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PubMed1989

[Tensile strength of short-fiber-reinforced temporary plastics].

Glass fibers added to temporary crown and bridge material (Proviso-Blend, Blendax) by 5% to the weight increased the tensile strength of the acrylic resin by 38%. The increase was even greater when carbon fibers were added (50%), but the resin discoloured to a greyish shade. The results were less spectacular with Dentalon Plus (Kulzer), and the experiment did not work with Protemp (Espe). The amount of improvement in tensile strength depended on the type and geometry of the fiber and of the fiber concentration. Neither the properties of the polished surface of a fiber-reinforced acrylic nor adverse effects of such fibers possibly swallowed by the patient are investigated as yet.

Composite Resins↗
PubMed1990

[Multiple agenesis and prosthetic restoration].

Cases of multiple agenesia present some difficulties in the treatment planing. Three situations may be encountered: limited agenesia, restored by a fixed, bonded or cemented prosthesis, multiple uni- or bimaxillary agenesia without remaining of deciduous teeth, restored by a fixed, bonded or cemented prosthesis or the partial adjacent prosthesis, multiple uni- or bimaxillary agenesia with remaining of deciduous teeth, restored by means of a supra-dental prosthesis. The first two situations have been described in dental literature and are relatively easy to treat. The same is not true for the third situation, where the decision to keep the temporary teeth considerably increases the difficulty of prosthetic restoration. This subject will be illustrated by the presentation of a clinical case of multiple bi-maxillary agenesia. The patient has: on the maxilla: an absence of 9 permanent teeth (18, 15, 14, 12, 22, 23, 24, 25, 28) and the presence of 4 deciduous teeth (62, 63, 64, 65), on the mandible: an absence of all permanent teeth, with the exception of 36 and 46, and the remaining of 4 deciduous teeth (75, 73, 83, 84). The remaining of deciduous teeth and the presence of a very high inter-arch space led to opting for dental coverage so as to keep the deciduous teeth and a proper vertical dimension. The patient wished to solve his "problem" in the maxilla first, and is not wanting to undergo the extraction of his deciduous teeth. The following therapeutic proposal was adapted: On the maxilla, a three-step procedure: first step: building of metal copings on 13, 16 and 26 and metal-ceramic crowns on 11 and 21, second step: building of telescop crowns on 16 and 26 and clasps on 13, 11 and 21, third step: casting of the removable partial denture framework and soldering to the telescop crowns and clasps. On the mandible, a provisional restoration using a supra-dental resin removable partial denture with ceramic occlusal surfaces was adopted. The aesthetic and functional improvement, as well as the comfort provided to the patient due to this kind of mixed prosthesis, appeared to be satisfactory.

Adult↗
PubMedDate not supplied

Technical and biophysical aspects in prosthetic occlusal rehabilitation for edentulous teenagers.

The loss of anterior teeth may be transient solved by temporary adhesive bridges (Oslo bridge, Rochette, Ellmann, Neumann, Tschemitscheck, Armatron systems). Provisional crowns and bridges could be used for Brackets fixing. Anterior bridge with subocclusal connector permits transversal expansion. When a successful orthodontic treatment is followed by a prosthetic treatment, it is not important to change the achieved occlusion, by the occlusal framework morphology. The framework design of the metal component can contribute to the improvement of the aesthetic aspect and reduce the cost by using a small quantity of expensive alloy. Cytocompatibility of the used Cr-Co alloy is confirmed by cell culture test.

Adolescent↗
PubMed1997

Long-term esthetic provisional restorations in dentistry.

The role of interim dental restorations used for indirect restorative and prosthodontic procedures has changed dramatically in the past several years. These restorations are no longer regarded as temporary restorations but rather as provisional restorations with distinct functions and purposes. Provisional restorations have become a vital diagnostic and assessment tool to evaluate function color, shape, contour, occlusion, periodontal response, implant healing, and overall esthetics. An accurate fit and margination is essential to insure and maintain pulpal health of the tooth. With increased demands being placed on provisional restorations, new materials and techniques are being developed and some existing protocols are being refined to accomplish the desired goals. Provisional restorations are often in the oral environment for several months, requiring a well-fabricated and stable restoration. This review is designed to report on current materials, techniques, and concepts in fabricating and maintaining long-term esthetic provisionals.

