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Clinical application of short hydroxylapatite-coated dental implants to the posterior mandible: a five-year survival study.

STATEMENT OF PROBLEM: The surgical and restorative procedures at the posterior region of the maxilla and the mandible present a complex task in the treatment of partially edentulous patients. PURPOSE: The purpose of this study was to investigate the applicability of short hydroxylapatite-coated dental implants to the posterior mandible of partially edentulous patients. MATERIAL AND METHODS: Eight and 11 mm implants were evaluated as to their cumulative survival rate, clinical status (plaque index, gingival index, probing depth), and marginal bone loss over a 5-year period. RESULTS AND CONCLUSIONS: The verified overall cumulative survival rate was 94% for implants and 91% for prostheses. These results suggest predictable success for the application of short implants to the posterior mandible.

Alloys↗

A proposal for the classification of bony defects adjacent to dental implants.

A new classification of bone defects adjacent to dental implants is proposed. The classification highlights the importance of defect anatomy in the progression of the regenerative process. Defects were divided into two main groups: (1) closed defects, characterized by the maintenance of intact surrounding bone walls; and (2) open defects, which lack one or more bone walls. The open defect group was then divided into several subgroups that include the majority of situations encountered in clinical practice. The classification could be a useful tool for planning the correct regenerative procedure for each type of defect.

Alveolar Bone Loss↗

Use of a tapered, porous-surfaced dental implant in combination with osteotomes to restore edentulism in the difficult maxilla.

The maxilla is the more difficult arch to restore with endosseous dental implants because of hurdles such as low bone density, narrow buccopalatal width, minimal bone height, and proximity to the maxillary sinus. In this article, a technique to resolve all of these problems using a short, tapered, porous-surfaced implant and a placement protocol using hand osteotomes rather than surgical burs is presented.

Dental Implantation, Endosseous↗

[Guided tissue regeneration around dental implants in immediate extraction sockets: comparison of resorbable and nonresorbable membranes].

OBJECTIVE: This study was performed to compare the efficacy of guided tissue regeneration (GTR) around dental implants immediately placed into extraction sockets by resorbable or nonresorbable membranes. METHODS: Mandibular P2, P3, and P4 of four adult beagle dogs were extracted bilaterally, and buccal standard defects were created and measured. Eighteen commercially pure titanium Steri-Oss implant fixtures were placed into the fresh extraction sockets. Four untreated implants were as controls, four implants received polytetrafluoroethylene (e-PTFE, Gore-Tex) membranes, five implants received collagen membranes, and five implants received polyglactin 910 mesh. After 14 weeks, clinical measurements were taken and the dogs were sacrificed and all specimens retrieved for histologic and histomophometric evaluation. RESULTS: The average gain in bone height was 2.1 mm for untreated control sites, 3.3 mm for Gore-Tex sites, 3.8 mm for collagen sites, and 1.3 mm for polyglactin 910 sites. CONCLUSION: The results of this study indicated that Gore-Tex and collagen membrane produced good results for GTR around implants. Collagen membrane can be a valid alternative to Gore-Tex membrane to improve bone regeneration around dental implants, while polyglactin 910 mesh seemed not suitable to be used as GTR membrane in immediate implantation for its high infection rate.

Animals↗

[A biomechanical study of the mechanical stress transmission of dental implants using finite element analysis. Review of literature. Part I].

Finite Element Analysis (FEA) is a computerised investigative method that is capable of determining the mechanical stress arising in various objects and their environment as a result of forces effecting the system by using a mathematical model. The method is most often used for purposes of technical, engineering design, but is very useful for medical purposes-the static and functional investigation of the skeletal and motor system of the human body-as well. The transmission of mechanical stress between the implant and bone depends on a number of factors, and its description is quite complicated. A model has to be created to perform a FEA, the geometric data of the implant, the mechanical properties of the bone and the parameters of the bone-implant interface have to be determined, a so-called finite element network has to be created. Valuable data can be obtained by changing the individual elements of the system. The study of dental implants makes it possible to better investigate biomechanical conditions and thus the further perfection of implant methods. In the first part of the present two-part publication authors review the possibilities of use of the finite element analysis in examining the stress transmission of dental implants. In the second part of the publication their own studies will be presented.

Biomechanical Phenomena↗

A prospective human clinical trial of Endopore dental implants in restoring the partially edentulous maxilla using fixed prostheses.

This is the first report of a group of 50 partially edentulous patients who received a total of 151 Endopore dental implants in the maxilla. A mean implant length of 8.7 mm was used, and 76.8% of implants were placed in the posterior maxilla. At re-entry, all implants appeared to be osseointegrated and were used to support fixed prostheses. Approximately half of the crowns (57%) in these prostheses were splinted to one another, while the remainder (43%) were not. At the time of this report, the mean functional time was 34.6 months and the cumulative survival rate was 97.3% (4 implants had failed). Analysis of carefully standardized sequential radiographs indicated no significant changes in mean crestal bone levels between baseline and any of the examination times (after 6 months, 1 year, and 2 years in function). There were no detectable correlations between crestal bone loss and the factors implant length (7, 9, or 12 mm); implant diameter (3.5, 4.1, or 5.0 mm); implant position anteriorly or posteriorly in the maxilla; or whether or not the implant-supported crowns were splinted.

Adult↗

Validation of spiral computed tomography for dental implants.

OBJECTIVES: To investigate the accuracy of 2DCT orthoradial reformatted images from spiral computed tomography (CT) for pre-surgical planning of dental implants in proximity to the mental foramen. METHODS: Eight cadaver heads were imaged by spiral CT (S/Xpress, Toshiba-America, Tustin, CA) with 1 mm thick axial slices by 1 mm/sec of table feed. The image data set was transferred to a networked computer workstation. Using computer graphics the data was analysed with 2D orthoradial reformatting using the ToothPix (Cemax, Fremont, CA, USA) protocol. Linear measurements were made by two oral radiologists independently from the superior border of the mental foramen to the crest of the alveolar process and from the inferior border of the mental foramen to the mandibular inferior border. The soft tissues were removed and physical measurements made using a 3 Space (Polhemus, Colchester, VT) electromagnetic digitizer with a personal computer running Windows 95. RESULTS: The differences between the measurements on orthoradial 2DCT images and the physical measurements were not statistically significant (P > 0.05). CONCLUSIONS: Two-dimensional spiral CT imaging allows highly accurate measurements for dental implant placement in proximity to the mental foramen. Computer graphics software, using reformatted reconstruction, is suitable for implant planning.

Aged↗

Dental implants.

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Adult↗

Pre-prosthetic surgery options for fixed dental implant reconstruction of the atrophic maxilla.

Four different treatment scenarios exist when considering fixed dental implant restoration of the atrophic maxilla. This paper discusses the use of pre-prosthetic surgery for the increasingly large section of the edentulous population who demand a natural intra- and extra-oral post-operative appearance. Based on residual ridge position, resorption pattern and lip support the treatment modalities must be appropriate for each diagnosis. Sinus augmentation, onlay bone grafting and orthognathic surgical techniques can be employed singly or in combination to adequately address hard and soft tissue deficiencies.

Alveolar Ridge Augmentation↗