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Biomedical subjects

Michael S Block

Publications and source records attributed to Michael S Block.

24 records · Page 2Linked to original sources
PubMed2002

Tibial bone harvesting under intravenous sedation: Morbidity and patient experiences.

PURPOSE: The aims of this study were to evaluate the complication rate, the recovery, and the experience in patients undergoing tibial bone harvesting under intravenous sedation. PATIENTS AND METHODS: This was a prospective study of 10 consecutive patients who underwent unilateral or bilateral sinus grafting with tibial bone grafts under intravenous sedation in a 3-month period in the oral and maxillofacial surgery outpatient clinic. All medications used perioperatively were recorded. Postoperative analgesic requirements were evaluated, along with patient recovery and complications and the patients' subjective experiences. RESULTS: All patients underwent unilateral tibial bone harvesting using a nontrephination technique under sedation with meperidine and methohexital. On average, 11.3 mL of compressed marrow was harvested. All patients described a sensation of scraping intraoperatively but not of severe pain. On average, patients required narcotic analgesics for 1.2 days postoperatively and non-narcotic analgesics for 10.2 days. Discomfort and a gait disturbance were present for an average of 9 to 10 days. There were no wound complications, and all patients were satisfied with the recovery and donor site. CONCLUSIONS: Tibial bone harvesting under intravenous anesthesia in an office setting is well tolerated and well accepted. The postoperative recovery and complication rate also seem to compare favorably with those of tibial grafting under general anesthesia.

Adult↗
PubMed2002

Human mineralized bone in extraction sites before implant placement: preliminary results.

BACKGROUND: Bone loss after tooth extraction may prevent dental implant placement. Human mineralized bone grafts can be used to restore bone volume and allow for tooth replacement with dental implants. METHODS: The authors grafted 22 sites in 18 patients with human mineralized bone after tooth extraction. They allowed molar sites 16 weeks for graft healing, placed the implants and restored them with a final crown after a four-month integration period. Single-rooted maxillary sites received implants and immediate placement of provisional crowns or underwent a delayed two-stage restoration approach. The authors used radiographs and clinical examinations to evaluate the results. RESULTS: All of the sites were restored successfully with a single-tooth implant restoration. Periapical radiographs indicated that the crestal bone levels were limited to the first thread of the implants or slightly coronal to the first thread of the implant. Clinical evaluation indicated excellent gingival health around the provisional and final restorations, without obvious gingival migration. CONCLUSIONS: The use of human mineralized bone may have significant potential to reconstruct missing bone resulting from tooth extraction and to preserve bone after tooth extraction. In addition, healed bone graft sites seem to be able to support immediate placement of a provisional crown and implant restorations. CLINICAL IMPLICATIONS: Patients who are having teeth extracted may become candidates for implant restorations when the sites are appropriately grafted to preserve and reconstruct bone volume, thus allowing for more options for reconstructing the missing tooth site.

Alveolar Ridge Augmentation↗
PubMedDate not supplied

Clinical considerations for enhancing the success of implant-supported restorations in the aesthetic zone with delayed implant placement.

Several factors (e.g., root configuration, periapical pathoses, periodontal disease, severe bone loss, patient accessibility) determine the timing of the implant placement. When delayed implant placement is the only feasible option for implant restoration, achieving a functional and aesthetic restoration is more complex and challenging. This article will discuss the surgical and prosthetic methods for enhancing the success of an implant-supported crown in the aesthetic zone in cases where delayed implant placement is the only available treatment option for patients missing single teeth.

Adult↗
PubMedDate not supplied

Prospective evaluation of implants connected to teeth.

PURPOSE: This prospective clinical trial examined the effect on teeth and implants when rigidly or non-rigidly connected in a cross-arch model. MATERIALS AND METHODS: Thirty patients received 2 implants, 1 on each side of the mandible, and were restored with 3-unit fixed partial dentures connected either rigidly or non-rigidly to an abutment tooth. Patients were followed for at least 5 years post-restoration. RESULTS: Repeated-measures analysis revealed no significant difference in crestal bone loss at implants (rigid versus non-rigid methods). An overall significant difference (P < .001) was found comparing methods for teeth. Paired t tests revealed no significant differences in crestal bone levels for implants or teeth at the 5-year recall. Kaplan-Meier methods and the Cox proportional hazards model showed no differences between attachment methods with regard to success based on survival and bone loss criteria. During the 5-year recall period, 1 implant (rigid side) was removed. Four implants developed bone loss greater than 2 mm during the course of this trial. One tooth on the rigid side and 2 teeth on the non-rigid side had greater than 2 mm of crestal bone loss and were removed secondary to fractures. In all, 5 abutment teeth were removed, all of which had been treated with root canal therapy and fractured at the interface of the post within the tooth. There was no clear relationship of tooth fracture to attachment. Repeated-measures analysis of mobility values revealed no significant changes over the time course of this study, and paired t tests revealed no statistically significant differences between implants for mobility. Repeated-measures analysis and paired t tests for probing depth revealed no significant changes over the time course of this study. There were no significant differences in soft tissue indices for either attachment method. The percentage of patients who had measurable intrusion was 66% for the non-rigid group, and 44% for the rigid group; 25% of the non-rigid teeth had greater than 0.5 mm intrusion, compared with 12.5% for the rigid group. For the 2 time periods evaluated, there was no significant increase in intrusion over time. The non-rigid-side implant required more nonscheduled visits to treat problems than the rigid implant and the teeth. DISCUSSION: Most patients were treated successfully with rigid or non-rigid attachment of implants to teeth. CONCLUSION: The high incidence of intrusion and non-scheduled patient visits suggest that alternative treatments without connecting implants to teeth may be indicated.

Adult↗
PubMedDate not supplied

Immediate implant placement and provisionalization using implants with an internal connection.

Single-tooth implant restoration has evolved from traditional two-stage surgical procedures to techniques that allow implant placement and provisionalization immediately following tooth extraction. Restorative success using an immediately provisionalized implant system is based upon adherence to several clinical and biological parameters. This article will discuss the clinical and restorative considerations that must be addressed when immediately loading single-tooth implants. Four cases are presented demonstrating the clinical versatility of an immediate implant system for predictable and aesthetic restoration of the posterior region.

Adult↗