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At least 1,045 records · Page 58Linked to original sources
PubMed1976

Inferior-border rib grafting for augmentation of the atrophic edentulous mandible.

Use of inferior-border grafting eliminates many of the problems associated with transoral onlay graft procedures. With an inferior-border graft, the graft does not bear the direct pressure of a prosthesis and allows for increase in mandibular height without as much loss of vestibule as in a transoral graft. A skin-graft vestibuloplasty is performed 6 to 12 months after rib grafting but the patient can wear a denture in the interim.

Adult↗
PubMed1994

[Current surgical approach to masticatory system pain-dysfunction syndrome (except arthroscopy)].

The surgical treatment of SADAM concerns patients with irreversible lesions who continue to complain (disk displacement with pain and limited opening, painful arthrosis) after all the other therapeutic options have been unsuccessful and when no long-lasting improvement can be reasonable expected. Indications for surgery have declined with progress in aetiological treatment, particularly of occlusion, and arthroscopic treatment, but arthrotomy is the only remaining technique feasible in certain cases. SADAM should be a conservative surgery, protecting the disk (repositioning displaced disks, repairing perforated disks) and the articular surfaces (correcting bone irregularities). Anatomic and functional reconstruction of the joint cannot be successful unless the cause of the dysfunction is treated at the same time.

Arthroscopy↗
PubMed1999

Clinical complications of osseointegrated implants.

STATEMENT OF PROBLEM: There is no comprehensive review of the literature that identifies the complications reported in clinical dental implant studies. PURPOSE: This article attempted to determine the types of complications that have been reported and to provide data regarding their frequency. METHODS: All available clinical studies from 1981 to 1997, published in English or with English abstract, that presented success/failure data regarding implant treatment were evaluated to determine the types of reported complications and to quantify implant loss as it relates to type of prosthesis, arch, time, implant length, and bone quality. RESULTS: Greater implant loss occurred with overdentures than with other types of prostheses. There was greater loss in the maxilla than mandible with fixed complete dentures and overdentures, whereas little arch difference was noted with fixed partial dentures. Implant loss increased with short implants and poor bone quality. The time of implant loss (preprosthetic vs postprosthetic) varied with type of prosthesis. Surgical complications included neurosensory disturbance, hematoma, mandibular fracture, hemorrhage, and tooth devitalization. Initial and long-term marginal bone changes were identified. Peri-implant soft tissue complications included dehiscence, fistulas, and gingival inflammation/proliferation. Mechanical complications were screw loosening/fracture, implant fractures, framework, resin base and veneering material fractures, opposing prosthesis fractures, and overdenture mechanical retention problems. Some studies also presented phonetic and esthetic complications. CONCLUSIONS: Although the literature presents considerable information on implant complications, variations in study design and reporting procedures limited the available data and therefore precluded proper analysis of certain complications.

Dental Arch↗
PubMed2005

A clinical trial of patient satisfaction and prosthodontic needs with ball and bar attachments for implant-retained complete overdentures: three-year results.

