[Experiences with aged patients at the University Clinical Center for Jaw Surgery in Vienna].
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Age Factors↗
Biomedical subjects
G Watzek
Publications and source records attributed to G Watzek.
[Diagnosis of amylosis in jaw surgery].
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Adult↗
[Differential diagnosis of macroglossia].
In addition to a survey of differential diagnoses to be considered in cases of macroglossia, rare general disorders connected with macroglossia are pointed out. As shown especially in a case of primary amyloidosis, recognition of and differential diagnostic considerations with regard to macroglossia sometimes make it possible to diagnose a general disorder not yet recognized.
Acromegaly↗
Implant-surgical and prosthetic rehabilitation of patients with multiple dental aplasia: a clinical report.
The expanded experience with oral implants and supplementary augmentation techniques has opened new possibilities for treating patients with oligodontia or anodontia with fixed prostheses. A problem in treating such patients is the need to place implants in growing maxillae or mandibles, as many of these patients are children or adolescents. When implant treatment is postponed until the patient is full grown, dysfunctions become manifest, which necessitates extensive surgical measures to achieve a fixed prosthetic restoration. This report illustrates the problems associated with different concepts for the treatment of multiple aplasia with implants. The results are based on the findings of 22 patients with oligodontia who underwent surgical treatment and were followed over a period of 5 years. Two controversially treated cases are presented.
Adolescent↗
Use of crestal bone for augmentation of extremely knife-edged alveolar ridges prior to implant placement: report of 3 cases.
A technique is presented for interforaminal lateral augmentation of mandibles with adequate bone height, but extremely knife-edged mandibular alveolar ridges (Class IV of Cawood and Howell's classification of residual ridges), in which the crestal portion of the knife-edged ridge is used as grafting material. Following an osteotomy and rotation of the grafts by 180 degrees, the grafts were fixed to the residual ridge below the osteotomy line by means of miniscrews. All grafts showed only mild resorption after a healing period of 3 months, and it was possible to place 4 implants in the now sufficiently wide host region.
Alveolar Bone Loss↗
Treatment of a patient with severe osteoporosis and chronic polyarthritis with fixed implant-supported prosthesis: a case report.
This article reports the treatment and 5-year follow-up of an 80-year-old female with a history of severe osteoporosis and chronic polyarthritis. Treatment included methotrixate disodium and acemetacin. After the last tooth was removed from the mandible, the patient was successfully treated with a fixed mandibular prosthesis supported by 6 implants placed between the mental foramina. The implants have remained osseointegrated, and peri-implant smears have been negative for bacterial colonization. Radiographic follow-up examination has revealed bone loss that is slightly greater than expected. This article focuses on the placement of implants in a patient receiving medication for chronic polyarthritis and osteoporosis.
Aged↗
Lethal photosensitization, autogenous bone, and e-PTFE membrane for the treatment of peri-implantitis: preliminary results.
This clinical study reports on the results of a new method in the treatment of peri-implantitis. The surfaces of 24 plasma flame-sprayed cylindric implants in 17 patients who were diagnosed with peri-implantitis were decontaminated with a combination of toluidine blue (100 micrograms/mL) and laser irradiation at a wavelength of 906 nm. Bone defects were filled with autogenous bone using e-PTFE membranes for retention of the grafting material. Premature membrane exposure occurred in all patients after an average of 3 weeks (+/- 10 days), which required immediate removal of the exposed membrane in 1 patient. Since the soft tissue showed minimal signs of inflammation, the membranes were left in situ for another 6 weeks in all other patients. The mean radiographic peri-implant bone gain was 2 mm +/- 1.90 mm after 9.5 months (maxilla 2.5 mm +/- 2.38 mm; mandible 1.9 mm +/- 1.87 mm). Two implants around which the initial bone defect had already reached the basket had to be removed after 10 months and 35 months, respectively, despite radiographic evidence of improvement of the peri-implant defect. The longer the membrane stayed in situ, the more bone was gained, as long as the membrane was covered by soft tissue (P = .01). However, the longer an exposed membrane was left in place, the smaller the resultant bone gain (P = .0001). Therefore, despite the absence of clinical signs of inflammation, exposed membranes should be removed immediately. The short-term results of this study corroborate the efficacy of the applied treatment method in prolonging the service time of dental implants involved with peri-implantitis.
Alveolar Bone Loss↗
Experimentally induced peri-implantitis: a review of different treatment methods described in the literature.