Denture Design↗
PubMed1999

Study of the effect of using mini-transitional implants as temporary abutments in implant overdenture cases.

In an attempt to improve patient satisfaction during the healing period after placement of implants, mini-transitional implants (MTIs) have been advocated to allow immediate use of temporary dentures and to prevent transmucosal loads over the definitive implants. Twelve edentulous patients received two screw implants each in the predetermined mandibular canine region. At the time of surgery, six patients had two MTIs placed medially to the permanent ones. The flap was repositioned allowing transmucosal penetration of MTIs. Patients left the operating room wearing their relined lower dentures. The results indicated that MTIs integrated sufficiently in bone, giving successful immediate support for the transitional prosthesis and allowing proper mucosal healing. Two of these transitional implants showed mobility three months after phase I surgery. After loading the final implants, patients who had MTI-supported dentures showed bone loss that was not significantly different from the control group.

Cuspid↗
PubMed2003

Treatment of advanced periodontal destruction with immediately loaded implants and simultaneous bone augmentation: a case report.

BACKGROUND: Advanced periodontal destruction is often associated with extraction of the teeth. Oral rehabilitation in these cases may include the traditional prosthetic restoration or an implant-supported reconstruction. Immediately loaded implants present an alternative treatment modality using a bar in the anterior mandible, along with the placement of higher numbers of implants, which are connected with a fixed prosthetic reconstruction. METHODS: This clinical case report presents the surgical and prosthetic rehabilitation in a patient who had lost all teeth due to advanced periodontal bone destruction. Six implants were placed in the upper and lower jaw each. Some implants required guided bone regeneration in conjunction with autologous bone grafting. All of the implants were connected with their abutments, and a temporary fixed restoration was placed immediately after surgery. The final metalloceramic-fixed reconstruction was cemented after 6 weeks of loading. RESULTS: All of the implants were osseointegrated and showed no clinical signs of mobility or infection. Mobility values were evaluated during healing and were found to be reduced. Radiological findings showed a stable peri-implant bone level during the total 18-month loading observation period. CONCLUSIONS: This case report presents an alternative treatment concept for the oral rehabilitation in a patient with advanced periodontal destruction. The concept of immediate loading of implants might provide a better opportunity to meet patient needs than more traditional treatment modalities.

Alveolar Bone Loss↗
PubMedDate not supplied

A new method for achieving passive fit of an interim restoration supported by Brånemark implants: a technical note.

When carrying out restorations supported by dental implants, it is advisable to have a temporary method that offers the possibility of evaluating and/or creating a proper emergence profile, peri-implant health, occlusion, esthetics, acceptable phonetic response, and hygiene, as well as one that facilitates progressive loading of the implants during the bone maturation period. To maintain osseointegration it is essential that a prosthesis fit with total passivity, since the lack of a periodontal ligament renders the implant unable to modify its position. Gold cylinders for EsthetiCone abutments, which were modified following a previously reported technique, were used so that provisional prostheses could be fixed to the cylinders in the mouth by means of an alternative cementing technique. By this way, a provisional prosthesis with total circumferential fit, maintaining the option of retrieval, could be routinely obtained.

Acrylic Resins↗
PubMed1984

Pulpal response to a bis-acryl-plastic (Protemp) temporary crown and bridge material.

The pulpal response to Protemp (ESPE Gmbh) was compared to zinc oxide-eugenol, Super Syntrex (de Trey) and Protemp plus zinc oxide-eugenol liner in 144 vervet monkey (Cercopithecus pygerythus) incisor teeth, according to ADA Specification No. 41. Cellular displacement into dentinal tubules, superficial and deep inflammation were present only in the 3-day specimens in all materials. Mean scores for the test material were lower than both negative and positive controls. In the 30-day specimens the prevalence of reparative dentine under the test material was similar to the negative control, while at 90 days it was less than the negative control, although the severity in affected specimens was more than the positive control. Use of a zinc oxide-eugenol liner reduced the severity of reparative dentine formation.

Acrylates↗
PubMed2001

Peri-implant bone reactions to immediately loaded implants. An experimental study in monkeys.

