Originally, osseointegrated implants were used principally in the anterior region of the mandible and maxilla, but use in the posterior segments of both arches is common today. The long-term success of implants placed in the posterior region, an environment of stronger forces and poorer bone quality, has not been thoroughly reviewed. The purpose of the present study was to review a large series of Brånemark System implants placed in posterior maxillae (660 implants in 202 patients) that have been restored with fixed partial ceramometal restorations and followed for as long as 12 years after loading. Thirteen of the implants (2%) failed between placement and loading, 12 implants were lost between loading and the end of the first year, and 10 failed thereafter, 2 as the result of fractures at 3 and 4 years. The cumulative success rate is therefore 94.4% at 5 to 6 years and 93.4% after 10 years. The quality and quantity of bone appeared to have little influence on the success rate. Surgical techniques are particularly important to the success of osseointegrated implants placed in the posterior maxilla. With careful surgical planning and execution, a success rate of approximately 95% at 5 years can be achieved.

Adolescent↗

PubMedDate not supplied

[Initial therapy in periodontal treatment].

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Dental Occlusion, Traumatic↗

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Prosthetically formulated natural aesthetics in implant prostheses.

The discrepancy in the anatomic dimensions between an endosteal root-form dental implant and the root of a natural tooth can compromise the aesthetic appearance of the final restoration. For the past five years the authors have used an abutment system, the components of which are designed to enable the clinician to achieve a predictable aesthetic result. This article describes and illustrates the anatomic abutment system (AAS). Until recently, the restoration usually began at the gingival line where a cylindrical implant emerged to be restored with a noncylindrical prosthesis. The new system uses components which compensate for the difference between the diameter of the natural tooth root and the endosteal implant. The importance of teamwork is emphasized, and a step-by-step procedure is presented, indicating which steps are performed by the combined team and which are the responsibility of the laboratory or the restorative dentist. The learning objective of this article is to introduce this system to the reader.

Dental Abutments↗

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Use of wide implants and double implants in the posterior jaw: a clinical report.

As experience with osseointegrated implants has grown, greater use has been made of placement in the posterior jaw. To reduce the risk of implant failure and increase the ability of posterior implants to tolerate the occlusal forces, it is beneficial to create a wider base either by using wider (eg, 5-mm) implants or by placing two or even three standard implants at one site. In the present series, unpaired 5-mm Nobelpharma implants were placed in 38 sites in the mandible and 21 sites in the maxilla. All implants were uncovered and restored with ceramometal crowns, with follow-up ranging from 3 to 26 months (mean 16 months) postloading. Two implants in one patient failed and were replaced successfully at 14 months. At 20 sites, pairs of 5-mm implants were placed and restored, and with a loading period of 3 to 26 months (mean 14 months), all of these implants were successful. At 34 sites, a 5-mm implant was paired with a 3.75-mm or 4-mm implant. With a loading period of 3 to 24 months (mean 13 months), one implant 5 mm wide and 8 mm long failed and was replaced successfully at 13 months, and an implant 4 mm wide and 10 mm long failed and was not replaced. The failure rate for this group of implants therefore was 3%. Double 3.75-mm or 4-mm implants were placed at 149 sites in the mandible and 13 sites in the maxilla. All of these double-root implants were uncovered and restored with ceramomental crowns. With follow-up ranging from 4 to 78 months (means 37 months) postloading, there were five implant failures in four patients, for a failure rate of 1.2%. The failure rate for all 5-mm implants was 2.3%, and that for all double implants was 1.6%. The use of either 5-mm or double implants necessitates changes in surgical technique, and both are highly dependent for their success on proper surgical execution.

Bite Force↗

PubMedDate not supplied

Surgical reconstruction--a prerequisite for long-term implant success: a philosophic approach.

Loss of teeth results in the loss of other tissues. Without adjunctive reconstruction of the hard and soft tissues, this loss can impair the reconstruction of the dentition using osseointegrated implants. Inadequate treatment planning-based on rules derived from anterior implant use in older edentulous patients or poor execution of the surgical plan, leading to errors in the number, angulation, distribution, and position of implants-can be the foundation for future failure. The learning objective of this article is to review specific reconstructive measures that may be appropriate in patients with special functional, aesthetic, or phonetic demands. The authors suggest that the present definition of failure be expanded to include long-term functional, aesthetic, and phonetic outcomes.

Alveolar Bone Loss↗