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PubMed1985

Long-term effects on chewing with mandibular fixed prostheses on osseointegrated implants.

Twenty-seven edentulous patients with denture adaptation problems were first given optimal conventional complete dentures and then a fixed prosthesis on osseointegrated dental implants in the lower jaw (and a complete maxillary denture). Masticatory function was evaluated by means of a questionnaire, a comminution test for chewing efficiency, and bite force measurements on four occasions: with the original (I) and optimal complete dentures (II) and 2 months (III) and 3 years (IV) after insertion of the fixed mandibular prosthesis on implants. No significant improvement of masticatory function was found after conventional denture treatment. After insertion of the fixed mandibular implant bridge, a marked improvement of the patients' assessment of their chewing ability and of the results of the chewing efficiency test and the bite force measurements was recorded. The test results were further improved after the 3-year observation period, which indicates that adaptation to the new prosthetic situation is a gradual process.

Bite Force↗
PubMed2002

A multicenter prospective evaluation of 2-months loaded Osseotite implants placed in the posterior jaws: 3-year follow-up results.

In this prospective study, the clinical outcome of 2-months loaded implants placed in the posterior jaws was evaluated after up to 3 years of functional loading. 405 Osseotite implants with microtextured acid-etched surface were consecutively placed in 11 fully and 164 partially edentulous patients (mean age 53.5 +/- 15.3 (S.D.) years) using a one-stage technique. 282 implants, supporting 154 restorations, were placed in the mandible, while 123 implants, supporting 75 restorations, were placed in the maxilla. A total of 99 single-tooth restorations, 119 short-span fixed bridges and 11 full-arch prostheses were applied. The mean time interval from surgery to connection of provisional restoration was 2.0 +/- 0.7 months. 9 failures were reported up to 3 years of follow-up; of these, 4 mandibular and 2 maxillary implants failed during the initial healing period (before prosthesis connection), while 3 mandibular implants failed after loading. No other complications occurred throughout the study. Life table analysis showed a cumulative survival rate of 97.5% for the mandible and 98.4% for the maxilla. Post-loading implant survival rate was 98.9% for the mandible and 100% for the maxilla. The excellent outcome of this interim report suggests that microtextured Osseotite implants in the posterior jaws may safely bear a functional load applied 2 months after insertion. The results of the present study are particularly encouraging for implants placed in the maxilla, since both a significant reduction of the healing period compared to the 6 months suggested by the classical Brånemark protocol, and an excellent post-loading function may be achieved also in low quality bone.

Acid Etching, Dental↗
PubMed2000

Fabrication of a two-piece superstructure for a fixed detachable implant-supported mandibular complete denture.

This article describes a procedure to fabricate a 2-piece superstructure for a fixed detachable implant-supported mandibular complete denture prosthesis. With this unique technique, unsuitable implant angulation can be corrected, and retention of the second superstructure is accomplished with 2 esthetically positioned screws and an antirotational attachment.

Dental Prosthesis, Implant-Supported↗
PubMed1992

Osseointegrated Brånemark implants used to retreat a fractured mandibular bone plate staple implant: a case report.

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.

Aged↗
PubMed2003

Extractions, implant placement, and immediate loading of mandibular implants: a case report of a functional fixed prosthesis in 5 hours.

The purpose of this report is to present a reliable surgical and prosthodontic protocol for immediate loading of implants, allowing patients to receive a fixed implant-supported prosthesis in a matter of hours. The surgical, prosthodontic, and laboratory steps for this protocol of immediate functionally loading the implants are described for the treatment of a 51-year-old woman who presented with a hopeless mandibular dentition and an edentulous maxillary arch. It is possible to decrease the treatment time in successfully restoring the patient's oral function by means of immediate functional loading of dental implants and immediately placing a fixed implant-supported prosthesis. Compared with the traditional implant protocols, this protocol of a one-visit approach for patient treatment 1) decreases the number of office visits; 2) decreases the treatment time; 3) reduces the patients' costs; 4) allows the patient to avoid wearing a removable interim prosthesis; and 5) increases the patients' acceptance of treatment while maintaining predictability in treating mandibular edentulism.

Dental Implantation, Endosseous↗
PubMedDate not supplied

Treatment of a patient with cleidocranial dysplasia using osseointegrated implants: a patient report.

