizontal probing depth when compared to the regenerative therapy alone.

Absorbable Implants↗
PubMed1998

Autogenous mandibular bone grafts in the treatment of the resorbed maxillary anterior alveolar ridge: rationale and approach.

Patients can present with a variety of conditions that limit, or prevent, the ideal placement of endosteal implants. One of these situations is depicted by an insufficient amount of bone for implant placement in the maxillary anterior alveolar ridge. Autogenous bone grafting can be used to augment the ridge to provide a sufficient amount of bone for implant placement. Using the mandibular symphysis as a donor site offers ease of access, good bone quality for localized repair, a corticocancellous block graft morphology, low morbidity, and minimal graft resorption. A procedure for harvesting and placing an autogenous mandibular bone graft is presented; as are the advantages of using this location as a donor site compared with other locations.

Alveolar Bone Loss↗
PubMed1998

Bone structure, metabolism, and physiology: its impact on dental implantology.

When placing implants in the mandible or maxilla, it is important for clinicians to understand the process of bone remodeling, the different types of bone, and how these factors can affect the integration of osseous dental implants. Approximately 0.7% of a human skeleton is resorbed daily and replaced by new healthy bone. With aging and metabolic disease states, the normal turnover process may be reduced, resulting in an increase in the mean age of the present bone. This increase can affect the placement and integration of implants. Herein follows a discussion of different types of bone cells, the metabolism of bone, the microscopic, macroscopic, and molecular structure of bone, and the process of bone modeling and remodeling.

Bone Morphogenetic Proteins↗
PubMed1998

Sinus floor augmentation with simultaneous implant placement in the severely atrophic maxilla.

Dental implant placement associated with augmentation of the sinus floor in the severely atrophic maxilla can be performed in 1- or 2-surgical stages, depending on the height of the residual alveolar bone. A minimum of 4 to 5 mm of residual alveolar bone height is recommended for a 1-stage surgical procedure. The present study describes a 1-stage procedure in cases where the residual alveolar bone height in the posterior maxilla was 1 to 2 mm. A total of 55 hydroxyapatite-coated dental implants were inserted in 20 grafted sinuses of 20 patients. No case presented any difficulty in achieving initial stabilization and parallelism. No perforation of the sinus membrane or clinical complications of the sinuses were evident. Prior to exposure, radiographic evaluation revealed bone consolidation and a close bone-implant relation. At second-stage surgery, there was no clinical evidence of crestal bone loss around the implants. All implants were clinically osseointegrated. All patients received fixed implant-supported prosthesis. The mean follow-up was 26.4 months (range 15 to 39 months). There was no implant loss after loading. The following surgical modifications are essential: a wide lateral window opening, the use of a bone mill to homogenize the bone graft, meticulous condensation, and clinical measurements to ensure implant parallelism.

Adult↗