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Primary stability and osseointegration: preliminary clinical results with a tapered diminishing-thread implant.

Due to their success and predictability, osseointegrated implants are used with increasing frequency for the prosthetic restoration of edentulous patients. Analysis of implant failures, however, enables clinicians to improve the clinical results achieved with this modality. While the literature discusses varying etiological factors (e.g., poor surgical technique, patient immune factors, insufficient bone quality or quantity), this article addresses primary stability as a predicator of implant success. The article also demonstrates the use of an anatomically shaped implant system that may improve primary stability in common clinical scenarios.

Bone Density↗

Immediate implant placement and temporization in extraction and healing sites.

While single tooth replacement can be predictably accomplished using implant therapy, this procedure is challenging in the esthetic zone where numerous criteria must be evaluated by the restorative team. If the gingival and osseous architecture of the failing tooth is acceptable, the therapeutic goal is to maintain the existing morphological condition. The optimal tridimensional implant is placed in the esthetic zone immediately after extraction or 8 to 12 weeks after extraction. The abutment connection and the nonfunctional temporary tooth restoration are prepared in advance and should respect the forms of contour of the contralateral tooth. In some specific clinical cases, not only can the patient's smile be returned after only a few hours of clinical work, but more importantly, initial capital of soft and hard tissues can be preserved. After healing, maturation, and stabilization during the 3 to 6 months of osseointegration, a compressive impression of the implant site can be taken and the implant restoration can be cemented. A multi-centric study performed by several dentists during the past 3 years have drawn interesting statistics on the rate of success, the different type of implants, and the variation of the peri-implant bone and gingival contour.

Alveolar Process↗

The direction and location of mental foramen and incidence of accessory mental foramen in south Indian mandibles.

One hundred and forty two south Indian mandibles of unknown sex were examined for the variations of the location and direction of the mental foramen. Accessory mental foramen were also looked for. The findings have been compared with those of other studies in the literature. Topography of the mental foramen is of practical importance to the dental and maxillo-facial surgeon for purpose of anesthesia and surgical procedures.

Adult↗

[Clinical study of immediate implant].

OBJECTIVE: To evaluate the clinical result of immediate implant. METHODS: 32 cases underwent immediate implant surgery for 59 implants simultaneously when the teeth or roots extracted. 55 implants were placed with bone grafts or bone substitutes. The second stage operation were performed in the sixth month and ceramic crown were fixed in the seventh to eighth month postoperatively, the follow up were mean 39 months. RESULTS: One implant was lost. Bone resorption of alveolar crest was observed in 4 implants. Mean resorption was 2 mm. CONCLUSIONS: The result of immediate implant is predictable, the advantages are avoiding the alveolar bone resorption after teeth extraction, implant could be placed in an ideal position; less operation trauma, good esthetics results.

Adult↗

Biological characteristics of cell lines of human dental alveolus.

OBJECTIVE: To investigate the biological characteristics of cell lines of healthy and diseased human dental alveoli. METHODS: Primary cell lines from either healthy or diseased human dental alveoli were obtained. Two cell lines, H-258 and H-171 derived from healthy and diseased human tissues respectively, were selected for morphological study and research on their growth and aging, using cell counting, and histochemical and immunohistochemical staining. RESULTS: Primary cell lines were successfully established from innormal dental alveoli. After freezing and thawing for three times, cell growth was continued and no morphological alterations were observed. The doubling time was 53.4 hours and mean division index (MDI) was 4 per thousand. Cells were kept normal after twenty generations with no obvious reduction of doubling time and MDI. Of twenty-six primary cell lines derived from healthy human dental alveoli, only three cell lines achieved generation. After freezing and thawing for twice, cultured cells were still alive at a decreased growth speed, with doubling time of 85.9 hours and MDI of 3 per thousand. Both cell lines, H-171 and H-258, shared the characteristics of osteoblast. CONCLUSIONS: Primary cell lines of diseased human dental alveoli show greater growth potential. All cell lines of dental alveoli share characteristics of osteoblast. The technique we developed may be put into practice for the treatment of abnormal dental alveoli.

Cell Division↗

[Dental ingenuity 2. Implant treatment using transitional implants].

The applications in oral implantology are strongly increased due to the advance in the field of osseointegration and in material technology. As a result of this gained knowledge the area of indications increased in both edentulous and partially dentate patients. With the extension of the indications of dental implants there also is a growing patients' demand for direct replacement of lost tooth. Sometimes it is possible to fulfill the expressed wish of immediate loading. In case of poor bone quantity or quality this is impossible. Transitional implants supply the prosthodontist with an additional possibility to fulfill the need for uninterrupted healing as well as patients' demands for immediate functional and esthetic restorations.

Dental Implantation, Endosseous↗

[Resonance frequency analysis in immediate loading of dental implants].

Immediate loading of dental implants aims to shorten treatment time. Stability at implant insertion is critical to success. The aim of this prospective study is to compare primary implant stability, measured by insertion torque (IT) with resonance frequency analysis (RFA) expressed as ISQ. Patients requiring implant therapy were treated by teeth extractions, placement of 1-9 MIS implants, bone augmentation as needed and fixed provisional restorations. We measured IT and ISQ for non-submerged loaded (NSL), non-submerged non loaded (NSNL) and submerged (S) implants. 14 patients, aged 34-79 years, were recruited. 53 implants were inserted (38 maxillary & 15 mandibular). 30 implants, 18 in fresh extraction sites, were immediately loaded. ISQ was 63.3 +/- 2.8 (S.E.), 67.2 +/- 3.5 (S.E.) and 58.8 +/- 2.7 for the NSL, NSNL and S groups, respectively (p = 0.0459). IT was 40.4 +/- 1.8 Ncm, 46 +/- 4.0 and 35.3 +/- 2.1 (p = 0.0646). ISQ and IT were not statistically different between extraction vs. non-extraction and augmented vs. non-augmented sites. We found a significant difference in IT between maxillary & mandibular sites, and a significant correlation between ISQ & IT and between ISQ & implant diameter. These data suggest that ISQ is correlated to IT and is influenced mainly by implant diameter and not by implant length, location or bone level. Finally, a case including immediate implants, bone augmentation and immediate provisional restoration is presented.

Adult↗

When is an implant ready for a tooth?

The capability of placing an osseointegrated implant at the time of tooth extraction and immediately placing a restoration on the implant depends upon a number of factors. This paper describes the traditional Brånemark protocol, the evolution of single-stage surgery, the guidelines for immediate placement, the measurement of implant stability, and the considerations critical to immediately loading.

Dental Implantation, Endosseous↗