This patient report describes the treatment of a 42-year-old woman with cleidocranial dysplasia. Endosseous implants were used to restore the mandibular and maxillary arches with fixed prostheses. Six implants were placed in the mandible and immediately loaded with an acrylic resin fixed prosthesis. In the maxillary arch, 10 implants were submerged for 4 months prior to functional loading. A transitional denture was relined and placed in the maxilla 10 days after implant placement. Three months later, a definitive mandibular prosthesis was fabricated. The definitive maxillary restoration was delivered 6 months after surgery. The most recent follow-up, 6 months after delivery, confirmed a satisfactory treatment result to date.

Adult↗
PubMed1990

[A complete intermediate temporomandibular joint prosthesis. Evaluation after 6 years].

Since 1983 we have inserted more than 100 temporomandibular joint prostheses. A review after 6 years allows the respective indications to be listed and the complications to be studied in 72 insertions involving 62 cases suitable for analysis. The prosthesis is a total intermediary prosthesis forming an unsealed cupula composed of 2 halves--a mandibular portion and a temporal portion. Insertion of the prosthesis requires preliminary facial nerve dissection then osteotomy of the mandibular condyle and its subsequent drilling to allow the screwing in of the prosthesis. The prosthesis was used in traumatology, in condylar and high sub-condylar fractures, in the event of failure of functional treatment, in malformation syndromes, in tumors and, finally, in degenerative pathology. 13 prostheses were removed. A study of the probable causes of complications shows a predominance of technical problems related to inaccurate positioning of the prosthesis, in that it was not placed in the axis of the condyle, or that inadequate bicortical support was present. In our opinion, these complications do not question the conception of the prosthesis but rather indicate that it is necessary to perfect the insertion technique while taking advantage of improvements in the prosthesis which are currently under study.

Ankylosis↗
PubMed1989

The use of the maxillary interocclusal splint as a mouthpiece for the mouthstick prosthesis.

In the past, the maxillary and mandibular teeth have been firmly indexed on the mouthpiece prosthesis, which can produce significant occlusal discrepancies. The construction of a mouthpiece consisting of a maxillary interocclusal splint is described. The two advantages for this type of mouthpiece are (1) it can be adjusted clinically to accommodate errors in the mounting of the casts and the laboratory processing of the prosthesis, and (2) the use of the maxillary interocclusal splint will reduce the likelihood of the development of masticatory muscle spasms.

Dental Occlusion↗
PubMed2001

Upper dental prosthesis instability consecutive to the resection of a cerebral tumor.

A 57-year-old female patient was evaluated for an unstable maxillary dental prosthesis. The patient stated that approximately 2 weeks prior to this consultation the prosthesis was relined four times. Despite this, it often had a tendency to shift during meals. On the other hand, she is very satisfied with a complete fixed prosthesis on implants in the mandibular arch. She has been wearing this latter lower prosthesis for the same length of time as the upper prosthesis. She indicated that a similar problem existed with the former upper prosthesis, resulting in her consulting a prosthodontist.

Brain Neoplasms↗
PubMed1994

Management of the maxilla after alveolar ridge augmentation with hydroxylapatite when opposed by mandibular implants.

Maxillary ridge augmentation and vestibuloplasty are often adjuncts to mandibular implant reconstructions. Careful management of the augmented ridge after surgery is critical to the success of the maxillary prosthesis and osseointegration of the mandibular implant. A technique is described for alteration of an existing maxillary complete denture after ridge augmentation. Precautions regarding prosthesis function during the osseointegration phase of different types of mandibular reconstructions are noted. Technique and rationale for denture flange modification when a prosthesis is rebased for a patient who received simultaneous vestibuloplasty and ridge augmentation are described.

Alveolar Bone Loss↗
PubMed1993

Mandible reconstruction with metallic endoprosthesis following Commando's operation for advanced head and neck cancer. Personal experience.

Invasion of the mandible is found in 22% to 29% of advanced (Stage III-IV) head and neck cancers; only an aggressive surgical technique, such as Commando's operation with subsequent reconstruction of tissue defects, can give a chance of cure to these patients. The reconstruction is feasible both by means of microsurgical free-tissue transfers or with alloplastic materials and myocutaneous flaps. Between 1982 and 1991, 34 patients in Stage III (n = 6; 17.7%) and IV (n = 28; 82.3%) head and neck cancers underwent Commando's operation with different types of reconstruction in 30 patients: pectoralis myocutaneous flap (n = 9), osteo-myocutaneous flap with the underlying segment of the fifth rib (n = 2), myocutaneous flap plus prosthesis (n = 17), or prosthesis alone (n = 2). Two different prostheses were implanted: the linear A-O mandibular reconstruction plate (n = 13), and the Dumbach titanium cage (n = 6). In the group of patients in which the linear A-O mandibular reconstruction plate was used there were four cases of prosthesis dislodgement and major exposure and one case of prosthesis breakage while in patients who were given the Dumbach titanium cage there were four cases of major exposure. Prosthesis removal was required in five and two patients with linear A-O and Dumbach titanium cage prosthesis, respectively. Median survival was 14 months with 28% five-year survival. In our experience, metallic prostheses with a shape and arrangement that allow a distribution of traction forces on a wider surface, with screws drilled in nonaligned points of the mandible, seem to be more reliable as they reduce the risk of dislodgement and breakage.