The aim of this article was to present the experimental peri-implantitis models described in the literature and to provide a review of currently used treatment methods. For this purpose, 29 English- and German-language studies published in internationally reviewed journals were examined for similarities and differences regarding animal models, types of implants, and methods used for inducing peri-implantitis. In almost all studies, the implants were located in the mandible, which suggests that peri-implantitis of the maxilla has been researched very little. While in most studies, peri-implantitis was induced by means of ligature and plaque accumulation, only 3 studies have been published that attempted to induce peri-implantitis by means of mechanical overload. Of the latter, only one author observed peri-implant bone resorption. Eleven studies reporting on ligature-induced peri-implantitis presented enough data to be subjected to further statistical data analyses. Meta-analysis revealed that the period of ligature application, and thus the duration of plaque accumulation, generally had no influence on the resultant depth of the bone defect. However, when screw-type and cylindric implants were analyzed separately, a weakly significant positive effect of the duration of ligature application on the resultant defect depth was determined for cylindric implants (P = .092). This could imply that smooth screw-type implants were less susceptible to ligature-induced peri-implant inflammation. Regenerative treatment methods included the membrane technique using non-resorbable membranes (guided bone regeneration), augmentation with autogenous bone, augmentation with bone substitute materials (hydroxyapatite or demineralized freeze-dried bone) or with recombinant human bone morphogenetic protein-2, and a combination of membrane and augmentation procedures. While all described methods resulted in acceptable bone gain, it seems to be difficult to achieve new osseointegration (reosseointegration) of treated implants. Of all tested treatment methods, the combination of guided bone regeneration and augmentation with demineralized freeze-dried bone resulted in the most favorable results regarding bone gain and reosseointegration.
Animals↗
A distraction abutment system for 3-dimensional distraction osteogenesis of the alveolar process: technical note.
To date, distraction osteogenesis has been carried out exclusively with devices that allow distraction in one given direction only. However, the new distraction abutment system described in this article allows distraction in any functionally or esthetically desired direction following osseointegration of 1 or several implants, provided that there are adjacent teeth or other osseointegrated implants. With this abutment system, an implant fixed in a position dictated by available bone volume can be moved into a prosthetically desirable position following segmental osteotomy. Accordingly, it also allows correction of the position of implants that were placed at an early age but whose position has changed as the result of jaw growth. Compared with conventional augmentation techniques carried out before or after implant placement, this method should lead not only to a shorter overall treatment time, but also to reduced strain on the patient and better long-term prognosis for success of implants.
Adolescent↗
Immediate and delayed implantation for complete restoration of the jaw following extraction of all residual teeth: a retrospective study comparing different types of serial immediate implantation.
From April 1986 to September 1993, 134 implants (97 immediate implants, 26 early secondary immediate implants, and 11 late secondary implants) were placed in 20 patients following extraction of all residual teeth. After a mean follow-up period of 27.1 months, the implants were analyzed with regard to peri-implant soft tissue parameters and bone resorption. When the examination was performed, 131 implants (97.7%) were found to be functioning successfully. The mean pocket depths varied between 1.3 and 2.6 mm, and the peri-implant bone resorption showed values between 0.5 and 1.3 mm. Fixed and removable prostheses revealed equal results with regard to the parameters examined. The results of the present study indicate that serial immediate implantation can be considered to be a very promising implant treatment modality for serial teeth extraction, if specific parameters are taken into account.
Aged↗
Incidence and suggested surgical management of septa in sinus-lift procedures.
A variable number of septa, also referred to as Underwood's septa, divide the floor of the maxillary sinus into several recesses and may thus cause various complications during sinus-lift procedures. The incidence of Underwood's septa was evaluated by examining 41 edentulous maxillas. In 13 of these maxillas (31.7% of the cases), sinus floors with at least one septum were observed. Most of the septa were located in the region between the second premolar and the first molar. A possible cause of septal formation could be the variable phases of maxillary sinus pneumatization of the empty alveolar process following tooth extraction.
Adult↗
Survival of 1,920 IMZ implants followed for up to 100 months.
A total of 1,920 IMZ implants, placed between March 1984 and December 1993, were evaluated retrospectively. The Kaplan-Meier cumulative survival rate of the implants was 89.9% after 60 months and 83.2% after 100 months. Life table analysis revealed a statistically significantly lower cumulative survival rate for maxillary implants (71.6% at 60 months and 37.9% at 100 months) than for mandibular implants (90.4% at 100 months). Implants placed in the anterior region of the maxilla failed significantly more often than those placed in the posterior region. This was not observed in the mandible. The age and sex of the patients, the status of the jaw (edentulous, partially edentulous), the time of implant placement in relation to tooth extraction, and the length and diameter of the implants had no statistically significant influence on the cumulative survival rate.
Adult↗