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Biomedical subjects

C E Misch

Publications and source records attributed to C E Misch.

At least 19 recordsLinked to original sources
PubMed1995

The repair of localized severe ridge defects for implant placement using mandibular bone grafts.

Severe alveolar deficiencies can prevent ideal implant placement. Management of osseous defects often necessitates autogenous bone grafting. The mandibular symphysis graft technique offers ease of access, good bone quantity for localized repair, a corticocancellous block graft morphology, low morbidity and minimal graft resorption. An improved bone density results along with a shorter healing time as compared with other methods for bone repair. An understanding of graft management and implant placement is essential for clinical success.

Alveolar Process↗
PubMed1994

Implant-protected occlusion: a biomechanical rationale.

The clinical success and longevity of endosteal dental implants are controlled, in a large part, by the mechanical milieu within which they function. The occlusion is a critical component of such a mechanical environment. "Implant-protected occlusion" refers to an occlusal schema that is often uniquely specific to the restoration of endosteal implant prostheses. Implant orientation and the influence of load direction, the surface area of implants, occlusal table width, and protecting the weakest area are blended together from a biomechanical rationale to provide support for a specific occlusal philosophy.

Alveolar Process↗
PubMed1994

Endosteal implants and iliac crest grafts to restore severely resorbed totally edentulous maxillae--a retrospective study.

Autogenous grafts in conjunction with endosteal implants may be indicated in conditions of severe atrophy of the maxilla. From July, 1984, to December, 1990, 20 severely atrophic arches were restored with iliac crest onlay block grafts, subantral augmentation, and 148 endosteal root-form implants. Twenty-one implants were placed at the same time as the graft to stabilize a corticotrabecular bone block. Two implants were lost (90% implant survival). One hundred twenty-seven implants were placed after graft maturity, and one implant was removed (99% implant survival). Thirteen fixed restorations and 7 completely implant-supported overdentures were fabricated. Follow-up evaluation of prostheses and implants ranged from 26 to 97 months. All the implants used for initial prosthesis fabrication and all initial prostheses remain in function. The advantages of implant placement after graft maturity and subantral augmentation are addressed. One year after implant placement, the amount of additional bone lost around the implants placed in grafted bone is similar to the bone loss around maxillary implants inserted into non-grafted bone.

Alveolar Bone Loss↗
PubMed1994

Implant-protected occlusion.

Implant-Protected Occlusion is that occlusal scheme which reduces the forces at the crestal bone/implant interface. Biomechanical principles form the basis of this concept. The direction of force, force magnification, and implant position relative to arch or location are blended together for a consistent approach to implant reconstruction. The direction of force demonstrates that angled forces increase the type of forces, alter their point of application, and reduce bone strength. Force magnifiers include cantilevers, offset loads, and monumental forces to the implant body. These magnifiers dramatically increase the among of force applied to a prosthesis. The implant position relative to arch or arch position often determines the density of bone and the amount of force. Adequate surface area of implant bodies considers width, length, and number. The surface area is a primary component in the resistance of force factors. In addition occlusal table width and occlusal contacts contribute to the force amount type and direction and may be modified to reduce crestal loads.

Bite Force↗
PubMed1993

Bone-grafting materials in implant dentistry.

There are three classes of bone-grafting materials based upon the mode of action. Autogenous bone is an organic material and forms bone by osteogenesis, osteoinduction, and osteoconduction. Allografts such as demineralized freeze-dried bone are osteoinductive and osteoconductive and may be cortical and/or trabecular in nature. Alloplasts such as hydroxyapatite and tricalcium phosphate may be synthetic or natural, vary in size, and are only osteoconductive. They can be divided into three types based upon the porosity of the product and include dense, macroporous, and microporous materials. In addition, alloplastic materials may be crystalline or amorphous. These materials have different properties and therefore indications. The use of the three classes of materials in diverse combinations depends upon the size and topography of the bony defect. Small defects or defects with four walls of host bone can be repaired with alloplasts alone or allografts in combination with alloplasts. The loss of three or more bony walls mandates the addition of autogenous bone to the graft or the use of a small pore membrane. The larger the defect, the more autogenous bone is required. The different indications of bone substitutes are discussed as to their specific applications in implant dentistry.

Alveolar Bone Loss↗
PubMed1993

Progressive loading of bone with implant prostheses.

The rationale and protocol to gradually load the implant after the initial bone interface have been established and discussed. Bone density is the most critical factor in determining the amount of healing time between first and second-stage surgeries and also between the five appointments for prostheses which are cement-retained.

Alveolar Process↗
PubMed1992

Generic terminology for endosseous implant prosthodontics.

