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Combination of natural teeth and osseointegrated implants as prosthesis abutments: a 2-year longitudinal study.

Twenty-three patients with Kennedy Class I mandibular dentition were supplied with prostheses in the posterior parts of the mandible. On one side they were given a prosthesis supported by two implants (prosthesis Type I) and on the other side they received a prosthesis supported by one implant and one natural tooth (prosthesis Type II). Sixty-nine fixtures were inserted and 46 prostheses constructed. Eight of the fixtures were lost during the observation period. The failure rate of the implants was about the same in the two types of prostheses; five fixtures belonged to prostheses Type I (10.9%) and two fixtures belonged to prostheses Type II (8.7%), while one fixture was lost prior to loading. From a theoretical point of view, the combination of a tooth and an osseointegrated implant should encounter problems with regard to the difference in bone anchorage and there should be a risk of biomechanical complications. However, the results of this study did not indicate any disadvantages in connecting teeth and implants in the same restoration.

Adult↗

[Clinical aspects of implant-supported telescopic crowns in partially edentulous jaw].

First clinical experiences indicate the possibility for implant-supported cone-overdentures to be used in the treatment of partial edentulism. In situations with statically unfavorable abutment distribution or uncertain prognosis of the natural teeth, fixtures could be implanted in suitable positions and used as abutments in combination with the remaining teeth. Clinical and biomechanical aspects of implant-supported cones in the treatment of partially edentulous patients are discussed.

Crowns↗

A technique for the replacement of multiple missing anterior teeth in the presence of a mutilated alveolar ridge.

The intent of this paper is to demonstrate a clinical technique for the replacement of multiple missing anterior teeth in the presence of a mutilated ridge. It also reviews basic rules governing the replacement of multiple adjacent missing teeth. The two cases presented clearly demonstrate that multiple adjacent missing teeth can be esthetically restored and still preserve that which remains; teeth, periodontium and soft tissues. The long-term success or failure of prosthodontic restorations relies heavily upon careful consideration of esthetic and foundational requirements. A technique has been described which incorporates the benefits of both fixed and removable dentures to restore multiple missing teeth in the presence of a mutilated alveolar ridge. The first patient was treated approximately twenty years ago. The anterior teeth and alveolar ridge were lost due to an automobile accident. The entire labial alveolar ridge was lost to the base of the nasal spine, thereby making a simple six-unit anterior fixed partial denture a complex and difficult problem. The second patient was recently treated. This patient's alveolar ridge and buccal plate were destroyed by a horse's hoof, again making a restoration procedure a difficult one.

Alveolar Process↗

[Rationale for fabrication of combination dentures].

The complexity of this type of restoration comes from the numerous clinical and laboratory steps required. Achievement of these prosthodontic restoration is based on a careful clinical examination, models mounted on an articulator, in centered relation and adequate vertical dimension. The models allow the surveyor examination, the teeth set up and/or wax up. Duplication of the teeth set up in acrylic will reduce the number of patient's appointments, and thus, the potential errors will be minimized. This acrylic teeth set up (A.T.S.) will allow: to keep the decided occlusal relationships; to visualize the teeth grinding to be made; to guide the tooth preparation; to take the abutment impression, in occlusion. Therefore: the final model; the vertical dimension; occlusal relationship; the aesthetic; and, the removable partial denture design will be available for the dental technician. Furthermore, in close to full denture cases (class I and large class IV), the A.T.S. can be used to take the impression, to achieve the framework, and to transfer the occlusal registration.

Dental Impression Technique↗

[Immediate denture and bar retention denture: two solutions of choice to re-establish function and improve esthetics].

Possibilities given by our technics concerning immediate denture and contra-mucosal retention bar mandibular complete denture, allow, at present time, in five clinical steps, an esthetical improvement and a functional rehabilitation, realizing dental prosthesis with all the standard characteristics of classical removal dentures. Any transitional treatment may be suppressed, temporary prosthesis giving often rise to para-functions and resorptions. Finally, these technics give to the patient perfect conditions for a functional integration of prosthesis, as well on psychological as on physiological point of view.

Dental Impression Technique↗