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An attached and keratinized mucosa is often preferable or necessary around the abutments of dental implants. This can be created by means of a free mucosal graft from the hard palate. A simple method to achieve this situation is described.
OBJECTIVES: To investigate the effect of deviation of mandibular positioning, by changing the gantry angle, on the measured height and width of dental implant sites in reformatted cross-sectional computed tomography (CT) scans. METHODS: CT images of ten human dry mandibles were made in three gantry positions to simulate changes in patient positioning: (1) parallel to the lower base of the mandible (standard); (2) with a gantry inclination of +19 degrees ; and (3) with an inclination of -19 degrees . One examiner measured the bone height and width at selected sites in the images at three different times. Results were compared with a paired test in SAS 8.02. RESULTS: In relation to bone height, when the jaws were inclined to the inferior direction (gantry angle +19 degrees ), there was no statistically significant difference for any region studied. There was a statistically significant difference for the incisor region when the jaws were inclined to the superior direction (gantry angle -19 degrees ). With respect to the width of the bone rim, there was a statistically significant difference only for the region of the molars when the jaw was inclined to the inferior direction and for the region of the canine, when the inclination was to the superior direction. CONCLUSIONS: Errors in mandibular positioning of 19 degrees produced image discrepancies with regard to bone height and width which were not excessive. Thus, examinations do not have to be repeated owing to variation of mandibular positioning because the differences were lower than 10% of the value found for the standard position.
Diabetes mellitus is no longer considered to be a contraindication for implant-supported prostheses, provided that the patient's blood sugar is under control, and that there is motivation for oral hygiene procedures. This paper presents the experiences of treating diabetic patients using implants with good success rates.
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A method is described for estimating bone volume and contour for dental implant placement in the edentulous arch.
INTRODUCTION: The aim of this study was to show the prevalence of single-tooth gaps in a population-based study. MATERIAL AND METHODS: The data of 3989 subjects (20-74 years of age) were taken from the Study of Health in Pomerania (SHIP-0) and classified by age, gender, and level of education. A single-tooth gap was defined as a gap of one tooth missing bordered by one or more natural teeth on either side. RESULTS: The tooth missing most in all age groups was the first molar. There were more single-tooth gaps in the maxilla than in the mandible. The lowest single-tooth gaps were found in the mandibular anterior region (<1.1%). There were no significant differences in gender (p > 0.05). The highest frequency of single-tooth gaps among all groups was found in subjects with a medium level of education and the lowest frequency was found in subjects with a high level of education. One single-tooth gap was found in 25%, whereas 16% of all subjects had 2 single-tooth gaps. The prevalence of having 1 single-tooth gap was between 3.8% and 13.1% whereas it was less than 0.5% for subjects with 5 and more single-tooth gaps. CONCLUSION: There was a high potential for dental implants to fill single tooth gaps.
The aim of the present study was to explore the possibility of achieving osseointegration of dental titanium implants, inserted into alveoli immediately after tooth extraction, by covering the recipient site with a teflon membrane. In each of 7 monkeys, mucoperiosteal flaps were raised on the buccal and palatal aspects of the maxillary molars in both sides of the jaw. The second molars were then extracted and self tapping titanium implants of the screw type (Astra Dental Implants) were inserted into the sockets of the largest roots. In the coronal portion of the sockets, a void was always present between the implant and the socket walls. In one side of the jaw, a membrane (Gore-Tex Augmentation Material) was adjusted to cover the implant. The implant in the other side of the jaw served as control and was only covered by the tissue flaps. Microscopic analysis after 3 months of healing revealed that soft tissue was facing the coronal portion of the implants to a varying degree in the control side, while osseointegration was consistently observed to the top of the membrane-covered implants which remained submerged throughout the experimental period. The results suggest that the membrane technique can secure complete osseointegration of implants inserted immediately into extraction sockets.
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The narrowing of an extraction site often becomes problematic when attempting to restore the space with a conventional wide-diameter implant. A woman is presented who was treated with a square head, mini-dental implant-supported fixed denture for a maxillary with a narrowed edentulous area, with a mesiodistal width of 5 mm. The implant, with a diameter of 2.4 mm, was inserted without reflecting the mucoperiosteal flap and was loaded immediately. During 12 months of follow-up, there has been no bone resorption and no inflammation observed around the implant. In conclusion, in terms of both clinical and aesthetic criteria, small diameter, mini-dental implants can be successfully used as an alternative to treatment with fixed partial dentures.
BACKGROUND: Implant failures are rare but do occur. Mechanical factors are certainly important in implant failures; so are biologic, iatrogenic, and functional factors. Mobility is the cardinal sign of implant failure. Three major etiologic factors have been suggested for implant failures: infection, impaired healing, and overload. The aim of the present study was to histologically and histochemically evaluate the fibrous connective tissue found around failed dental implants removed due to mobility. METHODS: In a 5-year period, 51 root-form implants were retrieved because of mobility and underwent histological examination. Thin ground sections were obtained from each implant. RESULTS: Almost all implants had been inserted in posterior (premolar-molar) regions of both jaws. In all specimens, there was the presence of a 600 to 1,100 microm thick connective tissue between implants and surrounding bone. In every case, the surrounding bone was compact and highly mineralized, with well-structured Haversian canals and few areas of remodeling. No bacteria were found in the most coronal portion of the implants. A scarce inflammatory cell infiltrate was present in the connective tissue of some specimens. In about 10% of specimens, the epithelium tended to surround the perimeter of the implant. CONCLUSION: Our histological results are consistent with the hypothesis that late failures of osseointegrated implants can be caused by a combination of poor bone quality, mechanical trauma to bone, and overloading forces.
Distraction osteogenesis of the edentulous alveolar ridges may be considered an alternative to many other augmentation oriented surgical techniques. It is now being widely used for treating severe forms of alveolar ridge atrophy, especially before the placement of dental implants. Leibinger Endosseous Alveolar Distraction System (LEAD; Stryker Leibinger, Kalamazoo, MI) is an intraosseous distraction device used for edentulous ridges. In this study, the healing was uneventful in all 5 cases that were treated except 1, in which the vitality of the distraction segment could not be maintained. No complications related to the prosthodontic restoration were observed.
Not infrequently a patient will attend seeking treatment for replacement of a lost abutment and crown from an implant placed by another dentist and no dental records are available. Many different root form implants of various designs, dimensions, surfaces, and connectors are available today posing a problem for the restorative dentist who must choose prosthetic parts that fit the implant or for a forensic dentist attempting to identify a victim. Implants installed in bone may be identified only by radiographs and knowledge of implant morphology. Four articles (1-4) were published between 1992-2002 dealing with the radiographic identification of implants. Since then many new implants have appeared on the market. Implants made in Israel do not appear at all on any of the lists. The object of this article is to provide radiographic pictures of implants available in Israel today together with a description of their radiographic features to enable Israeli dentists to identify implants where no dental records are available.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.