Implant dentistry has become an integral treatment modality in the restoration of the complete and partially edentulous patient. Most practitioners have been educated by manufacturer-sponsored courses oriented to the use of a specific implant system. The ever-increasing number of implant systems has made the names of many implant components product-unique and confusing. Fortunately, a prosthetic continuity exists between most implant systems. A generic terminology for endosseous root-form prosthodontics is presented that allows effective communication between members of the profession.

Dental Abutments↗
PubMed1992

Issues in bone mechanics related to oral implants.

The development and maintenance of the dental implant-to-tissue interface is clearly of paramount importance in the determination of clinical success. Yet, the precise mechanism with which bone responds to mechanical load remains unknown. A review of current thought on the performance of cortical and cancellous bone as structural foundations for dental implants is provided, with particular emphasis on the influence of its three-dimensional architecture at the macroscopic level. The mechanical response of bone is reported to depend upon the direction, magnitude, rate, and duration of loading. Quantitative relationships have been established to correlate cancellous bone strength and stiffness to its apparent density. Such data provide useful insights into the modeling/remodeling response of bone tissue, which is arguably the ultimate predictor of implant longevity.

Biomechanical Phenomena↗
PubMed1992

Reconstruction of maxillary alveolar defects with mandibular symphysis grafts for dental implants: a preliminary procedural report.

Partially edentulous patients with alveolar defects contraindicating implant placement were treated with bone grafts obtained from the mandibular symphysis. Complications encountered were minor and uneventful. Evaluation 4 months after surgery revealed minimal graft resorption, thus implant placement was possible in all potential sites. Advantages of the symphysis graft include easy access, availability of greater quantities of bone over other intraoral donor sites, low morbidity, no hospitalization, minimal discomfort, no alteration in ambulation, and no cutaneous scar. Compared with other bone regenerative methods for implant placement, a superior quality of bone was found and a shorter healing period is required. Results of this preliminary clinical investigation demonstrate that chin grafts offer a viable alternative for reconstruction of alveolar defects prior to dental implant placement.

Alveolar Bone Loss↗
PubMed1992

Force transfer in implant dentistry: basic concepts and principles.

The mechanism and efficiency of force transfer by dental implants to contiguous biological tissues are clearly important determinants in the development of the implant-to-tissue interface and, indeed, implant longevity. Whether a clinician seeks to gain a better understanding of implant design rationale and/or to implement biomechanics concepts in patient care, a fundamental, yet clinically relevant, understanding of biomechanics is required. A primer in force transfer is thus presented, with particular attention focused on implications for the long-term success of dental implants and restorative procedures. Forces and their components, moments, force transfer mechanisms, impact, and stress-strain relationships all influence clinical decisions and treatment plans.

Biomechanical Phenomena↗
PubMed1991

Autogenous bone grafts for endosteal implants--indications and failures.

The use of autogenous bone grafts (ABG) combined with endosteal implants permits to restore patients with conditions of extreme bone atrophy or with very demanding final results. The improvement of the biomechanics conditions, moment forces, C/I ratio, ridge relationship, length, diameter, number and location of the implants and esthetics improve the prognosis of the restoration. Large segments of autogenous bone is harvested from the iliac crest or cranium. Excellent autogenous membranous bone can be obtained intra-orally from the mandibular symphysis when smaller dimensions are needed. Indications for treatment with autogenous bone grafts are presented following the Misch/Judy available bone classification. In division C-w ridges, ABG improve the width of the ridge to permit the placement of root form implants. In Division C-h ridges, ABG improve the height available for implant placement, and permits to obtain a FP-1 or FP-2 result. In Division D ridges, ABG represent the treatment of choice. RP-4 restorations are encouraged. High success rates obtained by the author depend upon strict patient evaluation, treatment planning, careful placement of the minimum number of implants with the bone grafting procedure only to immobilize the grafted segment, progressive bone loading during the prosthetic phase, proper soft tissue management and sufficient number of implants for the planned prosthesis.

Alveolar Ridge Augmentation↗
PubMed1991

Post-operative maxillary cyst associated with a maxillary sinus elevation procedure: a case report.

Proper diagnosis, treatment planning, and surgical manipulation of the posterior maxilla require a thorough knowledge of the anatomy, physiology, and pathology associated with the maxillary sinus. This case report of a post-operative maxillary cyst diagnosed following routine post-operative examination of a sinus elevation procedure illustrates the need for a meticulous surgical technique, proper management of complications, and routine, long-term follow-up. With the increased utilization of sinus elevation techniques, reports of this destructive lesion may become more common.

Aged↗