STATEMENT OF PROBLEM: Few prospective trials of implant-retained mandibular dentures have evaluated the increase and duration of patient satisfaction, costs of denture maintenance in relation to different methods of attaching overdentures to implants, or the use of a reinforced framework. PURPOSE: This report evaluates subjects' satisfaction and prosthodontic maintenance during a 3-year randomized clinical trial of implant-retained mandibular complete dentures, whether reinforced or not with a cast framework, and attached by bar-clip or 2.25-mm ball-spring matrices to endosteal dental implants. MATERIALS AND METHODS: One hundred edentulous subjects, each having at least 1 year's experience with conventional complete dentures, were selected from respondents to a university dental clinic's request for volunteers. Candidates were examined to verify adequate mandibular bone and medical suitability for implants. Subjects then received 2 implants in the anterior mandible before being stratified by mandibular bone height and gender and assigned randomly to 1 of 4 treatment groups. Every subject received a new maxillary complete denture in addition to an implant-supported mandibular complete denture, with or without a reinforcing framework, connected to implants by either a bar-clip or a ball-spring patrix and matrix. The dentures were adjusted and repaired as needed. Subjects indicated on a visual analogue scale (VAS) satisfaction with conventional dentures prior to the study and then with new dentures at 1 month, 1 year, and 2 years. The results reported here are from the first 68 subjects observed for 3 years after receiving new dentures (19 subjects received new dentures less than 3 years before this analysis, and another 13 subjects were lost to follow-up). VAS scores are presented in simple tables and graphs, and results for different groups were compared using 2-sided nonparametric rank tests and repeated measures ANOVA. With respect to costs and maintenance, t tests were used to compare group means. Sample size and other design considerations used a .05 significance level. RESULTS: After receiving new dentures with mandibular implant supports, improved satisfaction "within subject" was prompt, durable, substantial, and statistically significant, regardless of the attachment mechanism, and with or without a reinforcing framework. In contrast, there were no notable satisfaction differences between the 2 attachment mechanisms, or with the presence or absence of a reinforcing framework, either at specific intervals after receiving the new dentures, or in repeated measures ANOVA. For both attachment groups, most denture adjustments occurred during the first year. This accounted for 81% of total adjustments during 3 years, when the 34 subjects in the ball-spring group and the 34 in the bar-clip group were combined. The mean numbers of adjustments per subject and associated clinical times did not differ significantly between the 2 groups. Conversely, denture repairs declined more slowly than adjustments. Almost all repairs (90%) occurred in the ball-spring group to correct problems with the attachments, 39% in the first year, and tapering off only slightly in the following 2 years. Over 3 years of follow-up, mean numbers of repairs per subject differed significantly between groups: 6.7 repairs per person in the ball-spring group, compared to 0.8 in the bar-clip group ( P<.001), and mean time per appointment was greater for repairs in the ball-spring group: 18.9 minutes compared to 16.9 ( P<.01). The cast framework had no influence on the satisfaction expressed or on adjustments and repairs. CONCLUSION: Subjects were very satisfied with the new dentures, although the ball-spring attachment tested in this trial required substantially more repairs.

Analysis of Variance↗
PubMed2000

A short-term study in sheep with the Groningen temporomandibular joint prosthesis.

As part of the pre-clinical testing process of a newly developed temporomandibular joint (TMJ) prosthesis, animal experiments were performed. In 14 sheep, the right TMJ was replaced by the developed TMJ prosthesis. The prosthesis consisted of a skull part, a mandibular part and an intervening polyethylene disc. In the first series (6 sheep), three designs were tested, differing in the applied metal (stainless steel or titanium) and in the fitting method of the skull part (a fitting member or bone cement). The sheep were sacrificed after 8-16 weeks. In the second series (8 sheep), the preferred titanium fitting member design was applied, and the sheep were sacrificed after 2-10 weeks. One sheep was excluded because no correct position of the prosthesis parts could be achieved. At sacrifice, the removal torque of the screws was measured, and the surrounding tissues were harvested for histologic examination. The sheep recovered well and functioned until the end of the scheduled sacrifice date. Encountered problems were two disc dislocations, one fistula formation, and one screw failure. All mandibular parts were clinically stable, as were most skull parts with a fitting member, and one of both skull parts fitted with bone cement. The clinically observed stability was confirmed by the removal torque values, which indicated well-integrated screws. It is concluded that the TMJ prosthesis could remain stable and functional over the initial healing period. The main restriction of the sheep model is the much larger translatory capacity compared with patients, which adversely influences tissue healing.

Animals↗
PubMed1997

[A three-dimensional finite element stress analysis of implant-supported prosthesis and its supporting tissue in the edentulous mandible. Part 6. The influence of superstructure in mandibular complete implant overdenture and its supporting tissue].

The effect of superstructure, including telescope, conventional-bar and modified-bar, on the stress distribution of mandibular complete implant overdenture and its supporting tissue was investigated in this study. The results demonstrated that bar could lower the extreme principle stress of the implant, but the stress distribution of implant-bone interface was better when the implants were not linked with each other. Modified-bar is not preferred because it increases the stress of implant and its interface.

Alveolar Process↗
PubMed1999

One-step resection and reconstruction of the mandible using computer-aided techniques--experimental and clinical results.