Bone Plates↗
PubMed1988

Primary reconstruction of the mandible in cancer surgery. A report of 13 reconstructions according to the principles of rigid internal fixation.

This study comprises 30 patients with extensive oral cancer invading the mandibular bone. In each case, large segmental composite resections were performed and the mandibles primarily reconstructed, according to the principles of rigid internal fixation. All but one of the reconstructions were successful and the functional and cosmetic results were excellent or good in 12 patients. The results indicate that primary reconstruction can be performed without major complications. Bone transplantation may be omitted or postponed to a later date. The fact that tracheostomy and intermaxillary fixation can be avoided, is a major advantage for these patients.

Adult↗
PubMed1991

[Dynamic bite block in fractures of the mandibular condyle and following surgery of temporomandibular ankylosis in children].

Early mobilization is the rule in cases of fracture and temporomandibular joint surgery. When prematurely discontinued, it may sometimes prove insufficient to prevent temporomandibular ankylosis in the child. Blockade in the open-mouth position is in keeping with an important general orthopedic rule, i.e., immobilization of joint fractures in position of function (ankylosis is loss of function, and is reflected by the child's inability or limited capacity to open his/her mouth). Continued night wear of re-habilitation devices, once consolidation is acquired, affords active joint mobilization during meals that is sufficient owing to the strength of the elevator muscles (five times than of the depressors).

Ankylosis↗
PubMed1997

The reliability of implant-retained hinging overdentures for the fully edentulous mandible. An up to 9-year longitudinal study.

The treatment of fully edentulous mandibles by means of implant-supported hinging overdentures has become a routine therapy, although long-term data on the success rate of implants and prostheses are lacking. This longitudinal study examined 207 consecutively treated patients who received, during the past 10 years, 449 Brånemark implants to retain a mandibular hinging overdenture, mainly on a Dolder bar. Clinical parameters and standardized radiographs taken at every recall visit with an interval of 6-12 months were used to judge the implant rigidity in the jawbone, the marginal bone level, and attachment level changes. The cumulative implant failure rate at 9 years was 3%. After loading, implant loss was concentrated during the first 12 months, with only one failure observed at 22 months. A radiographically determined bone loss of 0.7 mm was observed during the first year. From the second year, a mean annual bone loss of 0.05 mm occurred. The attachment loss, calculated as the sum of probing pocket depth plus the recession, was 0.07 mm/year and paralleled the changes in marginal bone level over time. The rigidity of the implant-bone interface revealed an increase over time, as shown by a decrease in Periotest values. The bar-overdenture complications were related to relining (23%), untightening of the retention clip (10%), and renewal of the prosthesis (7%). When magnets or ball attachments were used, more aftercare was needed. Fracture of the antagonistic full denture occurred in 7% of patients. The present data indicate that the mandibular overdenture therapy on two (Brånemark) implants is a very reliable and cost-effective treatment, even in a long-term perspective for the fixed full mandibular prosthesis and especially in elderly patients.

Adult↗
PubMed1986

Total temporomandibular joint replacement in a patient with rheumatoid arthritis: report of case.

This case is an example of a patient with apparent successful total TMJ replacement. With reconstruction of the joints with artificial implants, the loss of posterior ramus height because of complete erosion of the joints, mandibular retrognathia, and severe open bite were corrected. The improved masticatory function, absence of choking, and disappearance of sleep apnea symptoms allowed the patient to resume a more normal life. The patient will continue to be examined periodically, but the current prognosis is favorable.

Arthritis, Rheumatoid↗
PubMed1997

[Temporomandibular joint prosthesis. A retrospective study from 1947].

Degenerative troubles of the temporo-mandibular joint constitute a major pathology for the maxillo-facial surgeon. While articular replacements have long been developed and used by orthopedic surgeons, none of these seem to give satisfaction in the TMJ. After a short historical and physiological recall, a number of techniques are described, together with a short evaluation of their use. In all 597 cases are reported, whilst an attempt at classification is made in the different types of prostheses used, ie interpositional, endo-osseous, extra-cortical, and prostheses designed for extensive reconstruction.

Alloys↗