BACKGROUND: There are reports which demonstrate that immediately loaded splinted implants can be osseointegrated when they are placed in the anterior part of the lower jaw. The concept of immediate loading has not been well investigated in the posterior mandible. The aim of this study was to evaluate the bone reactions around immediately loaded implants placed in the posterior region of the lower jaw in the monkey model. METHODS: Six adult Macaca fascicularis monkeys were used in this study. A total of 36 implants were placed after extraction of the second premolars, first and second molars, and complete healing of the sockets. Three control (C) group implants were placed in one quadrant of the lower jaw of each monkey. After a delay of 3 months to allow osseointegration to take place, the implants were loaded for 1 month using temporary resin bridges and later for 2 months using metal splinted crowns. In the contralateral region of the lower jaw, 3 test (T) group implants were placed and loaded immediately with the same sequence as carried out for the C implants. Specimens were examined and evaluated histologically after sacrifice. RESULTS: All of the implants were osseointegrated. Compact, cortical bone in contact with the implant surface without any gaps or connective tissue formation was observed. CONCLUSIONS: It was concluded that immediately loaded, splinted implants can be osseointegrated with a similar hard and soft tissue peri-implant response as delayed-loaded implants in the posterior mandible.

Alveolar Process↗
PubMed1999

Immediate loading of modular transitional implants: a histologic and histomorphometric study in dogs.

Modular Transitional Implants (MTI) are made from pure titanium and are used to support fixed provisional restorations during the osseointegration of definitive implants. This study histologically examined the jaw response to loaded MTIs in the dog mandible. Three implants were inserted transmucosally into each side of the mandible in 3 dogs. Stability was examined using a Periotest. Anterior and posterior implants were splinted using a cemented acrylic resin fixed partial denture to allow immediate loading. The middle implant remained unloaded and was used as a control. Dogs were sacrificed 11 to 12 weeks after implantation, and tissue blocks containing the implants were removed. Histologic examination showed that 10 of the 18 implants had good bone-to-implant contact, with the percentage of bone contacting the threaded portion of the implant varying from 30% to 65%. There was no statistical difference (p > 0.1) in percentage of bone-to-metal contact between loaded and unloaded implants. Six implants were entirely surrounded by connective tissue with or without inflammation; two implants were lost during the study. The success rate did not differ between loaded and unloaded implants. In the successful implants trabecular bone made good contact with the implant, forming supporting struts. There was bone remodeling in some bone-to-metal contact areas. It is believed that success was mainly influenced by the initial bone density at the implant site and by the uncontrolled load that the animals applied to the implants during the early healing stage.

Animals↗
PubMed1986

Human gingival attachment responses to subgingival crown placement. Marginal remodelling.

13 teeth in block were extracted from 2 patients. Their facial periodontal condition was essentially within normal clinical limits. Temporary crowns covering the bevel were placed below the base of the crevice 1 to 8 weeks prior to extraction. At time of extraction, all blocks were decalcified, the temporary crown dissolved, and the blocks prepared for histologic examinations using buccolingual cut, step serial sections. Histologic data revealed reformation of a new supracrestal attachment unit within 1 week following crown placement. The reformation of the gingival unit consisted of marginal recession with apical and lateral migration of the junctional epithelium to the level of remaining cementum inserted fibers. With gingival recession and migration of junctional epithelium, resorption of crestal portions of the facial plate occurred. However, periodontal fibers anchored into cementum opposite the resorbed bone were not lysed. Rather, the attached fibrillar ends appeared to interdigitate with fibers from the corium of the facial gingiva at this site, thereby forming a more apically located crestal attachment. This response may be one mechanism of reformation of the gingival attachment unit taking place following mechanical and/or surgical injury to this site and is completed often, within 2 weeks after injury.

Connective Tissue↗
PubMedDate not supplied

Fracture resistance of fiber-reinforced PMMA interim fixed partial dentures.

