Advanced periodontitis treated with osseointegrated implants.
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Biomedical subjects
Publications and source records attributed to T J Balshi.
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Fixed prosthodontic rehabilitation can be accomplished in partially edentulous patients whose maxillary antrum prohibits successful placement of multiple fixtures. A single posterior fixture is placed in the tuberosity region to support a tissue-integrated prosthesis directly connected to a periodontally sound anterior abutment tooth. The treatment planning considerations and surgical aspects are described, and a case report is used to illustrate the technique.
This article describes postimplant follow-up and retreatment of a 66-year-old patient with an esthetically compromising fixed maxillary tissue-integrated prosthesis and a mobile mandibular overdenture stabilized by precision attachments with a gold clip bar cemented to the transmucosal posts of a bone plate staple implant. Following successful completion of prosthodontic treatment, the patient returned with a fracture of the left transmucosal pin in the mandibular bone plate staple implant that was retreated with Brånemark implants and a fixed prosthesis.
Sports injuries to the mouth and oral cavity may be treated with a variety of prosthetic treatment methods. These may include a temporary removable appliance, especially when adjacent teeth are unrestored and free of caries. Other traditional forms of prosthetic rehabilitation can range from conventional clasped removable partial dentures to traditional fixed prosthesis. The use of clip bar overdentures has demonstrated their clinical acceptability, especially for athletes involved in contact sports. The optimal treatment for patients suffering tooth loss, however, is the use of the osseointegrated implant. This concept, developed and refined by P.I. Branemark, permits successful replacement of single as well as multiple lost teeth. Criteria for patient selection must be evaluated carefully, especially for immediate fixture placement in sockets of avulsed teeth. Professional athletes in high-impact contact sports should receive a resilient prosthesis and protective appliance to use during the sport season, followed by a screw-retained nonremovable prosthesis to be used in the off season. Considering all forms of prosthodontic treatment available to patients with missing teeth, the use of osseointegrated implants currently appears to be the most biologically conservative approach. Retrospective studies document the effectiveness of the treatment of partially edentulous jaws, results similar or better than those reported for fully edentulous patients indicate the effectiveness of the Branemark method of osseointegration.
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The effectiveness of using Vicryl mesh (polyglactin 910) in combination with a Brånemark titanium implant is described. A maxillary central incisor with an apical osseous defect resulting from endodontic failure was treated with the Brånemark method of osseointegration for single tooth replacement. Vicryl mesh was used over the osseous defect site and uncovered 5 months later. New bone formation filling the defect and around the implant was observed.
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The philosophy of dental disease control has been discussed. Various devices used in the elimination of plaque have been listed and discussed. These include dentifrices, brushes, flosses, devices for holding and carrying floss, stimulating devices, disclosing solutions, and water irrigating devices. The responsibility for complete and thorough restorative therapy is shared by both dentist and patient. The treatment is not final when the restoration or prosthesis is inserted. Ongoing physiotherapy in the form of a rigid plaque-control program will influence the ultimate success or failure of any restorative treatment.
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Several methods for positioning dowel pins used in the fabrication of removable dies have been presented. Needles, pins, paper clips, hairpins, and matches are all useful in positioning dowel pins in the impression. The use of paper matches is a simple and effective method for holding the dowel pin in the proper relation while the die stone portion of the cast is being poured.
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