In patients with advanced oral cancer, a resection of the mandible continuity is often indicated. This new method presented here uses computer-aided design and manufacturing (CAD/CAM) for preoperative fabrication of individual mandibular prostheses and their corresponding resection templates in a direct fashion without the need for additional physical models. In this experimental application, a segment of a dried mandible was resected and replaced by a titanium prosthesis prefabricated by CAD/CAM. It was the aim of this investigation to verify the processing chain and its precision, i.e., the fit of an individual implant, such as this. Although this new technique offers fascinating opportunities, possible clinical drawbacks have to be taken into account.

Bone Screws↗
PubMed2005

Short dental implants: a literature review and rationale for use.

Implant prostheses are often used to restore partially or completely edentulous patients. The posterior regions of the mouth often have less available bone height than the anterior regions. The bone density of the remaining bone after tooth loss is often less in the posterior regions than the anterior region of the mouth. A review of the literature reveals implants shorter than 10 mm often have a higher failure rate than longer implants. These complications may be related to an increase in crown height, higher bite forces in the posterior regions, and less bone density. As a result, biomechanical methods to decrease stresses to the implant-bone interface are warranted. The forces to the implants may be reduced by eliminating lateral contacts in mandibular excursions and eliminating cantilevers on the prosthesis. The area of forces applied to the prosthesis may be increased by increasing the implant number, increasing the implant diameter, increasing the implant design surface area, and splinting the implants together. As a result of these biomechanical methods to decrease stress, Misch, et al reported a 99% implant survival with 7-mm and 9-mm implants in the posterior regions of the jaws. It is interesting to note that the natural teeth follow a similar biomechanical approach to accommodate the higher bite forces in the posterior regions of the mouth. The molar teeth do not become longer than the anterior teeth. The diameter is increased, the design of the roots is different, and the roots are splinted together. The anterior teeth have incisal guidance and eliminate posterior lateral forces to the posterior teeth in all mandibular excursions. A similar biomechanical approach is logical for posterior implants, especially when shorter implants are used to support the prosthesis.

Alveolar Bone Loss↗
PubMed1989

[Reconstruction of extensive mandibular defects with the use of Osteo-Mesh and a bone graft. A preliminary report].

In the reconstruction of extensive bone defects of the facial skeleton, bone grafts are taken for granted even though the handling and stress such grafts are subjected to do not always guarantee the functional and aesthetic result. The use of a special kind of prosthesis (osteo-mesh) consisting of the synthesis of two biocompatible substances (polyurethane and dacron) with bone graft, preferably iliac spongiosa, is suggested by the preliminary experience of the Authors, as a good solution for the achievement of a satisfactory result.

Bone Transplantation↗
PubMed1998

Computerized tomography with CT models for contemporary ramus frame implant planning and construction.

Loss of bone in the mandible after tooth removal is associated with anatomic and aesthetic complications and instability of the mandibular complete denture. This continuing bone loss is not limited to alveolar bone; portions of the basal bone may also be resorbed. Thus, mandibular complete denture is the most unstable, unretentive, conventional prosthesis fabricated in routine dental practice. Root-form endosteal implants cannot always be placed in advanced atrophic mandibles without autogenous bone grafting (from either the iliac hip crest or another site) or bone regeneration. The ramus frame implant (RFI) is indicated when the atrophy in the mandible is advanced. An RFI is an immediate, totally implant-supported prosthesis, which can use homologous grafting material and platelet-rich plasma for increased bone regeneration. The third-generation RFI provides all of the benefits of the first- and second-generation RFIs as well as improvements provided by computed tomography and computer-aided design/stereolithography applications: planning, simplified placement, improved grafting, predictable manufactured components, and retrievability.

Alveolar Bone Loss↗
PubMed1987

[Relation of the major connector of a removable partial denture (RPD) with mandibular mucosal tissue; clinical case].

When the performance of removable partial prosthesis is analyzed, it can be seen that failures outnumber the successes. These failures, however, should not be imputed to the prostheses themselves, but rather to the fact that proper biomechanical principles were not observed in the planning of these devices. Each component of a prosthesis should be carefully planned in order to obtain maximum stability with respect to the supporting tissues. One of these principles is concevued to the relieve that must be established between major connectors and mandibular mucosae. It is important to remember that mandibular mucosae is fine, moveable, very sensitive and weak, so that this mucosae be considered very susceptible to mechanical aggression. In this work the authors emphasize the necessity of relieve in the mandibular major connector in order not to pressure the investing tissues. Otherwise serious periodontal damage can occur.

Denture Design↗