PURPOSE: To compare different fiber reinforcements on fracture toughness of interim polymethyl methacrylate materials and then use the best combination to determine the optimal position for fiber placement in an interim 3-unit fixed partial denture (FPD). MATERIALS AND METHODS: In the first stage of the study, five groups of notched fracture toughness specimens were fabricated and loaded to failure (Instron): (1) unreinforced (control); (2) reinforced with pre-impregnated silanized E-glass fibers (Fibrestick); (3) cold plasma-treated woven polyethylene fibers (Ribbond triaxial); (4) pre-impregnated silanized plasma-treated woven polyethylene fibers (Construct); and (5) 1.0-mm-diameter stainless steel wire. In the second stage, the optimal position (occlusal, middle, or cervical third of pontic) for reinforcement with glass fibers (regimen 2) was tested by loading a 3-unit FPD to failure. All groups were compared with analysis of variance (alpha < 0.05). RESULTS: The fracture toughness (in MPam(1/2)) for each reinforced group (Fibrestick 2.74 +/- 0.12, Construct fibers 2.59 +/- 0.28, Ribbond triaxial 2.13 +/- 0.20, and orthodontic wire 1.66 +/- 0.09) was statistically greater (p< 0.05) than for the unreinforced group (control = 1.25 +/- 0.006). Fracture loads for FPDs were greatest when the fiber reinforcements were placed in the cervical third (cervical = 1165 N). CONCLUSIONS: The use of fiber and, to a lesser extent, orthodontic wire is an effective method to reinforce interim restoration resins.

Analysis of Variance↗
PubMed1995

The influence of splinting procedures on the periodontal and peri-implant tissue damping characteristics. A longitudinal study with the Periotest device.

The aim of the present study was to evaluate the capability of the Periotest device in detecting and monitoring functional changes in the periodontal as well as in the pari-implant damping characteristics. In the first part of this study, 107 teeth were splinted by means of 40 full acrylic fixed prostheses (AFP) and another 37 teeth were splinted by means of 14 ceramometallic fixed prostheses (C-MFP). The Periotest measurements of individual teeth were done the day the fixed prostheses were cemented temporary (PTV 1), and again after a mean observation period of 27.4 days (PTV 2). In the 2nd part, 78 osseointegrated two-stage implants were splinted by means of 23 full acrylic fixed prosthesis (AFP) and other 18 implants were left without it. Using the same abutment length, Periotest measurements were performed, at abutment connections and before installation of the final prosthesis. In a 3rd part, using both implants and teeth as abutments, 29 osseointegrated implants were connected with 25 abutment teeth by means of 7 AFP. The measurements were performed at the beginning of the prosthetic treatment and 2, 4 and 6 weeks later. After splinting teeth by means of AFP for the observation period, no statistically significant reduction in PTVs was found. When on the other hand, a C-MFP was used, PTV 2 showed a significant reduction. The PTVs at abutment connection went down after a period of time, during which some implants were interconnected by means of an AFP and others were not.(ABSTRACT TRUNCATED AT 250 WORDS)

Acrylic Resins↗
PubMed2004

Early function of splinted implants in maxillas and posterior mandibles, using Brånemark System Tiunite implants: an 18-month prospective clinical multicenter study.

BACKGROUND: Immediate or early loading of implants placed in maxillas and posterior mandibles has been a concern as bone density is often low in these areas, making it difficult to establish good initial implant stability. By adapting implant design and insertion protocols, however, high initial implant stability may be achieved in these regions. Further, a modified implant surface texture has been proved to help in maintaining stability during the initial healing period. PURPOSE: The aim of the present study was to investigate the clinical performance of oxidized titanium implants (TiUnite, Nobel Biocare AB, Gothenburg, Sweden) when used for early function in the maxilla and in the posterior mandible, locations where the bone density often is low. A further aim was to evaluate the marginal bone level at oxidized implants and compare it with that of machined-surface implants used in a previous study. MATERIALS AND METHODS: Thirty-one patients were consecutively included in the study, and 37 edentulous areas in maxillas and posterior mandibles were treated. Bruxism and uncontrolled periodontal disease were exclusion criteria. Temporary prostheses were generally placed within 9 days but not after 16 days from implant placement. A previous study applying the same study design and clinical protocol but using machined-surface implants was used for comparisons. RESULTS: Of the 111 implants installed, 1 failed, giving an overall survival rate of 99.1% after 18 months. The prosthesis survival was 100%. The marginal bone resorption was 0.8 mm (standard deviation [SD], 1.0), as opposed to 1.6 mm (SD, 1.3) in the previous study with machined-surface implants, but was not statistically significantly different (p = .10). CONCLUSION: The present clinical protocol (aiming at high primary stability) and the use of oxidized titanium implants for early functional loading in the maxilla and the posterior mandible resulted in a high implant survival rate and a favorable marginal bone level during a follow-up of 18 months. The difference in marginal bone resorption between the oxidized implants in the present study and the machined implants from a previous investigation with the same study design was not statistically significant.

Adult↗
PubMed2003

Immediate loading in the maxilla using flapless surgery, implants placed in predetermined positions, and prefabricated provisional restorations: a retrospective 3-year clinical study.

BACKGROUND: Immediate loading of dental implants shortens the treatment time and makes it possible to give the patient an esthetic appearance during the whole treatment period. PURPOSE: The aim of the present study was to evaluate an immediate-loading treatment protocol, which included flapless surgery, implants placed in predetermined positions and connected to prefabricated provisional restorations, and the 3-year clinical results. MATERIALS AND METHODS: A total of 97 Brånemark System Mk IV implants (Nobel Biocare AB, Gothenburg, Sweden) with a machined surface were inserted in the maxillas of 46 patients. A presurgical three-dimensional model of the patients' soft tissue and underlying alveolar bone anatomy was created, which allowed the clinician to place the implants in predetermined positions and connect them to prefabricated provisional restorations. A surgical template with drilling guides corresponding to each implant was used. The apical part of the master guide was equipped with a circular "mucotome," which punched out a 5 mm hole in the mucosa to eliminate the need for flap elevation. The patients received 25 fixed partial prostheses and 27 single-tooth restorations. Bone quality and quantity were assessed. Radiographic examinations were performed on the day of surgery/loading and at the 1-, 2-, and 3-year follow-up visits. RESULTS: All implant sites showed intact buccal and lingual bone walls during surgery, confirming the accuracy of the bone-mapping procedure. The prefabricated temporary restorations fitted, meaning that the implants were positioned clinically in the same way as on the cast. Nine implants in eight patients failed during the first 8 weeks of loading. This resulted in a cumulative survival rate of 91% after 3 years of prosthetic load. The survival rate of splinted implants was 94%. The number of failed implants was significantly higher in cases of single-tooth replacements and placement in soft bone sites and smokers. The failed implants were successfully replaced according to a two-stage protocol. All patients finally received the expected restoration. The marginal bone resorption was on average 1.0 mm during the first year of loading, 0.4 mm during the second year, and 0.1 mm during the third year. CONCLUSIONS: The study confirmed the feasibility of an immediate-loading treatment protocol in the maxilla, which included flapless surgery, implants and abutments placed in predetermined positions, and prefabricated provisional restorations. All failures occurred within the first 2 months of loading. The unchanged survival rate and the low average bone loss found during the following 34-month study period indicate a good long-term prognosis for the performed immediate-loading treatment.

Adult↗
PubMed1990

[The treatment of adults with removable appliances? A contribution to orthodontic-prosthetic collaboration].

Request of adults for orthodontic treatment increases. In that cases requirements to the practitioner are of many kinds, especially if in consequence of secondary changes after lost of teeth the patient is not able, as in the past to accept his irregularities of teeth in relation to masticatory, physiognomic and phonetic function. Absolutely there is willingness to wear also removable orthodontic appliances. Possibilities and advantages of plates for orthodontic-prosthetic problems are discussed and examples of treatment demonstrated.

Adult↗
PubMed1979

Treatment of compromised teeth: a multidisciplinary approach.

Treatment for uprighted abutment teeth that may have infrabony pockets can be considered complete when the following criteria are met: 1. The uprighted tooth is in its proper vertical axis. 2. There is a significant decrease in soft-tissue pocket depth. 3. Crestal leveling is evident radiographically. 4. Adequate space has been created to accommodate a pontic (minimally 6.5mm). The advantages of employing this orthodontic-periodontal technique are as follows: 1. Leveling of the osseous crest fosters pocket elimination obviating the necessity for removal of a great deal of supporting bone. Concomitantly, a significant decrease in pocket depth usually eliminated the need for periodontal surgery. 2. The resulting occlusal forces are placed in favorable axial inclinations. 3. There is an improved crown-to-root ratio, since the uprighted and extruded tooth is reduced to the level of the occlusal plane. This reduction is sufficient to improve considerably the prognosis of a questionable abutment tooth. 4. A pontic space is created for an esthetic and properly contoured pontic. 5. Parallelism is attained, so that the marginal integrity is more easily accomplished. 6. The orthodontic procedures are relatively uncomplicated, efficient, and esthetic, provided there is little or no lower anterior crowding. 7. The restorative dentist has a proper abutment tooth with a good prognosis for prosthesis.

Adult↗